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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Embryology, Physiology, Pathophysiology & Systems Management | 54% | - Eyes, ears, nose and throat - Neurological system - Musculoskeletal and integumentary system - Metabolic and endocrine system - Cardiovascular system - Respiratory system - Infectious diseases - Gastrointestinal system - Genetics and congenital anomalies - Hematopoietic and immune system - Renal and genitourinary system |
| Topic 2: General Assessment | 15% | - Systematic physical assessment - Interpretation of diagnostic data - Perinatal history collection - Growth and development assessment |
| Topic 3: Professional Issues | 3% | - Ethics and legal aspects - Scope and standards of practice - Interprofessional collaboration - Quality improvement and patient safety |
| Topic 4: General Management | 19% | - Resuscitation and stabilization - Care coordination and family education - Nutrition and growth support - Pain management and sedation - Thermoregulation - Fluids, electrolytes and acid-base balance |
| Topic 5: Pharmacology | 9% | - Safe administration principles - Adverse effects and interactions - Pharmacokinetics and pharmacodynamics in neonates - Common medications and dosages |
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NEW QUESTION # 84
The following drug(s) should always be included with infant resuscitation equipment
Answer: B
Explanation:
Medications that should always be included as part of the minimum neonatal resuscitation equipment include epinephrine and naloxone. Epinephrine is the AHA recommended pharmacologic intervention in the case of ineffective CPR in neonatal resuscitation. Naloxone is indicated in the case of respiratory distress in infants with opioid withdraw after the administrations of opioids as pain control in the labor process. Surfactant (indicated in respiratory distress, particularly in preterm neonates) and prostaglandins (indicated for cyanotic congenital heart defects) are useful in specific cases, but are not part of the minimum resuscitation equipment.
NEW QUESTION # 85
Which of the following electrolytes can help to reduce the incidence of neurological deficits in premature infants?
Answer: C
Explanation:
Studies have shown that maintaining a higher serum magnesium level can help to reduce the incidence of neurological developmental delay. It has been found to be helpful with advancing brain development in premature infants, and to some degree, in term infants who have suffered from asphyxia during labor and delivery. It is thought that magnesium can serve a neuroprotective role in early brain development.
NEW QUESTION # 86
A mother brings her term infant (and first child) for an exam at 2 weeks after birth. The baby has not regained birth weight, appears listless, face drawn, and skin turgor is poor. The mother is breastfeeding. The most appropriate first action is
Answer: B
Explanation:
The mother should be questioned about her nursing technique and frequency and observed while nursing the child. Since this is her first child, she may need further assistance in nursing properly to ensure the infant receives adequate nutrition. While further tests may be indicated, these signs are indicative of dehydration and poor nutrition, so that should be dealt with first. As there are no other indications of neglect, referral to child protective services is not appropriate at this time. Switching from human milk to formula is rarely necessary if mothers receive adequate support and instruction.
NEW QUESTION # 87
On examining the neonate, the NP notes 9 cafe au lait spots with a diameter greater than
5 mm and freckles on the axilla and inguinal are
a. The infant should be tested for
Answer: A
Explanation:
Cafe au lait spots (CAL) are flat skin lesions with increased melanin content and regular or irregular borders. If the CAL spots are faint, one can use a Wood lamp to make them easier to see.
Fewer than 3 cafe au lait spots have no clinical significance. However, 6 or more cafe au lait spots with a diameter larger than 5 mm occur in 95% of patients with neurofibromatosis type 1 (NFI), a disorder of chromosome 17. Lisch nodules on the child's iris and Crowe's sign (freckles on the axilla and inguinal area) corroborate the diagnosis of NFI.
NEW QUESTION # 88
A life-threatening condition that causes simultaneous hemorrhage and thrombosis is
Answer: C
Explanation:
Disseminated intravascular coagulation (DIC) is characterized by hemorrhage and thrombosis. It most often occurs in the newborn due to sepsis, respiratory distress syndrome, birth trauma, birth asphyxia, or necrotizing enterocolitis. Newborns are more susceptible to this condition because the clotting factors are at low levels at birth, which increases the risk of hemorrhage. The trauma of the underlying condition results in endothelial tissue damage, which causes hemorrhage. Fibrin and other clotting factors deposit in the microvasculature to stop bleeding, which results in microvascular thrombosis. Treatment of the condition is focused on treating the underlying cause.
NEW QUESTION # 89
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