Family Nurse Practitioner Exam

If a newborn's mother tests positive for HBsAg, what should be recommended for the infant?

1. Give the baby hepatitis B immunoglobulin

2. Give the baby both hepatitis B vaccine and hepatitis B immunoglobulin

3. Give the baby hepatitis B vaccine only

4. Send the baby home because he is not infected

The correct answer is: Give the baby both hepatitis B vaccine and hepatitis B immunoglobulin

When a newborn's mother tests positive for HBsAg, it indicates that the mother is infected with the hepatitis B virus and has the potential to transmit the virus to her infant during childbirth. To prevent vertical transmission of hepatitis B, it is critical to initiate appropriate post-exposure prophylaxis for the infant. The recommended course of action is to administer both the hepatitis B vaccine and hepatitis B immunoglobulin (HBIG) to the newborn as soon as possible, and ideally within 12 hours after birth. This combination provides immediate passive immunity through the immunoglobulin, while the vaccine prompts the infant's immune system to build its own active immunity against the virus. Administering both ensures a higher likelihood of preventing the infection and protects the infant from possible chronic hepatitis B infection later in life. This dual approach is well-established in guidelines for managing infants born to mothers who are carriers of the hepatitis B virus, reflecting the importance of prompt and comprehensive prevention strategies.