Intensive Care all neonatal 3rd year Midwifery – 10th round -Feb 2026 123456789101112131415161718192021222324252627282930 محصلین عزیز، قبل از شروع امتحان، لطفاً توجه داشته باشید که شما 60 دقیقه برای پاسخگویی به 50 سوال در اختیار دارید. برای هر سوال اضافه تر از ۱ دقیقه زمان در نظر گرفته شده است. موفق باشید! Intensive Care all neonatal 3rd year Midwifery - 2nd Chance -March 2026 Faculty / ClassMedicineDentistryMidwiferyNursing 1 / 30 To prevent Rh sensitization in an Rh-negative mother carrying an Rh-positive fetus during the first pregnancy, which of the following is recommended? A) A) No intervention is needed B) B) Anti-Rh immunoglobulin before 28 weeks C) C) Anti-Rh immunoglobulin within 72 hours after delivery D) D) Anti-Rh immunoglobulin at 28 weeks and again within 72 hours after delivery Correct answer: D 2 / 30 All of the following are manifestations of subtle neonatal seizures EXCEPT: A) A) Apnea B) B) Localized jerking movements C) C) Eye blinking D) D) Eye deviation Correct answer: B 3 / 30 Periventricular calcifications are characteristic of which congenital infection? A) A) Rubella virus B) B) Herpes simplex virus C) C) Parvovirus B19 D) D) Cytomegalovirus Correct answer: D 4 / 30 Which of the following statements regarding hemolysis due to ABO incompatibility between mother and newborn is correct? A) A) It can occur in the first pregnancy B) B) It becomes more severe in subsequent pregnancies C) C) It can be prevented by Rho(D) immune globulin D) D) It commonly causes hydrops fetalis Correct answer: A 5 / 30 A premature newborn weighing 1000 g develops seizures, pallor, and bulging of the anterior fontanelle on the second day of life. Hemoglobin level is 8 g/dL. What is the most likely diagnosis? A) A) Disseminated intravascular coagulation B) B) Subarachnoid hemorrhage C) C) Subdural hemorrhage D) D) Intraventricular hemorrhage Correct answer: D 6 / 30 Which of the following is NOT a complication associated with birth at 28 weeks of gestation? A) A) Retinopathy of prematurity B) B) Patent ductus arteriosus C) C) Meconium aspiration syndrome D) D) Air leak syndromes Correct answer: C 7 / 30 A term newborn weighing 3 kg is delivered vaginally. Immediately after birth, the infant is hypotonic and has absent effective spontaneous respirations. The heart rate is 100 beats per minute. The mother received pethidine (meperidine) two hours prior to delivery. What is the most appropriate initial management? A) A) Provide warmth, dry the infant, clear the airway if necessary, and stimulate B) B) Initiate positive pressure ventilation with bag and mask C) C) Administer naloxone D) D) Administer epinephrine Correct answer: A 8 / 30 The finding of leukocoria on eye examination of a newborn raises suspicion for all of the following conditions EXCEPT: A) A) Chorioretinitis B) B) Glaucoma C) C) Retinopathy of prematurity D) D) Cataract Correct answer: B 9 / 30 An 8-day-old newborn with a gestational age of 32 weeks develops necrotizing enterocolitis after initiation of enteral feeding. What is the most important risk factor for NEC? A) A) Intestinal mucosal injury B) B) Prematurity C) C) Infection D) D) Excessive feeding Correct answer: B 10 / 30 All of the following physical examination findings are used to assess gestational age at birth EXCEPT: A) A) Firmness of the ear cartilage B) B) Decreased skin transparency C) C) Degree of nasal development D) D) Size of breast tissue Correct answer: C 11 / 30 During routine physical examination of a normal newborn, which of the following findings requires further evaluation? A) A) Hair tuft over the lumbosacral region B) B) Bilateral subconjunctival and retinal hemorrhage C) C) Milky nipple discharge D) D) Gray, non-mobile tympanic membrane Correct answer: A 12 / 30 A newborn is born to a mother with COVID-19 infection. What is the recommended approach for diagnosing neonatal infection? A) A) Single RT-PCR within 24 hours B) B) Two RT-PCR tests at 24 and 48 hours C) C) Three RT-PCR tests at 24, 48, and 72 hours D) D) Routine testing is not required; clinical follow-up is sufficient Correct answer: B 13 / 30 A 2-day-old female newborn is brought for evaluation because of white, milky vaginal discharge mixed with streaks of blood. Which of the following statements is correct? A) A) No intervention is required B) B) Pelvic ultrasonography of the uterus and adnexa is indicated C) C) Culture and smear of the discharge should be performed D) D) Empiric antibiotic therapy without culture is indicated Correct answer: A 14 / 30 A healthy full-term newborn is delivered from a healthy mother without any delivery complications. What is the first intervention to prevent neonatal hypothermia? A) A) Immediately bathe the newborn, dry thoroughly, and place under a radiant warmer B) B) Transfer the newborn immediately to an incubator C) C) Immediately dry the newborn and cover with a warm blanket D) D) Place the newborn under a radiant warmer and perform a full examination Correct answer: C 15 / 30 A newborn weighing 2300 g is delivered vaginally and experiences shoulder dystocia. The affected upper limb is held in internal rotation, and the grasp reflex is preserved on the involved side. What is the most likely diagnosis? A) A) Total brachial plexus palsy B) B) Klumpke palsy C) C) Erb–Duchenne palsy D) D) Phrenic nerve palsy Correct answer: C 16 / 30 Prenatal ultrasonography in a pregnant woman reveals oligohydramnios. After delivery, evaluation of the newborn for which of the following conditions is most strongly indicated? A) A) Esophageal atresia B) B) Renal anomalies C) C) Duodenal atresia D) D) Cleft palate Correct answer: B 17 / 30 During physical examination of a newborn with abnormal skin coloration, which of the following findings requires further medical evaluation? A) A) Nevus simplex B) B) Nevus flammeus (port-wine stain) C) C) Mongolian spot D) D) Cavernous hemangioma Correct answer: B 18 / 30 A 28-week gestational age newborn weighing 1000 g is admitted to the NICU with a diagnosis of respiratory distress syndrome and is receiving appropriate treatment. When is the most appropriate time to perform ophthalmologic screening for retinopathy of prematurity? A) A) 2 weeks after birth B) B) 4 weeks after birth C) C) 8 weeks after birth D) D) At 36 weeks postmenstrual age Correct answer: B 19 / 30 In a term newborn with jaundice appearing within the first 24 hours of life, which of the following is the most likely cause? A) A) Physiologic jaundice B) B) Hemolysis C) C) Gilbert syndrome D) D) Breast milk jaundice Correct answer: B 20 / 30 Which of the following is NOT a cause of physiologic anemia of infancy? A) A) Rapid growth during infancy B) B) Shortened lifespan of red blood cells C) C) Increased oxygen saturation after birth D) D) Increased erythropoietin production Correct answer: D 21 / 30 A term newborn delivered vaginally from a primigravida mother develops visible jaundice involving the lower chest within the first hours after birth. The mother’s blood group is O positive and the newborn’s blood group is B positive. Which of the following maternal factors is NOT associated with the development of neonatal jaundice? A) A) Maternal dental procedures B) B) First-trimester abortion C) C) Normal pregnancy D) D) Ectopic pregnancy Correct answer: A 22 / 30 A 2-day-old newborn of a diabetic mother develops severe jaundice and experiences seizures during exchange transfusion. The blood glucose level measured by glucometer is 107 mg/dL. Seizures do not resolve after administration of intravenous calcium gluconate. What is the most appropriate next step in management? A) A) Repeat the dose of calcium gluconate B) B) Administer phenobarbital C) C) Discontinue the exchange transfusion D) D) Administer magnesium sulfate Correct answer: D 23 / 30 A term male newborn is delivered by normal vaginal delivery. The umbilical cord is clamped immediately after birth. What is the most likely complication? A) A) Anemia B) B) Cardiac murmur C) C) Impaired peripheral perfusion D) D) Increased risk of polycythemia Correct answer: D 24 / 30 Following a difficult vaginal delivery, a newborn develops a scalp swelling with the following characteristics: the swelling is located over the lateral aspect of the skull, extends across suture lines from the left parietal to the occipital region, the overlying scalp is ecchymotic, and the margins of the swelling are poorly defined. What is the most likely diagnosis? A) A) Cephalohematoma B) B) Subgaleal hemorrhage C) C) Caput succedaneum D) D) Craniotabes Correct answer: C 25 / 30 In a healthy term newborn, the first passage of urine and meconium is expected to occur within which time period after birth, respectively? A) A) 24 hours, 24 hours B) B) 48 hours, 48 hours C) C) 24 hours, 48 hours D) D) 12 hours, 24 hours Correct answer: C 26 / 30 A newborn with a gestational age of 32 weeks is born and develops apnea of prematurity starting on the second day of life. For how long can these apnea episodes persist? A) A) Up to 2 weeks B) B) 2 to 3 weeks C) C) 4 to 6 weeks D) D) 8 to 12 weeks Correct answer: C 27 / 30 A 3-day-old term newborn delivered at home is referred because of gastrointestinal bleeding. Physical examination is normal. What is the first-line treatment? A) A) Vitamin K B) B) Antibiotic therapy C) C) Omeprazole D) D) Lactulose Correct answer: A 28 / 30 Which of the following newborns is at greatest risk for developing respiratory distress syndrome? A) A) Male newborn of a diabetic mother B) B) Female newborn of a mother with eclampsia C) C) Male newborn of a mother with substance abuse D) D) Female first-born twin Correct answer: A 29 / 30 A newborn suspected of TORCH infection has microcephaly, microphthalmia, cataracts, hepatosplenomegaly, jaundice, glaucoma, chorioretinitis, and patent ductus arteriosus. Which congenital infection is most likely? A) A) Toxoplasmosis B) B) Rubella C) C) Cytomegalovirus D) D) Chlamydia trachomatis Correct answer: B 30 / 30 Phototherapy in newborns may lead to which of the following complications? A) A) Vomiting B) B) Diarrhea C) C) Gray baby syndrome D) D) Seizures Correct answer: B Your score is 0%