SNLE Maternal and Child Health 4 — Questions and Answers
Question 1: What is the most common cause of respiratory distress in premature newborns?
- Respiratory distress syndrome (RDS) from surfactant deficiency (Correct answer)
- Pneumonia
- Meconium aspiration
- Congenital heart disease
Correct answer: Respiratory distress syndrome (RDS) from surfactant deficiency
Surfactant, produced by type II pneumocytes, reduces alveolar surface tension and prevents alveolar collapse. Premature infants (<37 weeks) lack adequate surfactant, causing RDS (hyaline membrane disease). Treatment includes exogenous surfactant and respiratory support.
Question 2: A postpartum patient develops a fever of 38.5°C on day 3 with a tender, red area on her right breast. What condition is this?
- Mastitis (Correct answer)
- Breast engorgement
- Breast abscess
- Normal lactation changes
Correct answer: Mastitis
Mastitis is breast infection (most commonly Staphylococcus aureus) presenting with localized redness, warmth, tenderness, fever, and flu-like symptoms, typically on days 3–4 postpartum. Treatment includes antibiotics and continued breastfeeding or pumping.
Question 3: Which immunization is specifically contraindicated in a child with severe combined immunodeficiency (SCID)?
- Live vaccines such as MMR and varicella (Correct answer)
- Inactivated vaccines such as IPV
- Pneumococcal vaccine
- Hepatitis B vaccine
Correct answer: Live vaccines such as MMR and varicella
Live attenuated vaccines (MMR, varicella, oral rotavirus, BCG) are absolutely contraindicated in children with SCID or severe immunodeficiency because the live virus can cause disseminated infection and death in an immune-compromised host.
Question 4: What is the appropriate first response when a child is found in respiratory arrest?
- Open the airway with head-tilt–chin-lift and give 2 rescue breaths (Correct answer)
- Start chest compressions immediately
- Administer epinephrine
- Call for help before starting any intervention
Correct answer: Open the airway with head-tilt–chin-lift and give 2 rescue breaths
For pediatric respiratory arrest without cardiac arrest, the priority is restoring ventilation. Open the airway, give 2 rescue breaths, and check for a pulse. Chest compressions are added if there is no pulse or HR <60 with signs of poor perfusion.
Question 5: A pregnant patient reports decreased fetal movement. What is the initial nursing intervention?
- Perform a non-stress test (NST) and notify the physician (Correct answer)
- Reassure the patient that it is normal
- Schedule a routine follow-up appointment
- Advise the patient to increase activity
Correct answer: Perform a non-stress test (NST) and notify the physician
Decreased fetal movement can signal fetal compromise. The initial assessment tool is the non-stress test (NST), which evaluates fetal heart rate reactivity as an indicator of fetal well-being. The physician must be notified promptly.
Question 6: What is the primary complication of Rh incompatibility in pregnancy?
- Hemolytic disease of the newborn (erythroblastosis fetalis) (Correct answer)
- Gestational diabetes
- Placenta previa
- Premature labor
Correct answer: Hemolytic disease of the newborn (erythroblastosis fetalis)
When an Rh-negative mother carries an Rh-positive fetus, maternal anti-Rh antibodies cross the placenta in subsequent pregnancies, destroying fetal red blood cells. This causes hemolytic anemia, hydrops fetalis, and neonatal jaundice. Rho(D) immune globulin (RhoGAM) prevents sensitization.
SNLE Maternal and Child Health 4
What is the most common cause of respiratory distress in premature newborns?