MEDNAX 2 OBSTETRICS AND NEONATAL CARE ACTUAL EXAM
2025|156 QUESTIONS WITH ACCURATE SOLUTIONS
1. Discuss why venipuncture might be considered less painful than heel-stick
sampling in newborns.
Venipuncture is often considered less painful because it involves
a larger vein and may cause less tissue trauma compared to
heel-stick sampling.
Heel-stick sampling is less painful due to its quick execution.
Venipuncture is more painful due to the size of the needle used.
Heel-stick sampling is preferred because it is less invasive.
2. The underlying pathophysiology for the majority of women who develop
gestational diabetes is:
Antibodies directed against specific beta cell antigens
Genetic variants that have been identified as causes of diabetes in
the general population
Significant decreases in insulin sensitivity with advancing
gestation
3. What is the most common type of brachial plexus injury in newborns?
Upper arm paralysis (Erb-Duchenne)
Total arm paralysis
Klumpke's paralysis
Shoulder dystocia
4. A newborn is diagnosed with severe hemolytic disease, and the
healthcare provider recommends exchange transfusion. What is the
primary purpose of exchange transfusion in this condition?
,To stimulate RBC production and prevent anemia.
, To remove antibodies and damaged RBCs.
To prevent umbilical vessel bleeding after birth.
To increase bilirubin levels for accurate assessment.
5. Describe how the absolute neutrophil count (ANC) is clinically significant
in evaluating a patient's immune status.
The ANC helps assess a patient's risk of infection by indicating
the number of neutrophils available to fight off pathogens.
The ANC measures the overall white blood cell count without
differentiating types of cells.
The ANC indicates the level of hemoglobin in the blood, which is
unrelated to infection risk.
The ANC is primarily used to evaluate liver function in patients.
6. Describe what constitutes a prolonged deceleration in fetal heart rate
and its significance in obstetric care.
A prolonged deceleration is an abrupt decrease in FHR below
baseline of at least 15 beats/min lasting between 2 and 10
minutes, indicating potential fetal distress.
A prolonged deceleration is a gradual decrease in FHR that lasts
less than 2 minutes, which is not concerning.
A prolonged deceleration is any decrease in FHR lasting longer
than 10 minutes, which is always critical.
A prolonged deceleration is a decrease in FHR that does not
exceed 15 beats/min, lasting between 2 and 10 minutes.
7. Describe the characteristics of an omphalocele and how it differs from
other abdominal wall defects.
An omphalocele is an abdominal wall defect larger than 4 cm,
covered by a translucent, avascular sac, with the umbilical cord
, inserting into it.
An omphalocele is a small hernia that does not require surgical
intervention.
An omphalocele is characterized by the presence of bowel
protruding without a covering.
An omphalocele is a defect that occurs only in premature infants.
8. If a 2-day old newborn with an I:T ratio of 0.40 is suspected of having
sepsis, what immediate action should be taken by the healthcare team?
Initiate a sepsis workup and start empirical antibiotic therapy.
Monitor the infant's weight and feeding patterns.
Schedule a follow-up appointment in one week.
Perform a blood transfusion to correct anemia.
9. Which of the following clinical factors may significantly decrease
neutrophil counts in newborn infants:
Maternal hypertension
Meconium aspiration syndrome
Pneumothorax
10. If a pediatrician observes that a full-term male infant with cryptorchidism
has not achieved testicular descent by 9 months, what would be the
most appropriate next step in management?
Consider referral for surgical evaluation
Wait until the infant is 12 months old
Administer hormonal therapy immediately
Perform a diagnostic ultrasound
2025|156 QUESTIONS WITH ACCURATE SOLUTIONS
1. Discuss why venipuncture might be considered less painful than heel-stick
sampling in newborns.
Venipuncture is often considered less painful because it involves
a larger vein and may cause less tissue trauma compared to
heel-stick sampling.
Heel-stick sampling is less painful due to its quick execution.
Venipuncture is more painful due to the size of the needle used.
Heel-stick sampling is preferred because it is less invasive.
2. The underlying pathophysiology for the majority of women who develop
gestational diabetes is:
Antibodies directed against specific beta cell antigens
Genetic variants that have been identified as causes of diabetes in
the general population
Significant decreases in insulin sensitivity with advancing
gestation
3. What is the most common type of brachial plexus injury in newborns?
Upper arm paralysis (Erb-Duchenne)
Total arm paralysis
Klumpke's paralysis
Shoulder dystocia
4. A newborn is diagnosed with severe hemolytic disease, and the
healthcare provider recommends exchange transfusion. What is the
primary purpose of exchange transfusion in this condition?
,To stimulate RBC production and prevent anemia.
, To remove antibodies and damaged RBCs.
To prevent umbilical vessel bleeding after birth.
To increase bilirubin levels for accurate assessment.
5. Describe how the absolute neutrophil count (ANC) is clinically significant
in evaluating a patient's immune status.
The ANC helps assess a patient's risk of infection by indicating
the number of neutrophils available to fight off pathogens.
The ANC measures the overall white blood cell count without
differentiating types of cells.
The ANC indicates the level of hemoglobin in the blood, which is
unrelated to infection risk.
The ANC is primarily used to evaluate liver function in patients.
6. Describe what constitutes a prolonged deceleration in fetal heart rate
and its significance in obstetric care.
A prolonged deceleration is an abrupt decrease in FHR below
baseline of at least 15 beats/min lasting between 2 and 10
minutes, indicating potential fetal distress.
A prolonged deceleration is a gradual decrease in FHR that lasts
less than 2 minutes, which is not concerning.
A prolonged deceleration is any decrease in FHR lasting longer
than 10 minutes, which is always critical.
A prolonged deceleration is a decrease in FHR that does not
exceed 15 beats/min, lasting between 2 and 10 minutes.
7. Describe the characteristics of an omphalocele and how it differs from
other abdominal wall defects.
An omphalocele is an abdominal wall defect larger than 4 cm,
covered by a translucent, avascular sac, with the umbilical cord
, inserting into it.
An omphalocele is a small hernia that does not require surgical
intervention.
An omphalocele is characterized by the presence of bowel
protruding without a covering.
An omphalocele is a defect that occurs only in premature infants.
8. If a 2-day old newborn with an I:T ratio of 0.40 is suspected of having
sepsis, what immediate action should be taken by the healthcare team?
Initiate a sepsis workup and start empirical antibiotic therapy.
Monitor the infant's weight and feeding patterns.
Schedule a follow-up appointment in one week.
Perform a blood transfusion to correct anemia.
9. Which of the following clinical factors may significantly decrease
neutrophil counts in newborn infants:
Maternal hypertension
Meconium aspiration syndrome
Pneumothorax
10. If a pediatrician observes that a full-term male infant with cryptorchidism
has not achieved testicular descent by 9 months, what would be the
most appropriate next step in management?
Consider referral for surgical evaluation
Wait until the infant is 12 months old
Administer hormonal therapy immediately
Perform a diagnostic ultrasound
