Question 1

What is the normal head circumference at birth?

Accepted Answer

Answer reason: The normal head circumference of a full-term newborn typically ranges between 33–35 cm, with 34 cm being the standard average measurement. This reflects normal brain growth and fetal development.

Question 2

The nurse assesses a newborn whose Apgar score was 8 and 9. The MOST common reason for this score is?

Accepted Answer

Answer reason: Newborns who receive Apgar scores of 8 and 9 almost always lose 1–2 points due to color, because acrocyanosis (bluish hands and feet) is extremely common in the first minutes after birth. All other parameters—heart rate, respiratory effort/cry, muscle tone, and reflex irritability—are typically normal, so color is the most frequent deduction.

Question 3

The normal average respiratory rate for a newborn is?

Accepted Answer

Answer reason: The normal respiratory rate for a full-term newborn is 30–60 breaths per minute, with ~40 breaths/min representing the typical average. This reflects the newborn’s higher metabolic demand and immature respiratory mechanics.

Question 4

Sole creases in term neonates are?

Accepted Answer

Answer reason: In term newborns, plantar creases cover the entire sole; fewer or limited creases indicate prematurity.

Question 5

What is the typical weight of a full-term baby?

Accepted Answer

Answer reason: A term newborn typically weighs about 2.5–4.0 kg, with an average near 3.3–3.5 kg; thus, 3.5 kg is correct.

Question 6

While performing an initial assessment on a newborn following a breech delivery, the nurse suspects a hip dislocation. Which of the following is most suggestive of the abnormality?

Accepted Answer

Answer reason: Developmental dysplasia of the hip commonly presents with asymmetric gluteal/thigh folds and hip asymmetry. Flexion posture is normal; a positive (not negative) Ortolani indicates dislocation, and the affected leg appears shortened—not lengthened.

Question 7

Assessment of a male newborn reveals that the infant has hypospadias. The nurse knows that?

Accepted Answer

Answer reason: In hypospadias, the foreskin may be needed for urethral reconstruction; therefore, circumcision is deferred until surgical repair is completed.

Question 8

While assessing an Rh-positive newborn whose mother is Rh-negative, the nurse recognizes the risk of hyperbilirubinemia. Which of the following should be reported immediately?

Accepted Answer

Answer reason: A positive direct Coombs’ test indicates maternal antibodies have attached to the infant’s red blood cells, leading to hemolysis and hyperbilirubinemia. This immune-mediated process can progress to kernicterus if not promptly addressed with phototherapy or exchange transfusion.

Question 9

Which physical characteristic should the nurse expect to observe in a postterm infant?

Accepted Answer

Answer reason: Postterm newborns typically have desquamation (peeling) of the skin, little vernix or lanugo, and creases over the soles. Smooth soles, abundant lanugo, and thick vernix are features of preterm infants.

Question 10

APGAR, you might also hear it referred to as an acronym for Appearance, Pulse, Grimace, Activity, and Respiration. Total APGAR score is?

Accepted Answer

Answer reason: Apgar includes five criteria, each scored 0–2, so the maximum total is 10.

Question 11

The nurse is assessing a newborn delivered at home by an admitted heroin addict. Which of the following would the nurse expect to observe?

Accepted Answer

Answer reason: Infants of heroin-dependent mothers typically develop neonatal abstinence syndrome with signs such as jitteriness, irritability, and poor feeding that appear 24–48 hours after birth. Immediate CNS depression or lethargy is less consistent with opioid withdrawal.

Question 12

What is the age range that defines a neonate?

Accepted Answer

Answer reason: A neonate is defined as a newborn from birth through 28 days of life. This period is critical for adaptation to extrauterine existence, with nursing priorities focused on thermoregulation, infection prevention, and assessment for congenital conditions.

Question 13

The neonatal period is defined as?

Accepted Answer

Answer reason: The neonatal period is defined as birth through 28 completed days of life.

Question 14

Which of the following parameters is not included in the Apgar test?

Accepted Answer

Answer reason: Apgar scoring assesses heart rate, respiratory effort, muscle tone, reflex irritability, and color. Blood pressure is not part of the Apgar test.

Question 15

The following body systems are assessed in the APGAR score, except?

Accepted Answer

Answer reason: APGAR evaluates Appearance (skin color), Pulse (heart rate), Grimace, Activity, and Respiration—covering integumentary, cardiac, and respiratory parameters. There is no discrete overall "nervous system" parameter listed in the APGAR score.

Question 16

Hypoglycemia in the newborn of a diabetic mother appears in?

Accepted Answer

Answer reason: Infants of diabetic mothers often develop hypoglycemia within the first few hours after birth (typically within 1–6 hours) due to persistent hyperinsulinemia after maternal glucose supply stops.

Question 17

The advantages of breastfeeding include the following, EXCEPT?

Accepted Answer

Answer reason: Breastfeeding promotes GI function, supports immune defense through antibodies, and is cost-effective. It does not cause nutritional imbalance; rather, it provides balanced nutrition. Thus 'Nutritional imbalance' is the exception.

Question 18

Which of the following is not a component of kangaroo mother care (KMC)?

Accepted Answer

Answer reason: KMC components include continuous skin-to-skin contact, exclusive breastfeeding, and early discharge with follow-up. Supplementary nutrition contradicts the emphasis on exclusive breastfeeding and is not a component.

Question 19

What is the average chest circumference of a normal newborn baby?

Accepted Answer

Answer reason: Normal newborn chest circumference averages about 32 cm, typically 2–3 cm less than head circumference (~35 cm).

Question 20

The mother calls the clinic to report that her newborn has a rash on his forehead and face. Which action is most appropriate?

Accepted Answer

Answer reason: Common newborn facial rashes (erythema toxicum, milia, neonatal acne) are benign and self-limited; the appropriate nursing action is reassurance and education. Soap/powder may irritate, urgent reporting is unnecessary, and family rash history is not relevant.

Question 21

How many hours can breast milk be stored at room temperature?

Accepted Answer

Answer reason: Current guidelines (CDC/AAP) state freshly expressed breast milk is safe at room temperature for up to 4 hours.

Question 22

A newborn baby under 28 days is known as?

Accepted Answer

Answer reason: The period from birth through 28 days is the neonatal period; the infant is called a neonate. Fetus and embryo refer to intrauterine stages; 'baby' is nonspecific.

Question 23

Small for gestational age newborns are at risk of difficulty maintaining body temperature because?

Accepted Answer

Answer reason: SGA infants have decreased subcutaneous fat and glycogen stores, reducing their ability to conserve heat, thus predisposing them to hypothermia.

Question 24

Caput succedaneum resolves within?

Accepted Answer

Answer reason: Caput succedaneum is scalp edema from pressure during delivery, typically resolving spontaneously within 3–4 days without treatment.

Question 25

After a lengthy labor, a primigravid client delivers a healthy newborn boy with a moderate amount of skull molding. Which of the following would the nurse include when explaining this condition to the parents?

Accepted Answer

Answer reason: Newborn skull molding from passage through the birth canal is common after prolonged labor and typically resolves spontaneously within 24–48 hours. It is not typical of breech births, is not an indication for surgery, and the other statements are not accurate.

Question 26

The appropriate approach to a neonate presenting with vaginal bleeding on day 4 of life is?

Accepted Answer

Answer reason: Physiologic neonatal vaginal bleeding around days 3–5 results from withdrawal of maternal estrogens and resolves spontaneously; no treatment is indicated.

Question 27

Breast milk stored at room temperature for?

Accepted Answer

Answer reason: For NCLEX purposes, freshly expressed breast milk may be safely kept at room temperature for up to 4 hours. Although some guidelines allow longer storage under ideal conditions, exam questions prioritize conservative safety recommendations.

Question 28

Breast milk storage in the refrigerator is up to?

Accepted Answer

Answer reason: Standard nursing teaching for expressed breast milk in a refrigerator is storage up to 24 hours; longer times apply to freezer storage.

Question 29

Distended sebaceous glands, which appear as white dots on the nose and face of a newborn?

Accepted Answer

Answer reason: Milia are small white papules on the nose and face of newborns caused by distended sebaceous glands. Mongolian spots are bluish patches on the sacrum, erythema is generalized redness, and stork bite is a pink nevus simplex.

Question 30

What does APGAR stand for?

Accepted Answer

Answer reason: APGAR is an immediate newborn assessment scoring Appearance, Pulse, Grimace, Activity, and Respiration. Only option B includes Pulse; the others incorrectly use Pressure.

Question 31

To provide immediate care to all newborns at birth, a health facility must have within its delivery room?

Accepted Answer

Answer reason: Immediate post-birth care and resuscitation are provided at a newborn care corner (NBCC) located inside the delivery room. Stabilization and special care units are separate areas, not within the delivery room, and home-based care is not a facility room.

Question 32

Most newborns pass urine during one of the following time periods?

Accepted Answer

Answer reason: About 90% of term newborns void within the first 24 hours of life; delay beyond this may indicate urinary tract or renal issues.

Question 33

Bottle-fed babies are more prone than breast-fed babies to?

Accepted Answer

Answer reason: Bottle-fed infants have higher risk of diarrhea due to possible formula/milk contamination and lack of protective immunoglobulins in breast milk.

Question 34

The slight, downy distribution of fine hair over the neonate's body is termed?

Accepted Answer

Answer reason: Lanugo is the fine, soft, downy hair that covers the fetus/newborn. Vernix caseosa is the cheesy skin coating, erythema is redness, and milia are small white papules.

Question 35

The Apgar score includes assessment of?

Accepted Answer

Answer reason: APGAR evaluates Appearance (color), Pulse, Grimace/behavioral response, Activity, and Respiration. The option listing color, behavior, and respiration best aligns with these components.

Question 36

The early neonatal period is up to how many days of life?

Accepted Answer

Answer reason: The early neonatal period is defined as the first week of life (0–7 days).

Question 37

After-birth care of the newborn's eye is by?

Accepted Answer

Answer reason: Postnatal eye prophylaxis to prevent ophthalmia neonatorum is performed using Credé’s method (instillation of 1% silver nitrate or equivalent). Option D is the agent used, but the standard procedure is termed Credé’s method.

Question 38

Which of the following is true regarding the storage of expressed breast milk?

Accepted Answer

Answer reason: Freshly expressed breast milk is generally safe at room temperature for up to about 6 hours and can be refrigerated for roughly 5–8 days; the option that best matches accepted guidance is 6 hours at room temperature and 6 days in the refrigerator.

Question 39

Phototherapy is used in the treatment of what?

Accepted Answer

Answer reason: Phototherapy converts unconjugated bilirubin in the skin to water-soluble isomers that can be excreted, which treats neonatal hyperbilirubinemia (jaundice).

Question 40

A nurse in the newborn nursery observes a yellowish skin color in an infant whose mother had a cesarean birth. What is the immediate nursing action?

Accepted Answer

Answer reason: First assess the time of onset of jaundice. Jaundice within the first 24 hours is pathologic and requires urgent evaluation; after 24 hours it is usually physiologic. Determining hours since birth directs subsequent actions.

Question 41

Objective/function of the Baby-Friendly Hospital Initiative (BFHI)?

Accepted Answer

Answer reason: The Baby-Friendly Hospital Initiative (WHO/UNICEF) primarily aims to protect, promote, and support breastfeeding. Drug therapy is unrelated, and growth promotion is a result rather than the initiative’s objective; thus 'All of above' is incorrect.

Question 42

Breastfeeding for a newborn to be started?

Accepted Answer

Answer reason: Breastfeeding should be initiated as early as possible, ideally within the first hour after birth, to promote bonding, provide colostrum, and stimulate meconium passage.

Question 43

Which of the following findings in a new born baby girl is normal?

Accepted Answer

Answer reason: Normal newborns typically pass meconium within the first 24 hours. A resting respiratory rate of 70/min is tachypnea, jaundice at 12 hours is pathologic, and umbilical bleeding is abnormal.

Question 44

Breast milk storage in a refrigerator is up to?

Accepted Answer

Answer reason: Expressed breast milk can be stored in a refrigerator for up to 24 hours per common neonatal care guidelines; longer storage increases risk of bacterial growth.

Question 45

Which of these parameters should be assessed during the first minute of life in a newborn?

Accepted Answer

Answer reason: Immediate newborn assessment at 1 minute focuses on Apgar/ABC parameters—skin color, respiratory effort, and heart rate—to determine need for resuscitation. Temperature and anthropometrics are not assessed at 1 minute.

Question 46

Identify the incorrect statement related to mongolian spot in new-born baby-?

Accepted Answer

Answer reason: Mongolian spots are benign, flat gray-blue/black macules common in darker-skinned newborns, usually on the sacral area, and fade over time. They are not signs of abuse; they may be mistaken for bruises. Thus the statement that they indicate abuse is incorrect.

Question 47

Which of the following is not a component of Kangaroo mother care (KMC)?

Accepted Answer

Answer reason: KMC components include continuous skin-to-skin contact, exclusive breastfeeding, and early discharge with close follow-up. Supplementary nutrition contradicts exclusive breastfeeding and is not a standard KMC component.

Question 48

Normal HR in a newborn?

Accepted Answer

Answer reason: Normal resting heart rate for a newborn is approximately 120–160 beats per minute; values lower or higher indicate bradycardia or tachycardia.

Question 49

All of the following are features of prematurity in a neonate, except?

Accepted Answer

Answer reason: Preterm neonates typically have scant/no plantar creases, abundant lanugo, soft pliable ear cartilage with poor recoil, and undescended testes resulting in an empty scrotum. Thick ear cartilage indicates maturity, so it is the exception.

Question 50

Which of the following is considered as normal for the neonate?

Accepted Answer

Answer reason: Normal neonatal head circumference is about 33–35 cm (13–14 inches). The other ranges are incorrect: normal birth weight is ~2500–4000 g, length ~18–22 inches (not as low as 16), and chest circumference ~12–13 inches—not as low as 10.

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