# Situation: A nurse at a lying-in clinic prepares mothers and their healthy term newborns for discharge and follows them up by telephone and home visits during the first weeks after birth. According to the National Immunization Program (NIP), within what time after birth should a healthy term newborn whose mother is negative for hepatitis B surface antigen receive the hepatitis B birth dose?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=629626  
> language: ko  
> subject: Nursing Practice II — Maternal and Child Health Nursing

## 문제

Situation: A nurse at a lying-in clinic prepares mothers and their healthy term newborns for discharge and follows them up by telephone and home visits during the first weeks after birth.

According to the National Immunization Program (NIP), within what time after birth should a healthy term newborn whose mother is negative for hepatitis B surface antigen receive the hepatitis B birth dose?

## 보기

1. Within 12 hours of birth
2. Within 24 hours of birth **✔ 정답**
3. Within 7 days of birth
4. At 6 weeks, with the first pentavalent dose

**정답: 2**

## 해설

The Mandatory Infants and Children Health Immunization Act (RA 10152) and the NIP require the hepatitis B birth dose within 24 hours of birth. The 12-hour limit applies to vaccine plus hepatitis B immune globulin for infants of HBsAg-positive mothers.

## 심화 해설

Timing of the hepatitis B birth dose
The Mandatory Infants and Children Health Immunization Act of 2011 (RA 10152) and the National Immunization Program (NIP) require the hepatitis B birth dose to be given within 24 hours of birth. This applies to every newborn, including a healthy term infant whose mother is negative for hepatitis B surface antigen (HBsAg). The healthy term newborn of an HBsAg-negative mother receives the hepatitis B birth dose within 24 hours of birth.

Why the birth dose is given so early
Hepatitis B virus can be passed from mother to child at birth, and infants infected at this age have a very high risk of becoming chronically infected, which can lead to cirrhosis and liver cancer later in life. A mother's HBsAg test may be unknown, falsely negative, or done early in pregnancy, and infection can also spread through close household contact. Giving the vaccine to every newborn within 24 hours provides early protection regardless of these uncertainties. The sooner it is given, the better its protection.

Where the 12-hour limit comes from
Watch out! The 12-hour limit is a real rule, but it applies to infants of HBsAg-positive mothers, who receive hepatitis B vaccine plus hepatitis B immune globulin (HBIG) within 12 hours of birth. This infant's mother is HBsAg-negative, so the standard 24-hour rule applies.

| Situation | Timing |
| --- | --- |
| Mother HBsAg-negative | Hepatitis B vaccine within 24 hours of birth |
| Mother HBsAg-positive | Vaccine plus HBIG within 12 hours of birth |
| Later doses in the NIP | Within the pentavalent vaccine at 6, 10, and 14 weeks |

Why the other options are wrong
Seven days is a limit that relates to HBIG for some heavier infants of mothers found positive later, not the birth-dose rule. Waiting until 6 weeks to give hepatitis B within the first pentavalent dose is also wrong; the pentavalent vaccine contains hepatitis B antigen, but it does not replace the birth dose, which protects the infant during the first weeks of life.

Exam takeaway
Every newborn gets the hepatitis B birth dose within 24 hours; infants of HBsAg-positive mothers also get HBIG within 12 hours. Key point! Before discharge from a lying-in clinic, the nurse checks that the birth dose has been given and recorded on the infant's card.

## 임상 시나리오

Hepatitis B Birth DoseHealthy term newborn of an HBsAg-negative mother
Under RA 10152 and the NIP, give the hepatitis B birth dose within 24 hours of birth.

Infants of HBsAg-positive mothers receive vaccine plus HBIG within 12 hours.

Later hepatitis B doses are given within the pentavalent vaccine at 6, 10, and 14 weeks; record the birth dose before discharge.

CautionThe pentavalent vaccine at 6 weeks does not replace the birth dose.

## 핵심 개념

- **Hepatitis B birth dose** — The first hepatitis B vaccine, given within 24 hours of birth to prevent early infection.
- **HBsAg** — Hepatitis B surface antigen, a blood marker showing current hepatitis B infection.
- **Hepatitis B immune globulin** — Antibodies given with the vaccine to infants of HBsAg-positive mothers for immediate protection.
- **RA 10152** — The Mandatory Infants and Children Health Immunization Act of 2011, requiring basic immunization for children.

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