A neonate, 16 hours old, is in the NICU for respiratory distress. A chest X-Ray reveals heart failure. Lab results indicate: AB positive blood type, a positive Coomb’s test, serum bilirubin 16mg/dl, and severe anemia. The vital signs are 98.6 (F), HR 166, R 70. The infant is jaundiced from face to sole of feet and has generalized edema. What condition does the infant have?

Kernicterus.

Severe cardiac anomaly.

Respiratory distress syndrome.

Hydrops fetalis.

Answer and Explanation

The Correct Answer is D

Choice A rationale
Kernicterus is a rare type of brain damage that occurs in a newborn with severe jaundice. It happens when a substance in the blood, bilirubin, builds up to very high levels and spreads into the brain tissues. This condition can cause athetoid cerebral palsy and hearing loss. Kernicterus also causes problems with vision and teeth and sometimes can cause intellectual disabilities. However, the symptoms provided do not align with this condition.
Choice B rationale
A severe cardiac anomaly could cause heart failure and respiratory distress, but it would not explain the positive Coomb’s test, high bilirubin levels, severe anemia, jaundice, and generalized edema.
Choice C rationale
Respiratory distress syndrome (RDS) is a common problem in premature babies. It causes babies to need extra oxygen and help with breathing. RDS occurs most often in babies born before the 28th week of pregnancy and can be a problem for babies born before 37 weeks of pregnancy. It’s caused by a lack of a slippery substance called surfactant, which helps the lungs inflate with air and keeps them from collapsing. However, the symptoms provided do not align with this condition.
Choice D rationale
Hydrops fetalis is a severe, life-threatening problem of severe edema (swelling) in the fetus and newborn. It is also called hydrops. There are two types of hydrops fetalis: immune and nonimmune. Immune hydrops fetalis is a complication of a severe form of Rh incompatibility, which can be prevented. Nonimmune hydrops fetalis occurs as a result of other diseases, such as infections, heart or lung defects, liver disease, or genetic disorders, which aligns with the symptoms provided.

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Correct Answer is ["B","C","D"]

Explanation

Choice A rationale
Breastfeeding every 2 hours is actually recommended for newborns and is not a contributing factor to mastitis.
Choice B rationale
Substituting breastfeeding sessions with formula feeding can contribute to mastitis. This is because the milk that is not removed from the breast can lead to engorgement and blocked ducts, which can result in infection.
Choice C rationale
Blisters and cracks on the nipples can allow bacteria to enter the breast tissue, leading to infection and mastitis.
Choice D rationale
Alternating breastfeeding positions can help ensure that the breasts are emptied completely during each feeding, which can help prevent mastitis.

A. Negative pregnancy test B. Prothrombin time of 40 seconds C. Hemoglobin level of 10.1 g/dl D. Serum cholesterol of 140 mg/dl

Correct Answer is B

Explanation

Choice A rationale
A negative pregnancy test is not the priority in this case. While it’s important to rule out pregnancy as a cause of abnormal uterine bleeding (AUB), it’s not the most critical finding.

Choice B rationale
A prothrombin time of 40 seconds is significantly prolonged, indicating a potential coagulation disorder. This could explain the abnormal uterine bleeding and should be prioritized due to the risk of significant blood loss.
Choice C rationale
A hemoglobin level of 10.1 g/dl is slightly low but within acceptable limits for many individuals. While it could indicate some degree of anemia possibly due to chronic blood loss, it’s not as immediately concerning as a coagulation disorder.
Choice D rationale
A serum cholesterol level of 140 mg/dl is within the normal range and is not directly related to AUB1.

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Naxlex Comprehensive Predictor Exams

What factors could contribute to mastitis in a breastfeeding mother? (Select all that apply.)

Correct Answer is ["B","C","D"]

Explanation

The nurse is assessing the laboratory test results of a client with abnormal uterine bleeding (AUB). Which finding should the nurse prioritize?

Correct Answer is B

Explanation

For which reason would a nurse in the well-baby nursery report to the neonatologist that a newborn appears to be preterm?

What should the parents of infants with a positive phenylketonuria (PKU) test be instructed to do?

Which statement, if made by a couple receiving health education about fertility, would indicate that the teaching was successful?

Which of the following are hormonal methods of contraception? (Select all that apply)

What is a typical outcome of phototherapy?

The postpartum woman is experiencing heavy lochia and has required frequent fundal massage over the past 24- hour period. Which of the following factors may have contributed to the uterine atony?

After conducting an in-service program about ovarian cysts, what type of cyst would the nurse expect the group to identify as being commonly found in females of reproductive age and regresses with the menstrual cycle?

A client with genital herpes simplex infection asks the nurse, “Will I ever be cured of this infection?” Which response by the nurse would be most appropriate?