HYPERBILIRUBINEMIA

1. Injection of ……………………. prophylaxis prevents the production of antibodies against

blood cells from a rhesus positive foetus.

A. anti-D immunoglobulin

B. auto-beta immunoglobulin

C. auto-alpha immunoglobulin

2. A child is diagnosed of hyperbilirubinemia at the NICU even though tests detected the

presence of the hepatic enzyme glucuronyl transferase. A possible cause of the condition must be

A. auto immune deficiency

B. Renal obstruction

C. hepatic obstruction

3. Exchange blood transfusion to treat rhesus incompatibility is a clean procedure.

A. True

B. False

C. None of the above

4. A nurse observes muscle jerking and twitching in a 4-day old baby during an exchange

transfusion procedure. This is an indication of

A. Hypocalcaemia

B. Hyperglycaemia

C. Hyponatremia
5. A nurse is caring for 10-day old child who is receiving phototherapy at the neonatal intensive

care unit. To assess whether bilirubin is within the normal ranges she

A. measures child’s sublingual temperature at regular intervals

B. plots SBR concentration against phototherapy sessions on a chart

C. monitors intake and output chart.

PHYSIOLOGICAL AND INFECTIVE JAUNDICE

1. The physiological rise in bilirubin concentration the first few days after birth even in healthy

children is due to all except

A. increase in lung’s efficiency

B. Immature hepatic enzymes

C. Absence or insufficient RBC’s

2. Accumulation of unconjugated bilirubin underneath skin tissues causes yellowish

discolourations of the skin. This is because unconjugated bilirubin is

A. Water soluble

B. Fat soluble

C. Highly permeable
3. All these are causes of physiological jaundice except

A. Increased enterohepatic reabsorption

B. presence of glucuronyl transferase

C. shorter lifespan of RBC’s

4. Jaunice in a newborn is first observed in the

A. Head

B. Upper and lower extremities

C. Abdomen

5. Normal red blood cells have a lifespan of

A. 80 -90 days

B. 100-120 days

C. 120-140 days

ABO and RHESUS INCOMPATIBILITY

1. The best initiative for prevention of ABO and Rhesus incompatibility between a couple is

A. Allen’s test before marriage

B. Blood testing and counselling before marriage

 C. Blood transfusion of the female prior to marriage

2. Possible causes of jaundice in newborns includes

I Rhesus incompatibility

II ABO incompatibility

III Hemolytic disorder

IV Congenital palsy

A. I and II only

B. I, II and III only

C. I, II, III and IV

3. When there is rhesus incompatibility between the mother and foetus, Icterus is bound to occur.

This usually starts from

A. the 1st day of life

B. after the 5th day of life

C. the 8th day after birth

4. Therapy for rhesus incompatibility is generally aimed at

A. preventing intrauterine or extrauterine death from severe anaemia and hypoxia

B. extending the feotal life as long as possible

 C. transferring all required genes from the mother to the foetus

5. Blood group O has ………………

A. No antibodies

B. No antigens

C. Antigen A and Antigen B

References

1. Hockenberry, M. and Wilson, D., 2015. Wong's Nursing Care of Infants and Children.

11th ed. Elsevier, pp.252.

2. Marshall, J. and Raynor, M., 2014. Myles Textbook for Midwives. 16th ed. pp.681-689.

3. Hockenberry, M. and Wilson, D., 2015. Wong's Nursing Care of Infants and Children.

11th ed. Elsevier, pp.1180.

4. Marshall, J. and Raynor, M., 2014. Myles Textbook for Midwives. 16th ed. pp.685-687.