BTSC Staff Nurse 1 August-2025
Child Health Nursing (Pediatrics)
Easy
Which of the following is a characteristic feature of pathological jaundice?
Appeared in: BTSC Staff Nurse 1 August-2025
Explanation
- A total serum bilirubin (TSB) level exceeding 15 mg/dL in a term neonate is a key indicator of pathological jaundice.
- This level of hyperbilirubinemia is outside the normal range for physiological jaundice and suggests an underlying pathology.
- Such a high level requires prompt investigation into the cause (e.g., hemolysis, infection, metabolic disorders) and management to prevent bilirubin-induced neurologic dysfunction (kernicterus).
Why Other Options Were Wrong
- Option A: This describes the typical onset of physiological jaundice, which is a benign condition resulting from the immaturity of the newborn's liver.
- Option C: The peak of bilirubin levels on the 4th or 5th day is a hallmark of physiological jaundice as the liver's conjugation ability matures.
- Option D: This describes the expected resolution time for physiological jaundice in a term infant. Pathological jaundice is defined by its persistence beyond this period.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Distinguishing between physiological and pathological jaundice in neonates as background academic context rather than a clinical decision trigger.
- Early and accurate differentiation between physiological and pathological jaundice is a critical nursing responsibility to prevent kernicterus, a form of permanent brain damage caused by excessive bilirubin.
- Nursing interventions for neonatal jaundice include frequent monitoring of skin color and bilirubin levels (transcutaneous or serum), ensuring adequate hydration and feeding to promote bilirubin excretion, and administering phototherapy as prescribed.
- What if? If jaundice is noted at 18 hours of age, it is immediately considered pathological, regardless of the bilirubin level. This finding requires urgent investigation for causes like hemolysis (e.g., ABO/Rh incompatibility) or sepsis.
How to Approach the Question
- First, identify that the question asks for a specific feature of pathological jaundice, which is the abnormal or disease-related form.
- Recall the key differences between physiological (normal) and pathological (abnormal) jaundice in newborns.
- Evaluate each option against the criteria for pathological jaundice: onset within 24 hours, TSB greater than 15 mg/dL, rapid rise in TSB, and persistence beyond 14 days.
- Eliminate the options that describe physiological jaundice. Options A, C, and D all describe the typical course of physiological jaundice.
- Select the option that correctly identifies a criterion for pathological jaundice, which is a significantly elevated bilirubin level.
Concept Tested & Keywords
- Concept Tested: Distinguishing between physiological and pathological jaundice in neonates.
- Stem keywords: pathological jaundice, characteristic feature, neonate
- Lead-in keywords: Which
- Negative lead-in flag: false
Question ID
QuTuv8WkainvK10m2sBlMc
Reference Book
E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 1120-1122
E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 168-170
Practise the full BTSC Staff Nurse 1 August-2025
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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