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You are the NNP caring for a former 29-weeker (birthweight 1450 grams). As you prepare for discharge, at what point would you anticipate approaching the parent for administration of the hepatitis B vaccine?

The pediatrician has asked you to consult for a 3 kg term infant exclusively breastfeeding with no urine output reported at 48 hours of life. You order a 10 ml/kg bolus of normal saline. There is urine output of 1.5 ml/kg/hr over the next 6 hours. You suspect that the cause for the oliguria was

An infant is born with the feet turning inward and downward present at birth. This is

You are the NNP called to evaluate an infant in the nursery who is vigorous with history of 9/9 apgars, no other symptoms but the nurse auscultated an abnormal heart rhythm. When placed on an ECG monitor you note an irregular R-R interval. Mother’s history is unremarkable. You suspect this infant has:

You are called to assess a term infant in the nursery within the first hour of life. The nurse reports the infant is cyanotic at rest but pinks up when crying. What is the most likely cause of the cyanosis?

You are treating an infant for sepsis and just received the blood culture and sensitivity results. A key factor in your selection of antibiotic is a minimum inhibitory concentration (MIC) which represents what concentration of the drug which prevents visible in-vitro growth of a pathogen?

You have been asked to evaluate a newborn just born in labor and delivery delivered to a mother with no prenatal care and unable to provide history.  Your physical exam reveals a microcephalic infant with redundant nuchal skin, unilateral cleft palate, malformed ears, and scalp cutis aplasia in this male infant. The most likely diagnosis is

An associated finding in an infant with a fractured clavicle would be

A term infant was admitted to the NICU with tachypnea, a cleft palate, a pansystolic, left lower sternal border murmur, and hypocalcemia.  An echocardiogram was completed which demonstrated findings consistent with truncus arteriosus.  As the NNP caring for this infant you would also have a high degree of suspicion for which of the following?

An elderly female patient had been admitted for a hip replacement. The patient seemed to be recovering well until she developed redness, increased swelling, and purulent discharge at the surgical site. The wound was cultured and results from microbiological testing revealed that the infection was caused by Staphylococcus aureus. The patient successfully completed the course of antibiotic therapy, and within a few days, all signs of infection had subsided. The patient was progressing well with physiotherapy, and was planning for discharge when the patient suddenly began to experience diarrhea. On the first day, the patient had two loose bowel movements. By the second day, the episodes of diarrhea were occurring every 2 to 3 hours. The stools were watery and foul-smelling and contained large amounts of mucus. The patient complained of mild abdominal pain and cramping, and she subsequently developed a fever. The physician was notified, and a stool specimen was collected for laboratory testing.  The stool culture came back showing that the patient’s diarrhea was actually caused by the Clostridium difficile. The patient was placed on contact isolation and was started on intravenous metronidazole (Flagyl). With this treatment, the diarrhea gradually slowed and finally stopped. Repeat cultures performed after the metronidazole therapy was completed showed that the infection had been successfully cleared. QUESTION:  What are risk factors for this patient to develop Clostridium difficile infection (2.5 points)? Also give the Domain and type of microorganism C. diff  is (2.5 points).