For heroin-exposed infants, withdrawal signs may present at which time?

• A. 24 to 72 hours after birth
• B. 3 to 7 days after birth
• C. 7 to 14 days after birth
• D. At birth or within 24 hours of birth

Answer: (D)

The timing concept being tested is when withdrawal signs from opioid exposure in a newborn typically begin. Heroin is a short-acting opioid, so after birth, the infant rapidly clears the drug from their system. As a result, withdrawal symptoms can start right away or within the first 24 hours after birth. This early onset is why signs may be evident at birth or within 24 hours for heroin-exposed infants. Other timeframes (like 24–72 hours, 3–7 days, or 7–14 days) are more often associated with longer-acting opioids (such as methadone) or with later-onset patterns, not the immediate onset seen with heroin exposure.