PEDIATRICS
MOTHER BABY
WRITTEN EXAM
Q&A
2024
1. A 32-year-old woman with a history of gestational diabetes delivers a 4.2 kg
baby boy by cesarean section. The baby is admitted to the neonatal
intensive care unit (NICU) for hypoglycemia and respiratory distress. The
nurse caring for the baby should monitor him for which of the following
complications?
a) Polycythemia
b) Hyperbilirubinemia
c) Hypocalcemia
d) All of the above*
Rationale: Babies born to mothers with gestational diabetes are at risk of
polycythemia, hyperbilirubinemia, and hypocalcemia due to increased
insulin production, increased red blood cell breakdown, and decreased
parathyroid hormone secretion, respectively.
2. A 28-week-old preterm infant is receiving total parenteral nutrition (TPN)
through a peripherally inserted central catheter (PICC). The nurse notices
that the infusion pump is beeping and displaying an occlusion alarm. The
nurse should do which of the following actions first?
, a) Flush the PICC line with normal saline
b) Check the position of the PICC line on the chest x-ray
c) Stop the TPN infusion and notify the physician*
d) Change the infusion tubing and filter
Rationale: An occlusion alarm indicates that there is an obstruction in the
PICC line that prevents the flow of TPN. This could be due to a thrombus,
a kink, or a malposition of the catheter. The first action is to stop the TPN
infusion and notify the physician, as continuing the infusion could cause
damage to the vessel or dislodge the catheter. Flushing the PICC line could
also dislodge a thrombus and cause embolism. Checking the position of the
PICC line and changing the infusion tubing and filter are secondary actions
that can be done after stopping the infusion and notifying the physician.
3. A 3-year-old girl is brought to the emergency department by her parents
with a fever of 39.5°C, drooling, and stridor. She has a history of recurrent
tonsillitis and was diagnosed with streptococcal pharyngitis two days ago.
The nurse suspects that she has developed which of the following
conditions?
a) Epiglottitis*
b) Croup
c) Bronchiolitis
d) Pneumonia
Rationale: Epiglottitis is a life-threatening inflammation of the epiglottis that can cause
airway obstruction. It is usually caused by Haemophilus influenzae type b (Hib) infection,
but can also be caused by other bacteria such as Streptococcus pyogenes. The classic signs
of epiglottitis are fever, drooling, dysphagia, dysphonia, and stridor. Croup is a viral
infection of the larynx and trachea that causes barking cough, hoarseness, and inspiratory
stridor. Bronchiolitis is a viral infection of the lower respiratory tract that causes wheezing,
coughing, and tachypnea. Pneumonia is an infection of the lung parenchyma that causes
fever, cough, dyspnea, and crackles.
1. A nurse is assessing a newborn for signs of jaundice. Which of the
following symptoms would the nurse consider to be an early sign of
jaundice in a newborn?
a) Sunken fontanelle
b) Hypotonia
c) Yellowish tint to skin and sclerae
d) Poor feeding
MOTHER BABY
WRITTEN EXAM
Q&A
2024
1. A 32-year-old woman with a history of gestational diabetes delivers a 4.2 kg
baby boy by cesarean section. The baby is admitted to the neonatal
intensive care unit (NICU) for hypoglycemia and respiratory distress. The
nurse caring for the baby should monitor him for which of the following
complications?
a) Polycythemia
b) Hyperbilirubinemia
c) Hypocalcemia
d) All of the above*
Rationale: Babies born to mothers with gestational diabetes are at risk of
polycythemia, hyperbilirubinemia, and hypocalcemia due to increased
insulin production, increased red blood cell breakdown, and decreased
parathyroid hormone secretion, respectively.
2. A 28-week-old preterm infant is receiving total parenteral nutrition (TPN)
through a peripherally inserted central catheter (PICC). The nurse notices
that the infusion pump is beeping and displaying an occlusion alarm. The
nurse should do which of the following actions first?
, a) Flush the PICC line with normal saline
b) Check the position of the PICC line on the chest x-ray
c) Stop the TPN infusion and notify the physician*
d) Change the infusion tubing and filter
Rationale: An occlusion alarm indicates that there is an obstruction in the
PICC line that prevents the flow of TPN. This could be due to a thrombus,
a kink, or a malposition of the catheter. The first action is to stop the TPN
infusion and notify the physician, as continuing the infusion could cause
damage to the vessel or dislodge the catheter. Flushing the PICC line could
also dislodge a thrombus and cause embolism. Checking the position of the
PICC line and changing the infusion tubing and filter are secondary actions
that can be done after stopping the infusion and notifying the physician.
3. A 3-year-old girl is brought to the emergency department by her parents
with a fever of 39.5°C, drooling, and stridor. She has a history of recurrent
tonsillitis and was diagnosed with streptococcal pharyngitis two days ago.
The nurse suspects that she has developed which of the following
conditions?
a) Epiglottitis*
b) Croup
c) Bronchiolitis
d) Pneumonia
Rationale: Epiglottitis is a life-threatening inflammation of the epiglottis that can cause
airway obstruction. It is usually caused by Haemophilus influenzae type b (Hib) infection,
but can also be caused by other bacteria such as Streptococcus pyogenes. The classic signs
of epiglottitis are fever, drooling, dysphagia, dysphonia, and stridor. Croup is a viral
infection of the larynx and trachea that causes barking cough, hoarseness, and inspiratory
stridor. Bronchiolitis is a viral infection of the lower respiratory tract that causes wheezing,
coughing, and tachypnea. Pneumonia is an infection of the lung parenchyma that causes
fever, cough, dyspnea, and crackles.
1. A nurse is assessing a newborn for signs of jaundice. Which of the
following symptoms would the nurse consider to be an early sign of
jaundice in a newborn?
a) Sunken fontanelle
b) Hypotonia
c) Yellowish tint to skin and sclerae
d) Poor feeding
