Maternal Newborn Nursing Test Newborn Pharmacology and Procedures 1 — Questions and Answers
Question 1: Why is vitamin K (phytonadione) administered to the newborn at birth?
- Newborns have low vitamin K stores and lack intestinal flora to produce it, placing them at risk for hemorrhagic disease (Correct answer)
- To prevent neonatal jaundice
- To boost the newborn's immune system
- To prevent Group B Streptococcus infection
Correct answer: Newborns have low vitamin K stores and lack intestinal flora to produce it, placing them at risk for hemorrhagic disease
Neonates are born with low vitamin K due to poor placental transfer and lack of intestinal bacteria; without the injection, they are at risk for vitamin K deficiency bleeding (VKDB).
Question 2: Which site is preferred for vitamin K injection in a newborn?
- Vastus lateralis (anterolateral thigh) (Correct answer)
- Deltoid muscle
- Gluteus maximus
- Dorsal gluteal site
Correct answer: Vastus lateralis (anterolateral thigh)
The vastus lateralis (anterolateral thigh) is the preferred IM injection site for newborns because it has the largest muscle mass at this age and avoids critical nerves and vessels.
Question 3: Erythromycin ophthalmic ointment is administered to newborns to prevent which infection?
- Ophthalmia neonatorum caused by Neisseria gonorrhoeae and Chlamydia trachomatis (Correct answer)
- Retinopathy of prematurity
- Neonatal herpes simplex eye infection
- Group B Streptococcal conjunctivitis
Correct answer: Ophthalmia neonatorum caused by Neisseria gonorrhoeae and Chlamydia trachomatis
Erythromycin 0.5% ophthalmic ointment is required by law in most US states to prevent ophthalmia neonatorum, a potentially blinding infection transmitted during vaginal delivery.
Question 4: A newborn receives the hepatitis B vaccine at birth. What information should the nurse provide to the parents?
- The vaccine is part of a 3-dose series, with the second dose at 1–2 months and the third at 6 months (Correct answer)
- Only one dose is needed at birth for full protection
- The vaccine is optional and only needed if the mother is hepatitis B positive
- The vaccine provides lifetime immunity with the single birth dose
Correct answer: The vaccine is part of a 3-dose series, with the second dose at 1–2 months and the third at 6 months
The hepatitis B vaccine series requires 3 doses: at birth, 1–2 months, and 6 months; all three doses are needed for complete, long-term protection.
Question 5: A newborn born to an HBsAg-positive mother should receive which interventions within 12 hours of birth?
- Both hepatitis B vaccine and hepatitis B immune globulin (HBIG) administered at different sites (Correct answer)
- Hepatitis B vaccine only
- HBIG only, with vaccine deferred to 2 months
- No intervention is needed until lab confirmation
Correct answer: Both hepatitis B vaccine and hepatitis B immune globulin (HBIG) administered at different sites
Infants of HBsAg-positive mothers require both HBIG (passive immunity) and hepatitis B vaccine (active immunity) within 12 hours of birth at different injection sites for maximum protection.
Question 6: Which newborn screening test uses a heel stick blood sample collected on filter paper?
- Newborn metabolic screening (PKU/state metabolic panel) (Correct answer)
- Bilirubin level
- Blood type and Coombs test
- Complete blood count
Correct answer: Newborn metabolic screening (PKU/state metabolic panel)
The newborn metabolic screen (e.g., for PKU, congenital hypothyroidism, galactosemia) uses dried blood spots on filter paper obtained via heel stick, ideally at 24–48 hours after birth.
