SNLE - Saudi Nursing Licensing Maternal and Newborn Care Questions and Answers — Questions and Answers
Question 1: According to the Saudi Ministry of Health (MOH) National Immunization Schedule, which two vaccines are mandatory for a healthy newborn within the first 24 hours of life?
- Rotavirus and DTaP
- BCG (Bacillus Calmette-Guérin) and Hepatitis B (HBV) (Correct answer)
- MMR and Varicella
- IPV (Inactivated Polio Vaccine) and Hib
Correct answer: BCG (Bacillus Calmette-Guérin) and Hepatitis B (HBV)
The Saudi Ministry of Health's National Immunization Schedule mandates the administration of the first dose of the Hepatitis B vaccine (HBV) and the BCG vaccine at birth, typically within the first 24 hours, to protect against hepatitis B and tuberculosis, respectively.
Question 2: A nurse is caring for a 2-day-old newborn in Riyadh. A heel prick blood sample is collected as part of the mandatory National Newborn Screening Program. Which of the following conditions is included in this screening panel?
- Congenital Hypothyroidism (Correct answer)
- Type 1 Diabetes
- Retinopathy of Prematurity
- Developmental Dysplasia of the Hip
Correct answer: Congenital Hypothyroidism
The Kingdom of Saudi Arabia's National Newborn Screening Program mandates screening for several conditions, including endocrine disorders like Congenital Hypothyroidism and Congenital Adrenal Hyperplasia, as well as various inborn errors of metabolism. Early detection and treatment of Congenital Hypothyroidism are crucial to prevent severe intellectual disability.
Question 3: A 26-year-old pregnant woman at 26 weeks of gestation undergoes screening for Gestational Diabetes Mellitus (GDM) at a primary health clinic in Jeddah. According to common protocols in Saudi Arabia, what is the initial screening test performed?
- A 100-gram, 4-hour Oral Glucose Tolerance Test (OGTT)
- A fasting plasma glucose (FPG) test only
- A 50-gram, 1-hour Glucose Challenge Test (GCT) (Correct answer)
- A random blood sugar and HbA1c test
Correct answer: A 50-gram, 1-hour Glucose Challenge Test (GCT)
Standard practice for GDM screening in Saudi Arabia, typically between 24-28 weeks of gestation, involves an initial 50-gram, 1-hour Glucose Challenge Test (GCT). If the result of this non-fasting test is above the threshold, a diagnostic 75-g or 100-g Oral Glucose Tolerance Test (OGTT) is then performed to confirm the diagnosis of GDM.
Question 4: A nurse is providing discharge education to a new mother. Due to the high prevalence of Vitamin D deficiency in Saudi Arabia, what is the standard recommendation for a healthy, exclusively breastfed infant?
- Expose the infant to direct sunlight for 30 minutes daily.
- Administer 400 IU of Vitamin D daily, starting in the first few days of life. (Correct answer)
- Rely on the Vitamin D content from the mother's breast milk only.
- Start Vitamin D supplementation only after 6 months of age.
Correct answer: Administer 400 IU of Vitamin D daily, starting in the first few days of life.
Due to factors like limited sun exposure and low levels of Vitamin D in breast milk, deficiency is highly prevalent in Saudi Arabia. Health authorities and experts recommend that all infants, especially those who are breastfed, receive a daily supplement of 400 IU of Vitamin D, starting shortly after birth, to prevent rickets and support healthy bone development.
Question 5: A new father in Al-Khobar approaches the nurse and expresses his wish for a respected elder to perform 'Tahneek' for his newborn. What is the nurse's most culturally competent and safe response?
- Inform the father that no outside food or substances are allowed for the newborn.
- Document the request and inform the physician, recommending against the practice.
- Allow the family to perform the ritual using a minuscule amount of a softened date, ensuring aseptic technique and observing the infant for any adverse reaction. (Correct answer)
- Provide the family with a honey-based gel from the hospital pharmacy to use instead.
Correct answer: Allow the family to perform the ritual using a minuscule amount of a softened date, ensuring aseptic technique and observing the infant for any adverse reaction.
Tahneek is an important Islamic cultural and religious practice involving rubbing a small amount of a softened date or honey on a newborn's palate. A culturally competent nurse should respect this practice while ensuring safety. The best approach is to facilitate the ritual in a safe manner, using a tiny particle to minimize any risk of choking or infection, and ensuring proper hand hygiene is performed by the person conducting the Tahneek.
Question 6: A nurse is assessing a woman who is 12 hours postpartum after a vaginal delivery. Which finding requires immediate notification of the charge nurse or physician?
- Fundus is firm, at the level of the umbilicus.
- Lochia rubra is present, with one saturated perineal pad in 2 hours.
- Patient complains of moderate uterine cramping, especially during breastfeeding.
- Fundus is boggy and deviated to the right, 3 cm above the umbilicus. (Correct answer)
Correct answer: Fundus is boggy and deviated to the right, 3 cm above the umbilicus.
A boggy (soft) fundus that is deviated from the midline and located above the umbilicus is a classic sign of uterine atony and a full bladder. This places the patient at high risk for postpartum hemorrhage, which is a medical emergency. The other findings are normal for this postpartum period. This is a universal standard of care, applicable in Saudi Arabia and internationally.
SNLE - Saudi Nursing Licensing Maternal and Newborn Care Questions and Answers
According to the Saudi Ministry of Health (MOH) National Immunization Schedule, which two vaccines are mandatory for a healthy newborn within the first 24 hours of life?