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Maternal and Newborn Nursing · Newborn Nursing Practice Questions

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Showing all 15 practice questions with expert explanatory rationales.

Question 1 of 15

Case excerpt

A term newborn is 30 minutes old, pink centrally, and has acrocyanosis with a strong cry.

How should the nurse interpret the blue hands and feet?

A. It is a sign of respiratory arrest
B. Acrocyanosis can be an expected transitional finding when central color is pink
C. It confirms severe hypothermia
D. It requires immediate chest compressions
E. It always indicates congenital heart disease

Expert Explanatory Rationale

Correct Answer: B. Acrocyanosis can be an expected transitional finding when central color is pink

Peripheral cyanosis can occur during transition after birth; central cyanosis or respiratory distress requires urgent evaluation.

Question 2 of 15

Case excerpt

A newborn of a diabetic parent is jittery and has a weak suck two hours after birth.

Which test should the nurse anticipate?

A. Serum bilirubin only
B. Direct Coombs test only
C. Newborn hearing screen
D. Heel-stick hematocrit as the sole assessment
E. Blood glucose measurement

Expert Explanatory Rationale

Correct Answer: E. Blood glucose measurement

Infants of diabetic parents are at risk for hypoglycemia; jitteriness and poor feeding warrant prompt glucose assessment.

Question 3 of 15

Case excerpt

A newborn has a temperature of 36.1°C (97°F) after being weighed in a cool room.

Which intervention is most appropriate?

A. Place the infant near an open window
B. Give a cold bath
C. Delay warming until the next feeding
D. Provide skin-to-skin or a prewarmed radiant warmer and recheck temperature
E. Leave the infant uncovered

Expert Explanatory Rationale

Correct Answer: D. Provide skin-to-skin or a prewarmed radiant warmer and recheck temperature

Newborns lose heat rapidly. Prompt warming and reassessment help prevent cold stress and increased metabolic demand.

Question 4 of 15

Case excerpt

A 2-hour-old newborn has nasal flaring, grunting, and intercostal retractions.

What should the nurse do in this scenario: A 2-hour-old newborn has nasal flaring, grunting, and intercostal?

A. Initiate immediate respiratory assessment and escalate for neonatal support
B. Document as normal transition
C. Place the infant prone and unattended
D. Feed the infant a full bottle
E. Offer a pacifier and wait

Expert Explanatory Rationale

Correct Answer: A. Initiate immediate respiratory assessment and escalate for neonatal support

Grunting, flaring, and retractions are signs of respiratory distress and require immediate evaluation.

Question 5 of 15

Case excerpt

A newborn's axillary temperature is stable, but the infant has not passed urine by 20 hours of age.

What is the best nursing action?

A. Restrict feeding
B. Assume renal function is absent
C. Continue close intake/output assessment and notify the provider if no void by 24 hours or earlier concerns arise
D. Give water without an order
E. Insert a urinary catheter routinely

Expert Explanatory Rationale

Correct Answer: C. Continue close intake/output assessment and notify the provider if no void by 24 hours or earlier concerns arise

Most newborns void within 24 hours. Monitor and report delayed voiding according to protocol, assessing hydration and possible urinary issues.

Question 6 of 15

Case excerpt

A newborn has a yellow discoloration of the face and sclera at 18 hours of age.

Which action is indicated?

A. Promptly report and obtain bilirubin evaluation because jaundice in the first 24 hours is abnormal
B. Wait until the two-week visit
C. Place the infant in direct sunlight
D. Stop all feedings
E. Reassure the parents that all jaundice is physiologic

Expert Explanatory Rationale

Correct Answer: A. Promptly report and obtain bilirubin evaluation because jaundice in the first 24 hours is abnormal

Jaundice appearing in the first 24 hours may indicate pathologic hyperbilirubinemia and requires prompt assessment.

Question 7 of 15

Case excerpt

A parent asks why the newborn receives intramuscular vitamin K shortly after birth.

Which explanation is correct?

A. It treats neonatal jaundice
B. It replaces the first hepatitis B vaccine
C. Newborns have low vitamin K stores and need it to help prevent bleeding
D. It accelerates lung maturation
E. It prevents all bacterial infections

Expert Explanatory Rationale

Correct Answer: C. Newborns have low vitamin K stores and need it to help prevent bleeding

Vitamin K supports clotting factor production and prevents vitamin K deficiency bleeding.

Question 8 of 15

Case excerpt

A newborn is scheduled for a heel-stick blood sample.

Where should the nurse obtain the specimen?

A. Center of the heel
B. Medial or lateral plantar surface of the heel
C. Arch of the foot
D. Any toe tip
E. Posterior curvature of the heel

Expert Explanatory Rationale

Correct Answer: B. Medial or lateral plantar surface of the heel

The medial or lateral plantar heel is used to reduce risk of injury to the calcaneus and surrounding structures.

Question 9 of 15

Case excerpt

A 1-day-old newborn has a soft, flat anterior fontanel while calm and upright.

A newborn is jittery, feeding poorly, and has a low temperature. Which nursing actions are appropriate? (Select all that apply)

A. Assess temperature and provide warming
B. Delay assessment until the next routine newborn screen
C. Notify the neonatal clinician of concerning findings
D. Check blood glucose promptly
E. Evaluate feeding effectiveness

Expert Explanatory Rationale

Correct Answer: A. Assess temperature and provide warming; C. Notify the neonatal clinician of concerning findings; D. Check blood glucose promptly; E. Evaluate feeding effectiveness

Jitteriness, poor feeding, and temperature instability may indicate hypoglycemia or illness and require prompt assessment.

Question 10 of 15

Case excerpt

A newborn has a heart rate of 88/min while quietly awake and is not crying.

A newborn develops jaundice at 18 hours of age. Which actions should the nurse take? (Select all that apply)

A. Monitor for progression and follow the treatment plan
B. Obtain bilirubin testing as ordered
C. Place the newborn in direct sunlight as treatment
D. Report the early jaundice promptly
E. Assess feeding and hydration

Expert Explanatory Rationale

Correct Answer: A. Monitor for progression and follow the treatment plan; B. Obtain bilirubin testing as ordered; D. Report the early jaundice promptly; E. Assess feeding and hydration

Jaundice in the first 24 hours is abnormal and requires prompt bilirubin evaluation, feeding assessment, and monitoring.

Question 11 of 15

Case excerpt

A newborn has a cephalohematoma after a difficult vaginal birth.

A parent is preparing a safe sleep space for a newborn. Which practices should the nurse reinforce? (Select all that apply)

A. Place the infant prone after feeding for routine sleep
B. Use a firm, flat sleep surface
C. Keep pillows and loose blankets out of the sleep area
D. Use a separate sleep surface in the caregiver's room
E. Place the infant supine for sleep

Expert Explanatory Rationale

Correct Answer: B. Use a firm, flat sleep surface; C. Keep pillows and loose blankets out of the sleep area; D. Use a separate sleep surface in the caregiver's room; E. Place the infant supine for sleep

Supine sleep on a firm, flat, separate surface without soft objects is recommended to reduce sleep-related risk.

Question 12 of 15

Case excerpt

A parent is learning to position a newborn for sleep.

A newborn has grunting, nasal flaring, and intercostal retractions. Which actions are appropriate? (Select all that apply)

A. Offer a full oral feed before evaluation
B. Initiate prompt respiratory assessment
C. Monitor oxygenation and vital signs
D. Escalate for neonatal support
E. Maintain warmth while preparing for further care

Expert Explanatory Rationale

Correct Answer: B. Initiate prompt respiratory assessment; C. Monitor oxygenation and vital signs; D. Escalate for neonatal support; E. Maintain warmth while preparing for further care

Grunting, flaring, and retractions indicate respiratory distress. Assess and escalate promptly while supporting thermoregulation.

Question 13 of 15

Case excerpt

A newborn has a positive newborn screening result for a metabolic disorder, but appears well.

A parent asks how to reduce the risk of vitamin K deficiency bleeding. Which information should the nurse provide? (Select all that apply)

A. The injection replaces all newborn screening
B. Vitamin K supports normal clotting
C. Newborn stores are low at birth
D. Vitamin K is routinely offered after birth
E. The medication helps prevent serious bleeding

Expert Explanatory Rationale

Correct Answer: B. Vitamin K supports normal clotting; C. Newborn stores are low at birth; D. Vitamin K is routinely offered after birth; E. The medication helps prevent serious bleeding

Newborns have low vitamin K stores; prophylaxis supports clotting and prevents vitamin K deficiency bleeding.

Question 14 of 15

Case excerpt

Medication or fluid administration calculation in a maternal, newborn, or child-health setting.

A newborn is prescribed 60 mL of feeding over 3 hours. What is the average hourly volume in mL/hr? Enter the number only.

Expert Explanatory Rationale

Correct Answer: 20

60 mL ÷ 3 hours = 20 mL/hr.

Question 15 of 15

Case excerpt

The nurse is coordinating a time-sensitive maternal, newborn, or child-health response.

A newborn is found to have respiratory distress. Place the nursing actions in the safest order.

A. Recognize grunting, flaring, or retractions
B. Call for neonatal assistance
C. Assess airway, breathing, color, and oxygenation
D. Provide ordered respiratory support and maintain warmth
E. Reassess respiratory effort and vital signs

Expert Explanatory Rationale

Correct Answer: A. Recognize grunting, flaring, or retractions; B. Call for neonatal assistance; C. Assess airway, breathing, color, and oxygenation; D. Provide ordered respiratory support and maintain warmth; E. Reassess respiratory effort and vital signs

Recognize distress, summon help, assess the infant, provide support, and evaluate the response.

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