RNC-NIC Hematology & Hyperbilirubinemia 3

Question 1

Which condition is one of the most common causes of neonatal thrombocytopenia in the NICU?

Accepted Answer

Neonatal alloimmune thrombocytopenia (NAIT) or maternal immune thrombocytopenia (ITP)

Answer

NAIT occurs when maternal antibodies target fetal platelet antigens (commonly HPA-1a), and ITP transfers maternal anti-platelet IgG antibodies to the fetus, both causing significant neonatal thrombocytopenia.

Question 2

What is the primary clinical purpose of measuring the reticulocyte count in a neonate with suspected anemia?

Accepted Answer

To assess bone marrow response and differentiate hemolytic from hypoproliferative anemia

Answer

An elevated reticulocyte count indicates the bone marrow is responding to increased red blood cell destruction (hemolysis), while a low count suggests inadequate production (hypoproliferative anemia).

Question 3

A neonate receiving phototherapy develops a gray-brown discoloration of the skin, urine, and serum. Which condition does this indicate?

Accepted Answer

Bronze baby syndrome associated with elevated conjugated bilirubin

Answer

Bronze baby syndrome occurs when neonates with elevated direct (conjugated) bilirubin receive phototherapy; the resulting photoproducts cannot be excreted and accumulate, causing discoloration.

Question 4

Which blood product is preferred for exchange transfusion in a neonate with Rh hemolytic disease of the newborn?

Accepted Answer

O-negative, irradiated, CMV-negative PRBCs reconstituted with AB-positive plasma

Answer

O-negative irradiated CMV-negative PRBCs are used to avoid further hemolysis from Rh antibodies, prevent CMV infection, and avoid transfusion-associated graft-versus-host disease in the immunocompromised neonate.

Question 5

Which maternal condition most commonly causes neonatal polycythemia through the mechanism of chronic fetal hypoxia?

Accepted Answer

Maternal hypertension with placental insufficiency

Answer

Placental insufficiency from maternal hypertension reduces fetal oxygen delivery, stimulating erythropoietin production and compensatory erythrocytosis, resulting in neonatal polycythemia.

(RNC-NIC) Registered Nurse Certified in Neonatal Intensive Care Practice Test

(RNC-NIC) Registered Nurse Certified in Neonatal Intensive Care Practice Test

RNC-NIC Hematology & Hyperbilirubinemia 3