Deck 10: Hyperbilirubinemia in the Newborn

Question 1

The cause of conjugated hyperbilirubinemia is

A) Impairment in hepatic excretion or an extrahepatic obstruction
B) Impairment in hepatic excretion or impairment in bilirubin uptake
C) Elevation in bilirubin production or an extrahepatic obstruction
D) Elevation in bilirubin production or impairment in bilirubin uptake

Answer 1

Impairment in hepatic excretion or an extrahepatic obstruction

Question 2

Jaundice in a newborn with hyperbilirubinemia initially appears on the face and progresses in which pattern?

A) Proximodistal
B) Lateral
C) Cephalocaudal
D) Medial

Answer 2

Cephalocaudal

Question 3

The average bilirubin production in newborns is

A) Half that of adults
B) The same as adults
C) 2 to 3 times more than adults
D) 3 to 4 times more than adults

Answer 3

2 to 3 times more than adults

Question 4

Elevation of serum bilirubin is also affected by the rate of excretion. In a newborn, excretion of bilirubin is complicated by

A) Decreased transit time in the intestines
B) Decreased enterohepatic circulation time
C) Decreased glomerular filtration rate
D) Decreased transit time in the intestines and decreased enterohepatic circulation time

Question 5

Jaundice is considered pathological if it occurs

A) In the first 24 hours after birth
B) In the first 48 hours after birth
C) In the first 72 hours after birth
D) One week after birth

Question 6

Phototherapy is a treatment for jaundice. The mechanism of phototherapy is

A) Transforming conjugated bilirubin into bile so it can be eliminated
B) Transforming unconjugated bilirubin into bile so it can be eliminated
C) Transforming conjugated bilirubin into photoproducts that can be excreted
D) Transforming unconjugated bilirubin into photoproducts that can be excreted

Question 7

Potential complications for a newborn being treated with phototherapy include all of the following except

A) Temperature instability
B) Decreased stooling
C) Electrolyte imbalance
D) Interference with bonding

Question 8

When providing discharge education to the family of a newborn treated for hyperbilirubinemia, they should be instructed to contact the provider if they notice

A) More frequent feeding
B) Greenish-black bowel movements
C) Decreased voiding or stooling
D) Positive Moro reflex

Question 9

Newborns are least likely to develop jaundice if they are

A) Formula fed with over 38 weeks' gestation
B) Formula fed with less than 38 weeks' gestation
C) Breastfed with over 38 weeks' gestation
D) Breastfed with less than 38 weeks' gestation

Question 10

An accurate level assessment of hyperbilirubinemia can be performed by

A) Visualizing the skin
B) Visualizing the sclera
C) Measuring serum bilirubin
D) Measuring liver enzymes

Question 11

An early sign of bilirubin toxicity in newborns is

A) Apnea
B) Hypotonia
C) Fever
D) Irritability

Question 12

The hyperbilirubinemia risk score for a newborn who was delivered at 40 weeks' gestation via vacuum delivery, weighed 7 pounds at birth, and is exclusively breastfeeding would be

A) 11
B) 12
C) 14
D) 15

Question 13

A condition characterized by staining of the brainstem nuclei and cerebellum is known as

A) Kernicterus
B) Severe hyperbilirubinemia
C) Acute bilirubin encephalopathy
D) Chronic bilirubin encephalopathy

Question 14

When referring to Case Study 3: Newborn Nutrition, recommendations state solid foods can be initiated at

A) 3-5 months of age to complement breastfeeding or formula feeding
B) 4-6 months of age to complement breastfeeding or formula feeding
C) 3-5 months of age to wean off breastfeeding or formula feeding
D) 4-6 months of age to wean off breastfeeding or formula feeding