NMS Q&A Family Medicine

chapter 42Newborn and Infant Care andPrevention, Birth to Age 1Examination questions: Unless instructed otherwise, choosethe ONE lettered answer or completion that is BEST ineach case.1 A 15-year-old girl without prior medical care turnsup the emergency department complaining of mildmalaise and a rash. She manifests a mild generalizedmorbilliform eruption. Examination reveals readilypalpable retroauricular and suboccipital lymph nodesas well as erythematous palatal spots. If the pregnancyis carried to term and delivered the newbornwill be at risk for each of the following except:(A) Cataracts(B) Sensorineural deafness(C) Jaundice(D) Small for gestation(E) Koplik spots2 A primiparous Hispanic woman who has had no prenatalcare delivers at 36 weeks, 20 hours after prematurerupture of her membranes. On the third day ofextra-uterine life, the baby exhibits bouts of apneaand “floppiness.” There are rales heard upon auscultationof the lung fields. There is no rash, and thepharynx is unremarkable nor are there cardiac auscultatoryabnormalities. Which of the following isthe most likely diagnosis?(A) Beta hemolytic Group A streptococcus infection(B) Staphylococcus aureus infection(C) Group B streptococcus infection(D) Rubeola(E) Erythema infectiosa3 A full-term male infant is born cyanotic withoutapparent dyspnea. Each of the following is within thedifferential diagnosis of the condition except forwhich one?(A) Transposition of the great vessels(B) Anomalous pulmonary return(C) Truncus arteriosus(D) Critical pulmonary stenosis(E) Coarctation of the abdominal aorta4 Each of the following statements regarding routinecircumcision of the male newborn is true except forwhich one?(A) Circumcised males have fewer urinary tractinfections.(B) Phimosis is prevented.(C) Circumcision reduces the chances of carcinomaof the cervix in future female partners.(D) Circumcision is contraindicated in the presenceof hypospadias.(E) Circumcision reduces the lifetime risk of penilecancer.5 A healthy newborn boy, weighing 7 lb 6 oz (3.34 kg),has been accepted for well baby care. In regard tohydration and renal function, which of the followingis an accepted indication of adequate urine output inthe first 24 hours of life?(A) Moist mucosae(B) Good skin turgor(C) Nonsunken eyeballs(D) One wet diaper(E) Normal pasty stools6 A full-term newborn boy was born to a gravida 3, para3 woman who had not committed to regular prenatalcare. There is a history of neonatal jaundice in her secondbaby caused by a minor blood group incompatibility.Assuming this baby exhibits jaundice in the firstfew days of life, which of the following cutoff points issatisfactory for alerting the primary care physician tothe likely need for phototherapy?(A) Bilirubin level 15 mg/dL at 10 hours of age(B) Bilirubin level 10 mg/dL at 12 hours of age(C) Bilirubin level 15 mg/dL at 18 hours of age(D) Onset of clinical jaundice(E) Bilirubin level at 18 mg/dL at 48 hours of age255