1
WGU
WGU D119 PEDIATRIC PRIMARY CARE
EXAM QUESTIONS AND ANSWERS
UPDATED (2024/2025) (VERIFIED
ANSWERS)
What 2 Neonatal Screens are always done? - ANS ✓PKU (Phenylketonuria):
s/s MR, vomiting, athetosis, seizures and Galactosemia s/s MR direct
hyperbili/jaundice
3 day old with bilirubin 10, direct 0.5, eating/pooping well? - ANS
✓Physiologic Jaundice - gone by 5th day of life (immature liver) bilirubin usually
doesn't go above 15
7 day old, bilirubin 12, direct 0.5, dry mucous membranes, not gaining
weight? - ANS ✓Breastfeeding Jaundice (or lack of breastfeeding). Baby is
dehydrated, can be latching problems or not feeding long or often enough.
14 day old, bilirubin 12, direct 0.5. Has regained birth weight. - ANS ✓Breast
Milk Jaundice (milk contains glucuronidase and de-conjugates bilirubin)
1 day old bilirubin 14, direct 0.5? - ANS ✓Pathologic Jaundice (>12, direct >2,
day of life 1, fast rate of rise >5/day). Next best test is a Coombs test (+ means Rh
or ABO incompatibility; - indicated maternal foetal transfusion, twin/twin
transfusion, IDM, spherocytosis
7 day old with dark urine, pale stool. Bilirubin 12, direct 8, LFT's elevated: -
ANS ✓Biliary Atresia - can't drain bile, leads to liver failure, requires surgical
intervention
WGU D119
, 2
WGU
5 causes of direct hyperbilirubinemia - ANS ✓r/o SEPSIS, galactosemia,
hypothyroidism, choledochal cyst, cystic fibrosis
Inherited causes of indirect hyperbilirubinemia? - ANS ✓Gilbert syndrome -
decrease in UGT1A1 (asymptomatic)
Crigler-Najjar syndrome - total loss of UGT1A1 (in type 1; type 2 is about
90% loss)
Inherited causes of direct bilirubinemia? - ANS ✓Dubin-Johnson - black liver
Rotor Syndrome
What is the concern for hyperbilirubinemia in the newborn? - ANS
✓Kernicterus - Indirect bili can cross BBB and deposit in basal ganglia and
brainstem nuclei (>20 is huge concern). Treatment: Phototherapy or exchange
transfusion for very high levels.
What does phototherapy do for hyperbilirubinemia - ANS ✓Coverts
unconjugated bilirubin to an isomer that is water soluble
1 week old baby with cyanosis when feeding but pinks up when crying? -
ANS ✓Choanal Atresia - Restricted nasal passages (choana). Associated with
CHARGE syndrome (Coloboma, Heart defects, Atresia choanal, Growth
retardation, Ear anomalies)
The Centres for Disease Control and Prevention (CDC) recommends
that providers use what growth charts:
1 - Birth to 2 years of age
2 - 2 years and older - ANS ✓1 - World Health Organization (uses length - a
supine measure)
2 - CDC Growth Charts (uses height - a standing measure)
WGU D119
WGU
WGU D119 PEDIATRIC PRIMARY CARE
EXAM QUESTIONS AND ANSWERS
UPDATED (2024/2025) (VERIFIED
ANSWERS)
What 2 Neonatal Screens are always done? - ANS ✓PKU (Phenylketonuria):
s/s MR, vomiting, athetosis, seizures and Galactosemia s/s MR direct
hyperbili/jaundice
3 day old with bilirubin 10, direct 0.5, eating/pooping well? - ANS
✓Physiologic Jaundice - gone by 5th day of life (immature liver) bilirubin usually
doesn't go above 15
7 day old, bilirubin 12, direct 0.5, dry mucous membranes, not gaining
weight? - ANS ✓Breastfeeding Jaundice (or lack of breastfeeding). Baby is
dehydrated, can be latching problems or not feeding long or often enough.
14 day old, bilirubin 12, direct 0.5. Has regained birth weight. - ANS ✓Breast
Milk Jaundice (milk contains glucuronidase and de-conjugates bilirubin)
1 day old bilirubin 14, direct 0.5? - ANS ✓Pathologic Jaundice (>12, direct >2,
day of life 1, fast rate of rise >5/day). Next best test is a Coombs test (+ means Rh
or ABO incompatibility; - indicated maternal foetal transfusion, twin/twin
transfusion, IDM, spherocytosis
7 day old with dark urine, pale stool. Bilirubin 12, direct 8, LFT's elevated: -
ANS ✓Biliary Atresia - can't drain bile, leads to liver failure, requires surgical
intervention
WGU D119
, 2
WGU
5 causes of direct hyperbilirubinemia - ANS ✓r/o SEPSIS, galactosemia,
hypothyroidism, choledochal cyst, cystic fibrosis
Inherited causes of indirect hyperbilirubinemia? - ANS ✓Gilbert syndrome -
decrease in UGT1A1 (asymptomatic)
Crigler-Najjar syndrome - total loss of UGT1A1 (in type 1; type 2 is about
90% loss)
Inherited causes of direct bilirubinemia? - ANS ✓Dubin-Johnson - black liver
Rotor Syndrome
What is the concern for hyperbilirubinemia in the newborn? - ANS
✓Kernicterus - Indirect bili can cross BBB and deposit in basal ganglia and
brainstem nuclei (>20 is huge concern). Treatment: Phototherapy or exchange
transfusion for very high levels.
What does phototherapy do for hyperbilirubinemia - ANS ✓Coverts
unconjugated bilirubin to an isomer that is water soluble
1 week old baby with cyanosis when feeding but pinks up when crying? -
ANS ✓Choanal Atresia - Restricted nasal passages (choana). Associated with
CHARGE syndrome (Coloboma, Heart defects, Atresia choanal, Growth
retardation, Ear anomalies)
The Centres for Disease Control and Prevention (CDC) recommends
that providers use what growth charts:
1 - Birth to 2 years of age
2 - 2 years and older - ANS ✓1 - World Health Organization (uses length - a
supine measure)
2 - CDC Growth Charts (uses height - a standing measure)
WGU D119
