SNLE Maternal and Child Health 2 — Questions and Answers
Question 1: A newborn has a yellow tinge to the skin and eyes at 18 hours of life. What type of jaundice is this?
- Pathological jaundice requiring immediate evaluation (Correct answer)
- Normal physiological jaundice
- Breast milk jaundice
- Crigler-Najjar syndrome
Correct answer: Pathological jaundice requiring immediate evaluation
Jaundice appearing within the first 24 hours of life is always considered pathological and requires immediate evaluation. Causes include hemolytic disease (Rh or ABO incompatibility) or serious infection. Physiological jaundice appears after 24 hours.
Question 2: What is the primary nursing concern when oxytocin (Pitocin) is being used for labor induction?
- Monitor for uterine hyperstimulation and fetal heart rate changes (Correct answer)
- Monitor for maternal hypoglycemia
- Ensure adequate pain relief only
- Monitor urine output every 8 hours
Correct answer: Monitor for uterine hyperstimulation and fetal heart rate changes
Oxytocin can cause uterine hyperstimulation (more than 5 contractions in 10 minutes or contractions >90 seconds), which reduces uteroplacental blood flow and causes fetal hypoxia. Continuous fetal monitoring is mandatory during induction.
Question 3: What is the normal expected weight loss for a newborn in the first few days of life?
- Up to 10% of birth weight (Correct answer)
- Up to 20% of birth weight
- 5% maximum
- No weight loss is normal
Correct answer: Up to 10% of birth weight
Newborns normally lose up to 10% of their birth weight in the first 3–4 days due to meconium passage, urine output, and limited fluid intake. Birth weight should be regained by 10–14 days. Loss >10% warrants evaluation for feeding problems.
Question 4: Which finding in a postpartum patient requires immediate nursing attention?
- Uterine fundus soft and deviated to the right with excessive bleeding (Correct answer)
- Mild perineal discomfort
- Lochia rubra on day 2
- Breast engorgement
Correct answer: Uterine fundus soft and deviated to the right with excessive bleeding
A soft (boggy), displaced uterine fundus indicates uterine atony — the leading cause of postpartum hemorrhage. The bladder is likely full, displacing the uterus. Interventions: empty the bladder and perform uterine massage, then reassess.
Question 5: A child weighing 20 kg has a fever. Using weight-based dosing, the correct dose of acetaminophen (15 mg/kg) is:
- 300 mg (Correct answer)
- 150 mg
- 400 mg
- 200 mg
Correct answer: 300 mg
Dose = 15 mg/kg × 20 kg = 300 mg. Accurate weight-based dosing in pediatrics is critical to avoid under-dosing (ineffective) or overdosing (hepatotoxic with acetaminophen).
Question 6: Which developmental milestone is expected for a 12-month-old child?
- Taking first independent steps and saying 1–3 words (Correct answer)
- Running and speaking in sentences
- Riding a tricycle
- Reading simple words
Correct answer: Taking first independent steps and saying 1–3 words
By 12 months, most children can pull to stand and take a few independent steps, and say 1–3 meaningful words (mama, dada). Running typically develops around 18–24 months, and sentences at 2 years.
SNLE Maternal and Child Health 2
A newborn has a yellow tinge to the skin and eyes at 18 hours of life.
What type of jaundice is this?