Pediatric Nurse Exam Pediatric Nurse Neonatal and Newborn Care 2 — Questions and Answers
Question 1: Jaundice appearing within the first 24 hours of life is most commonly caused by which condition?
- Hemolytic disease due to ABO or Rh incompatibility (Correct answer)
- Physiological jaundice
- Breast milk jaundice
- Neonatal sepsis
Correct answer: Hemolytic disease due to ABO or Rh incompatibility
Jaundice within 24 hours is always pathological; hemolytic disease from blood group incompatibility is the most common cause.
Question 2: A mother is Rh-negative and delivers an Rh-positive newborn. Which postpartum medication should the nurse prepare?
- Rho(D) immune globulin (RhoGAM) (Correct answer)
- Oxytocin
- Progesterone supplement
- Anti-D vaccine booster
Correct answer: Rho(D) immune globulin (RhoGAM)
RhoGAM prevents Rh sensitization in the mother, protecting future pregnancies from hemolytic disease of the newborn.
Question 3: Which newborn reflex is expected to disappear by 4–6 months of age?
- Moro reflex (Correct answer)
- Babinski reflex
- Blink reflex
- Rooting reflex at feeding times
Correct answer: Moro reflex
The Moro (startle) reflex is present at birth and normally disappears by 4–6 months as the nervous system matures.
Question 4: During phototherapy for neonatal hyperbilirubinemia, which nursing action is most important?
- Apply eye shields to protect the retinas (Correct answer)
- Keep the newborn fully clothed to prevent hypothermia
- Apply moisturizing lotion to exposed skin
- Limit feedings to reduce bilirubin production
Correct answer: Apply eye shields to protect the retinas
Eye shields must be applied during phototherapy to protect the newborn's retinas from the intense light used to break down bilirubin.
Question 5: Which nursing intervention is critical to include when a newborn receives phototherapy?
- Ensure frequent feedings to promote bilirubin excretion (Correct answer)
- Maintain strict NPO status to reduce metabolic demand
- Keep the infant swaddled to prevent heat loss
- Reposition every 4 hours only
Correct answer: Ensure frequent feedings to promote bilirubin excretion
Phototherapy increases insensible water loss, so frequent feedings maintain hydration and enhance bilirubin excretion through stool.
Question 6: Which sign is most indicative of coarctation of the aorta in a newborn?
- Diminished or absent femoral pulses with bounding brachial pulses (Correct answer)
- Central cyanosis of the face and trunk
- Bradycardia and hypotension in all extremities
- Peripheral edema of the lower limbs only
Correct answer: Diminished or absent femoral pulses with bounding brachial pulses
Coarctation of the aorta reduces blood flow to the lower body, producing weak or absent femoral pulses while upper extremity pulses remain strong.
Pediatric Nurse Exam Pediatric Nurse Neonatal and Newborn Care 2
Jaundice appearing within the first 24 hours of life is most commonly caused by which condition?