Pediatric COMAT final update Questions and
Answers With 100% Verified Solutions, Exams
of Nursing 2025/2026
Which two disorders do every state screen for? - ANSWER-PKU and galactosemia
Deficiency in PKU - ANSWER-Phenylalanine hydroxylase
Symptoms of PKU - ANSWER-Mental retardation, vomiting, athetosis, seizures,
developmental delay
Signs of newborn with PKU - ANSWER-Fair hair, eyes, skin and musty smell
Treatment for PKU - ANSWER-Low phenylalanine diet
Deficiency of galactosemia - ANSWER-G1p-uridyl-transferase
--so G1p accumulates and damage to kidney, liver and brain
Symptoms of galactosemia - ANSWER-Mental retardation, direct hyperbili, jaundice,
decreased glucose, cataracts, seizure
Treatment for galactosemia - ANSWER-No lactose
3 days old, bili at 10, direct 0.5, eating and pooping well - ANSWER-Physiologic
jaundice
When does physiologic jaundice resolve? - ANSWER-By 5th day
--due to liver conjugation not yet mature
First number in APGAR - ANSWER-Info on how newborn tolerated labor (after 1 min)
Second number in APGAR - ANSWER-Info on infant's response to resuscitation (after
5min)
Grading for APGAR - ANSWER-2pts - pulse
1pt - color
1pt - irritability
2pts - tone
2pts - respiration
Erb-Duchenne - ANSWER-Injury to C5-C6
--arm remains extended and medially rotated
,Klumpke - ANSWER-C7-C8 + T1 injury
Management for Erb Duchenne or Klumpke - ANSWER-Refer if doesn't get better by 3-
6 months for neuroplasty
Edema that crosses suture lines - ANSWER-Caput succedaneum
Edema that doesn't cross suture line - ANSWER-Cephalohematoma
Area of alopecia with orange colored nodular skin - ANSWER-Nexus sebaceous
Management of Nevis sebaceous - ANSWER-Remove from scalp before adolescence
b/c could undergo malignant degeneration
Thick yellow/white oily scale on inflammatory base of scalp - ANSWER-Seborrheic
dermatitis
Treatment for seborrheic dermatitis - ANSWER-Gently clean with mild shampoo
(selenium)
7 day old, bili 12, direct 0.5, dry mucous membranes and not gaining weight -
ANSWER-Breast feeding jaundice
--from low feeding = dehydration = retain mechanism and absorb deconjugated bili
14 day old, bili 12, direct 0.5, baby regained birth weight and otherwise healthy -
ANSWER-Breast milk jaundice
--breast milk has glucuronidase and deconjugates bili
1 day old, bili 14, direct 0.5 worried? - ANSWER-Yes -- pathologically jaundice if have
high at first day of life bili >12 or rate of rise >5/day
Test for pathological jaundice - ANSWER-Get Coombs test
+ = Rh or ABO incompatibility
- = twin/twin or mom/fetus transfusion, IDM, spherocytosis, or G6pDH deficiency
7 days old, dark urine, pale stool, bili 12, dbili at 8, LFTS elevated - ANSWER-Biliary
atresia
--bile ducts can't drain bile causing liver failure! Need surgery!
Inherited causes of indirect hyperbilirubinemia? - ANSWER-Gilbert - decreased
glucoronyl transferase level
Critter-Najjar - total deficiency
Inherited causes of direct hyperbili - ANSWER-Dublin Johnson - black liver
Rotor - no black liver
, Problem with untreated hyperbilirubinemia - ANSWER-Indirect bili can cross BBB --
deposits in brain stem nuclei and can cause kernicterus (occurs when bili >20)
Treatment for jaundice - ANSWER-Phototherapy -- ionizes the unconjugated bili so it
can be excreted
What to do for jaundice if phototherapy fails? - ANSWER-Double volume exchange
transfusion
Newborn with resp distress and excess drooling - ANSWER-TE-fistula
Diagnostic test for TE fistula - ANSWER-Place feeding tube, X-ray and see if it coils in
the thorax
What else should you look for in TE-fistula? - ANSWER-VACTER assoc anomalies -
vertebral, anal atresia, cardiac, radial and renal
1 week old baby cyanotic when feeds but pink when cries - ANSWER-Choanal atresia
What else should you look for in choanal atresia? - ANSWER-CHARGE assoc
anomalies - coloboma, heart defects, retarded growth, GU anomalies, and ear
anomalies/deaf
32 week premature baby with dyspnea, RR 80 and nasal flaring - ANSWER-RDS =
surfactant deficiency
RDS prenatal diagnosis - ANSWER-L/S <2 = give antenatal betamethasone
Treatment for RDS - ANSWER-Oxygen therapy with nasal CPAP to keep alveoli open
38 week LGA infant born c-section with grunting/dyspnea - ANSWER-Transient
tachypneic neonate (TTN) = lung fluid not squeezed out
Prognosis of TTN - ANSWER-Minimal O2 needed, self-resolves in hours-days
41week infant born after ROM was green/brown - ANSWER-Meconium aspiration
syndrome
Management for meconium aspiration syndrome - ANSWER-Intubate and suction
before stimulation
Complications of meconium aspiration syndrome - ANSWER-Pulmonary artery HTN,
pneumonitis
gastroschisis - ANSWER-Lateral defect on anterior abdomen - without sac so can see
intestines out of belly
Answers With 100% Verified Solutions, Exams
of Nursing 2025/2026
Which two disorders do every state screen for? - ANSWER-PKU and galactosemia
Deficiency in PKU - ANSWER-Phenylalanine hydroxylase
Symptoms of PKU - ANSWER-Mental retardation, vomiting, athetosis, seizures,
developmental delay
Signs of newborn with PKU - ANSWER-Fair hair, eyes, skin and musty smell
Treatment for PKU - ANSWER-Low phenylalanine diet
Deficiency of galactosemia - ANSWER-G1p-uridyl-transferase
--so G1p accumulates and damage to kidney, liver and brain
Symptoms of galactosemia - ANSWER-Mental retardation, direct hyperbili, jaundice,
decreased glucose, cataracts, seizure
Treatment for galactosemia - ANSWER-No lactose
3 days old, bili at 10, direct 0.5, eating and pooping well - ANSWER-Physiologic
jaundice
When does physiologic jaundice resolve? - ANSWER-By 5th day
--due to liver conjugation not yet mature
First number in APGAR - ANSWER-Info on how newborn tolerated labor (after 1 min)
Second number in APGAR - ANSWER-Info on infant's response to resuscitation (after
5min)
Grading for APGAR - ANSWER-2pts - pulse
1pt - color
1pt - irritability
2pts - tone
2pts - respiration
Erb-Duchenne - ANSWER-Injury to C5-C6
--arm remains extended and medially rotated
,Klumpke - ANSWER-C7-C8 + T1 injury
Management for Erb Duchenne or Klumpke - ANSWER-Refer if doesn't get better by 3-
6 months for neuroplasty
Edema that crosses suture lines - ANSWER-Caput succedaneum
Edema that doesn't cross suture line - ANSWER-Cephalohematoma
Area of alopecia with orange colored nodular skin - ANSWER-Nexus sebaceous
Management of Nevis sebaceous - ANSWER-Remove from scalp before adolescence
b/c could undergo malignant degeneration
Thick yellow/white oily scale on inflammatory base of scalp - ANSWER-Seborrheic
dermatitis
Treatment for seborrheic dermatitis - ANSWER-Gently clean with mild shampoo
(selenium)
7 day old, bili 12, direct 0.5, dry mucous membranes and not gaining weight -
ANSWER-Breast feeding jaundice
--from low feeding = dehydration = retain mechanism and absorb deconjugated bili
14 day old, bili 12, direct 0.5, baby regained birth weight and otherwise healthy -
ANSWER-Breast milk jaundice
--breast milk has glucuronidase and deconjugates bili
1 day old, bili 14, direct 0.5 worried? - ANSWER-Yes -- pathologically jaundice if have
high at first day of life bili >12 or rate of rise >5/day
Test for pathological jaundice - ANSWER-Get Coombs test
+ = Rh or ABO incompatibility
- = twin/twin or mom/fetus transfusion, IDM, spherocytosis, or G6pDH deficiency
7 days old, dark urine, pale stool, bili 12, dbili at 8, LFTS elevated - ANSWER-Biliary
atresia
--bile ducts can't drain bile causing liver failure! Need surgery!
Inherited causes of indirect hyperbilirubinemia? - ANSWER-Gilbert - decreased
glucoronyl transferase level
Critter-Najjar - total deficiency
Inherited causes of direct hyperbili - ANSWER-Dublin Johnson - black liver
Rotor - no black liver
, Problem with untreated hyperbilirubinemia - ANSWER-Indirect bili can cross BBB --
deposits in brain stem nuclei and can cause kernicterus (occurs when bili >20)
Treatment for jaundice - ANSWER-Phototherapy -- ionizes the unconjugated bili so it
can be excreted
What to do for jaundice if phototherapy fails? - ANSWER-Double volume exchange
transfusion
Newborn with resp distress and excess drooling - ANSWER-TE-fistula
Diagnostic test for TE fistula - ANSWER-Place feeding tube, X-ray and see if it coils in
the thorax
What else should you look for in TE-fistula? - ANSWER-VACTER assoc anomalies -
vertebral, anal atresia, cardiac, radial and renal
1 week old baby cyanotic when feeds but pink when cries - ANSWER-Choanal atresia
What else should you look for in choanal atresia? - ANSWER-CHARGE assoc
anomalies - coloboma, heart defects, retarded growth, GU anomalies, and ear
anomalies/deaf
32 week premature baby with dyspnea, RR 80 and nasal flaring - ANSWER-RDS =
surfactant deficiency
RDS prenatal diagnosis - ANSWER-L/S <2 = give antenatal betamethasone
Treatment for RDS - ANSWER-Oxygen therapy with nasal CPAP to keep alveoli open
38 week LGA infant born c-section with grunting/dyspnea - ANSWER-Transient
tachypneic neonate (TTN) = lung fluid not squeezed out
Prognosis of TTN - ANSWER-Minimal O2 needed, self-resolves in hours-days
41week infant born after ROM was green/brown - ANSWER-Meconium aspiration
syndrome
Management for meconium aspiration syndrome - ANSWER-Intubate and suction
before stimulation
Complications of meconium aspiration syndrome - ANSWER-Pulmonary artery HTN,
pneumonitis
gastroschisis - ANSWER-Lateral defect on anterior abdomen - without sac so can see
intestines out of belly
