A 3-day-old infant is slightly jaundiced and has an elevated bilirubin level. What is the most probable cause for these changes?

Hemolysis of neonatal red blood cells by the maternal antibodies.

Delayed meconium excretion resulting in the production of direct bilirubin.

Pathological liver function resulting from hypoxemia during the birthing process.

Physiological destruction of fetal red blood cells during the extrauterine period.

Answer and Explanation

The Correct Answer is D

A. Hemolysis by maternal antibodies suggests hemolytic disease of the newborn (e.g., Rh incompatibility), which typically presents earlier and more severely.
B. Delayed meconium excretion may lead to increased bilirubin, but this is not the most common cause of jaundice at 3 days.
C. Pathological jaundice occurs within the first 24 hours or persists longer than a week.
D. Physiological jaundice is a common finding in newborns due to the natural breakdown of fetal red blood cells (RBCs) and the immature liver's inability to efficiently process bilirubin.

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Correct Answer is C

Explanation

A. Feed the infant at least 1 ounce of formula: Feeding may help if the baby is hungry, but it is not the first action in managing symptoms of NAS.
B. Collect a sterile urine specimen: This is an important step for diagnosing NAS but is not the immediate action to calm the infant.
C. Swaddle the infant with hands near its mouth: These symptoms are consistent with neonatal abstinence syndrome (NAS). Comfort measures such as swaddling and non-nutritive sucking are prioritized to soothe the infant.
D. Move the infant into a brightly lit area: A quiet, dim environment is better for soothing an overstimulated baby, so this action would be counterproductive.

A. Explain what colostrum is and offer to assist with latch. B. Call the physician for a prescription for formula. C. Obtain consent from her to use donor breast milk. D. Instruct her to burp after the baby eats 1/2 ounce.

Correct Answer is A

Explanation

A. Colostrum, the first form of breast milk, is produced in small amounts and is rich in nutrients and antibodies. Many new mothers are unaware of this and need reassurance.
B. Formula is not necessary unless medically indicated or the mother persists after being educated.
C. Donor breast milk is typically reserved for medically fragile infants.
D. Burping after feeding is important but does not address the client’s concern about milk supply.

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A 3-day-old infant is slightly jaundiced and has an elevated bilirubin level. What is the most probable cause for these changes?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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