Answer to Question 1
ANS: B
Anencephaly is the most serious neural tube defect. The infants have an intact brainstem and, if born alive, may be able to maintain vital functions for a few hours to several weeks. The family requires emotional support and counseling to cope with the birth of an infant with a fatal defect. The parents should be encouraged to hold their infant and provide comfort measures. This facilitates the grieving process because the infant has a limited life expectancy. Infants with anencephaly do not have cerebral hemispheres. There is no surgical correction available for this defect. Emotional support is needed as the family adjusts to the birth of a child who has a fatal defect.
Answer to Question 2
ANS: D
Phenobarbital is used to decrease the bilirubin level in a newborn with hemolytic disease. Phenobarbital promotes (1) hepatic glucuronyl transferase synthesis, which increases bilirubin conjugation and hepatic clearance of the pigment in bile, and (2) protein synthesis, which may increase albumin for more bilirubin binding sites. Dilantin, Depakene, and Tegretol are antiseizure medications and do not lower bilirubin levels.
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