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| Section | Objectives |
|---|---|
| High-Risk Neonatal Management | - Respiratory distress and ventilation management - Infectious diseases in neonates - Prematurity-related complications |
| Neonatal Health Assessment | - Identification of normal vs abnormal findings - Physical and neurological assessment of the newborn |
| Neonatal Physiology and Pathophysiology | - Cardiovascular adaptation and congenital conditions - Thermoregulation, metabolism, and fluid balance - Respiratory adaptation and disorders |
| Family-Centered Care and Ethics | - Parent education and communication - Ethical and legal considerations in neonatal care |
| Neonatal Pharmacology and Therapeutics | - Medication administration in neonates - Drug safety, dosing considerations, and pharmacokinetics |
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質問 # 86
A newborn has been diagnosed with neonatal testicular torsion that has left one testicle unsalvageable. The other testicle is not affected. The parents are asking if their son will have fertility problems when he is older because of this. The most appropriate
正解：C
解説：
Unilateral neonatal testicular torsion generally has little, if any, effect on future futility.
Bilateral torsion can result in bilateral testicular dysfunction, which can involve deficiencies in sex steroid hormones. Those patients should be seen by an endocrinologist to determine what sex steroid hormone replacement therapy will be necessary for normal development.
質問 # 87
When monitoring the fetal heart rate during labor, which of the following is most likely to be most dangerous to the fetus?
正解：C
解説：
Late decelerations present as smooth decreases in heart rate that begin at the peak of a contraction. When late decelerations occur along with tachycardia and without an acceleration, or a return to normal heart rate range, it can be a sign that the fetus is not getting enough oxygen. Early decelerations begin before the contraction peaks and usually occur as the fetus passes through the birth canal and the skull is compressed. They are generally not harmful. Variable decelerations occur when the umbilical cord is temporarily compressed and are very common during labor. They are usually not harmful when they occur later in labor and are followed by an acceleration. When variable decelerations occur early in labor and are severe, emergent delivery of the baby may be necessary.
質問 # 88
The parents of a newborn are asking the NP what PKU is and if it is really necessary to have this tested as part of the newborn screening process. The best response is
正解：B
解説：
PW, or phenylketonuria, is a metabolic disorder in which the body is not able to break down some of the amino acids in proteins. This leads to poor brain development and intellectual disabilities. It is highly recommended that this test be performed on all newborns so that treatment can be started and the devastating effects of this illness can be avoided.
質問 # 89
If a mother suffers from pregnancy-induced hypertension (preeclampsia) during pregnancy, the primary detrimental effect on the fetus is
正解：A
解説：
Preeclampsia is a disorder that develops in approximately 5% of all pregnancies. Its main feature is new onset elevated blood pressure that develops around 20 weeks of gestation.
Proteinuria is no longer a diagnostic requirement, but is a common feature accompanying the hypertension. The main detrimental effect on the fetus occurs because of longstanding hypertension that leads to utero-placental vascular insufficiency, which impairs the transfer of nutrients and oxygen to the fetus, resulting in intra-uterine growth restriction (IUGR). The IUGR is usually asymmetric (fetal head size is normal for gestational age). Placental abruption occurrence is also more common in fetuses exposed to longstanding hypertension, but not as common as IUGR.
質問 # 90
A mother delivers a child with sickle cell disease, an autosomal recessive disorder. The recurrence risk for subsequent children being born with the disorder is
正解：C
解説：
Autosomal recessive: Recurrence is 25% for each pregnancy and 50% risk of the child becoming a carrier. Autosomal dominant: Recurrence risk is 50%, but there is no carrier state. X- linked recessive: Recurrence risk is 50% for affected sons and 50% risk of daughters becoming carriers. Affected sons do not pass the disorder to sons, but all daughters become carriers. X-Iinked dominant: Father passes the disorder to 100% of daughters but no sons. Mother passes the trait to
50% of sons and 50% of daughters, but daughters are usually unaffected.
質問 # 91
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