Pretend you are a teacher preparing a quiz for the text I will provide. 
            Each quiz question should follow the format below. 
            Ensure that you carefully recheck the questions and answers for accuracy. 
            The output should be a ready-to-use list of dictionaries for the Python eval function:

            [

                    "question": "WRITE THE QUESTION HERE",
                    "options": ["A) OPTION_1", "B) OPTION_2", "C) OPTION_3", "D) OPTION_4"],
                    "answer": INDEX_OF_CORRECT_ANSWER_IN_OPTIONS_LIST,
                    "explanation": "EXPLAIN WHY THE ANSWER IS CORRECT"

            ]

            Text:
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Pediatric Nursing 
 
 
 
 
79 
 Abdomen is protruded. 
 Extremities and muscles are thin and small. 
 Small genitalia, as male newborn have few scrotal rugae and 
testes are undescended. Female newborn has separated libia 
majora and libia minora are protruding. 
 Soles and palms have minimal creases. 
 Short and soft finger nails and toenails. 
 Premature newborn is inactive and has a weak cry with 
extremities extended.  
Hyperbilirubinemia 
 
Hyperbilirubinemia is a condition in which the bilirubin 
level in the blood is increased. It is characterized by a yellow 
discoloration of the skin, mucous membrane, sclera, and 
various organs. The yellow discoloration is caused by 
accumulation of unconjugated bilirubin in the skin. 
 
 
 
 
 
 
 
(Fig. Bilirubin Metabolism) 
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Causes of Neonatal Jaundice 
 
 
Types of Hyperbilirubinemia: 
Items 
Physiological Jaundice 
Pathological 
Jaundice 
Onset 
 Appears in the 2nd or 3rd day in 
term baby. 
 In premature baby, it appears 
after 3rd or 4th day. 
 Appears within the 1st 
day (24 hours after 
birth). 
Duration 
 In term newborn, it disappears 
by the end of 7th days while in 
premature lasts for 9 to 10 
days. 
 Needs long time to 
disappear 
Serum 
biluribin 
concentratio
n 
 Never exceeds 12 mg/dl in full-
term newborn.  
 15 mg/dl in preterm newborn 
 The direct bilirubin doesn’t 
exceed 1 mg/dl of the total 
bilirubin. 
 Serum 
bilirubin 
exceeds that level. 
 
 
Daily raise 
of bilirubin 
 Daily raise of S. bilirubin never 
exceed 5 mg/dl. 
 Serum 
bilirubin 
exceeds that. 
Treatment 
 Requires no treatment 
 Treatment is important 
as soon as possible. 
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General 
appearance 
 The newborn is good sucker, no 
anemia, not sick, normal stool, 
and urine color.  
 The 
newborn 
looks 
sick, poor sucking, 
pale, abnormal stool 
and urine color.  
Complication
s 
 No kernicterus. 
 Cause kernicterus in 
indirect 
Hyperbilruibinemia. 
 
Kernicterus: 
         It is also called the bilirubin encephalopathy and is caused 
by the deposition of the unconjugated bilirubin in the brain. This 
deposition can occur because of unconjugated bilirubin is highly 
lipid soluble making it capable of crossing the blood –brain 
barrier resulting in the yellowish staining of the brain tissue and 
the necrosis of neurons and occurs if the concentration of the 
unconjugated bilirubin reaches toxic level. 
Management of Hyperbilirubinemia:  
 Increase feeds in volume and calories. Early feeding lowers 
serum bilirubin level by stimulating the peristalsis. 
 Stop drugs interfering with bilirubin metabolism. 
 Correct hypoxia, infection, and acidosis. 
 Photothera

            Quiz: