Question 1

What is the recommended dose of calcium supplement for a newborn?

Accepted Answer

Answer reason: Standard newborn supplementation is vitamin D 400 IU daily to support calcium metabolism; the option matching this guideline is 400 unit.

Question 2

Which of the following reflexes is considered normal in an infant?

Accepted Answer

Answer reason: A positive Babinski (toe dorsiflexion and fanning) is normal in infants due to immature corticospinal tracts. Decorticate and decerebrate posturing are pathologic, and finger flexion reflex is not a typical normal neonatal primitive reflex.

Question 3

The nurse is performing a gestational age assessment on a newborn delivered 2 hours ago. Findings compared to the Ballard scale may be affected by?

Accepted Answer

Answer reason: Ballard scoring includes neuromuscular maturity; perinatal distress/asphyxia can depress tone and reflex responses, altering the score. Birth weight, race, and birth trauma do not reliably change the gestational age markers used.

Question 4

A postpartum woman admits to alcohol use throughout the pregnancy. Which of the following newborn assessments suggests to the nurse that the infant has fetal alcohol syndrome?

Accepted Answer

Answer reason: Fetal alcohol syndrome is characterized by distinctive craniofacial features (smooth philtrum, thin upper lip, short palpebral fissures). Growth restriction and multiple anomalies can occur but are nonspecific, and prune belly syndrome is unrelated.

Question 5

What is the Apgar scoring used to appraise in a newborn infant?

Accepted Answer

Answer reason: Apgar scoring assesses five immediate neonatal parameters: heart rate, respiratory effort, muscle tone, reflex irritability, and color. Respiratory efforts are included; Rh sensitization, birth defects, and emotional stability are not part of Apgar.

Question 6

What is the typical length of a neonate?

Accepted Answer

Answer reason: Average term newborn length is about 50 cm (approximately 20 inches), making 50cm the best answer.

Question 7

A newborn weighed 7 pounds 2 ounces at birth. The nurse assesses her at home two days later and finds the weight to be 6 pounds 7 ounces. When the parents question this loss, the nurse explains that?

Accepted Answer

Answer reason: Term newborns commonly lose up to about 10% of birth weight by day 3–5 from normal diuresis and meconium loss; 7 lb 2 oz to 6 lb 7 oz is ~9.6% by day 2, which is normal.

Question 8

A neonate born 12 hours ago to a methadone maintained woman is exhibiting a hyperactive MORO reflex and slight tremors. The newborn passed one loose, watery stool. Which of the following is a nursing PRIORITY?

Accepted Answer

Answer reason: Infant of a methadone-maintained mother with hyperactive Moro, tremors, and loose stool shows signs of neonatal abstinence; the priority is to assess for NAS to guide monitoring and treatment. Comfort measures or fluids may follow, and paregoric is not first-line and requires a provider order.

Question 9

A pre-term newborn is to be fed breast milk through nasogastric tube. The nurse recognizes that breast milk is preferred to formula because it?

Accepted Answer

Answer reason: Breast milk supplies maternal antibodies that provide immune protection for preterm infants; formula does not. The other options are not accurate reasons for preference.

Question 10

First-time parents bring their 5 day-old infant to the pediatrician's office because they are extremely concerned about its breathing pattern. The nurse assesses the baby and finds that the breath sounds are clear with equal chest expansion. The respiratory rate is 38-42 breaths per minute with occasional periods of apnea lasting 10 seconds in length. The nurse's accurate analysis is?

Accepted Answer

Answer reason: Normal newborn respiratory rate is 30–60/min, and brief periodic apnea up to 15 seconds can occur. With clear breath sounds and equal chest expansion, the described pattern is normal.

Question 11

The nurse is providing instructions to a new mother on the proper techniques for breast feeding her infant. The nurse would identify the need for additional instruction if the mother stated?

Accepted Answer

Answer reason: Early pacifier use can cause nipple confusion and reduce effective breastfeeding; pacifiers should be avoided while establishing breastfeeding. The other statements reflect correct breastfeeding techniques.

Question 12

The nurse assessing a newborn notices that the breasts are enlarged bilaterally with a white, thin discharge. The INITIAL action of the nurse should be to?

Accepted Answer

Answer reason: Bilateral breast engorgement with thin white discharge (“witch’s milk”) is a normal newborn finding due to maternal hormones. The appropriate initial action is to document as normal; no culture or provider notification is indicated.

Question 13

A mother telephones the clinic and tells the nurse she is concerned because her breastfed 1 month-old has soft, yellow stools after each feeding. The nurse's BEST response would be based on the knowledge that?

Accepted Answer

Answer reason: Breastfed infants commonly pass frequent yellow to golden, soft to loose stools; this is normal and needs no supplementation or added water.

Question 14

What is the average weight of a newborn baby at birth?

Accepted Answer

Answer reason: Average full-term newborn weight is about 3.0 kg; 2500 g marks low birth weight and 4000 g indicates macrosomia. Among the options, 2950 g best represents the average.

Question 15

What is the first assessment of the newborn?

Accepted Answer

Answer reason: Immediately after birth the nurse first assesses whether the newborn has initiated effective respirations (airway and breathing). Suctioning is an intervention, and grunting or intercostal retractions are later findings of respiratory distress.

Question 16

What is the normal color of a newly born baby?

Accepted Answer

Answer reason: A healthy newborn should be pink; blue suggests cyanosis and yellow suggests jaundice.

Question 17

What is the normal respiratory rate of a newborn?

Accepted Answer

Answer reason: Normal newborn respiratory rate is 30-60 breaths/min; lower ranges fit older children/adults and higher range suggests tachypnea.

Question 18

What is the grayish white cheese-like substance that partially covers the skin at birth called?

Accepted Answer

Answer reason: Vernix caseosa is the gray-white, cheese-like protective coating on newborn skin. Lanugo is fine fetal hair; maculae and papules are lesion types.

Question 19

Normal head circumference at birth?

Accepted Answer

Answer reason: At term birth, normal head circumference averages about 35 cm, with a typical range of roughly 33–35.5 cm. This reflects normal brain and skull growth for term neonates. Values like 40 cm or 45 cm are abnormally large for a newborn, while 33 cm is at the lower limit and not the average. Therefore, 35 cm is the best single answer.

Question 20

Which of the following is not an appropriate action for tactile stimulation?

Accepted Answer

Answer reason: During initial newborn care, tactile stimulation should be gentle and limited to drying, rubbing the back, or flicking the soles/heel to prompt breathing. Slapping the sole can cause injury and is not recommended by neonatal resuscitation guidelines. Flicking the heel, rubbing the back, and drying with a towel are acceptable forms of gentle stimulation. Therefore, 'Slap the sole' is the inappropriate action.

Question 21

How many days is the Neonatal period?

Accepted Answer

Answer reason: The neonatal period is defined by WHO as from birth through the first 28 completed days of life (0–27 days inclusive). This period encompasses the critical physiologic transition to extrauterine life and carries the highest risk for morbidity and mortality. Therefore, the correct duration is 28 days.

Question 22

Ideal room temperature for a newborn is?

Accepted Answer

Answer reason: Newborns have limited thermoregulation and a high surface area-to-mass ratio, making them prone to heat loss. Maintaining an ambient temperature around 24–26°C (75–79°F) supports a thermoneutral environment. 25°C fits this range, whereas 20°C is too cool and 30°C or 37°C are excessively warm and may risk overheating.

Question 23

Weight of a newborn baby is?

Accepted Answer

Answer reason: The typical birth weight for a full-term newborn is about 2.5–4.0 kg, with an average around 3.2–3.4 kg. Weights below 2.5 kg are considered low birth weight, and above 4.0–4.5 kg indicate macrosomia. Among the given ranges, 2,5–3,5 kg best represents the normal expected range for healthy term newborns.

Question 24

Neonatal jaundice is first clinically visible on which part of the body?

Accepted Answer

Answer reason: In newborns, jaundice appears in a cephalocaudal pattern as serum bilirubin rises. The earliest clinical sign is yellowing of the face and sclera, where thin skin and high perfusion make discoloration more apparent. It then progresses to the chest, abdomen, and finally the extremities as levels increase.

Question 25

Exclusive breastfeeding should be continued for?

Accepted Answer

Answer reason: Authoritative guidelines (WHO, AAP) recommend exclusive breastfeeding for the first 6 months of life. At around 6 months, complementary foods are introduced while continuing breastfeeding. Exclusive breastfeeding for 6 months optimizes nutrition, immunity, and growth and lowers infection risk.

Question 26

Which reflex helps the neonate to turn his head to the side when the check is touched along the side of the mouth?

Accepted Answer

Answer reason: The rooting reflex is elicited by stroking the infant’s cheek near the corner of the mouth, causing the neonate to turn the head toward the stimulus and open the mouth. It facilitates feeding by helping the infant locate the nipple. The grasp reflex involves hand closure with palm stimulation, and the Moro reflex is a startle response. The sucking reflex occurs when the roof of the mouth is stimulated and does not produce head turning.

Question 27

The normal respiratory rate of a newborn is?

Accepted Answer

Answer reason: Normal resting respiratory rate for a term newborn is 30–60 breaths per minute. Rates above 60/min in a calm infant suggest tachypnea and possible respiratory distress, while rates below 30/min indicate depression. Because newborns have periodic breathing, respirations should be counted for a full minute.

Question 28

What is the normal weight of a newborn baby?

Accepted Answer

Answer reason: The typical birth weight for a term newborn is about 2.5–4.0 kg. Weights below 2.5 kg are considered low birth weight, and >4.0–4.5 kg suggests macrosomia. Among the options, 2.5 to 3.5 kg lies squarely within the normal range, while the other ranges are either too low or excessively high.

Question 29

A nurse working in the newborn nursery is caring for an infant who was born 3 hours ago. The infant's axillary temperature is 97.0F and the nurse notes that his respiratory rate is 60/minute. Which action of the nurse is most appropriate?

Accepted Answer

Answer reason: A temperature of 97.0°F in a 3‑hour‑old newborn indicates mild hypothermia, which increases oxygen consumption and can raise the respiratory rate. The priority is to prevent heat loss and rewarm the infant using environmental controls such as a radiant warmer and a hat. Oxygen is not indicated without signs of respiratory distress (grunting, flaring, retractions). Blood pressure measurement is not the priority, and checking glucose may be considered after addressing the primary problem of cold stress.

Question 30

The first urine of a newborn is passed within?

Accepted Answer

Answer reason: Most healthy term newborns void within the first 24 hours of life. Failure to pass urine by 24 hours warrants assessment for dehydration, urinary tract obstruction, or renal anomalies. While some infants may not void until later, the expected timeframe is within 24 hours.

Question 31

The color of a healthy newborn is?

Accepted Answer

Answer reason: A healthy term newborn should have a pink color centrally, reflecting adequate oxygenation and perfusion. Blue (central cyanosis) suggests hypoxemia, while pallor may indicate anemia or poor perfusion. Yellow suggests jaundice, which is abnormal in the immediate assessment. Mild acrocyanosis of hands and feet can occur, but overall color should be pink.

Question 32

APGAR score is assessed at?

Accepted Answer

Answer reason: The APGAR score is routinely performed at 1 and 5 minutes after birth to evaluate the newborn’s immediate adaptation. The 1‑minute score reflects how well the infant tolerated labor, and the 5‑minute score reflects the effectiveness of transition to extrauterine life. If the 5‑minute score is low, additional scores may be obtained at 10 minutes. Therefore, the standard assessment times are 1 and 5 minutes.

Question 33

The normal head circumference of a newborn is?

Accepted Answer

Answer reason: For a term newborn, the average occipito-frontal head circumference is about 34 cm, with a normal range of 33–35 cm when measured above the eyebrows and ears. Values like 25–30 cm suggest microcephaly, while 38 cm may indicate macrocephaly or hydrocephalus and warrant evaluation. Thus, 33–35 cm represents the expected normal range.

Question 34

Newborns should be bathed?

Accepted Answer

Answer reason: Current guidelines recommend delaying the first newborn bath for at least 24 hours. This reduces the risk of hypothermia and hypoglycemia, preserves vernix which supports skin barrier and microbial protection, and promotes early breastfeeding and bonding. Sponge cleansing of obvious contaminants can be done earlier, but routine bathing should wait until 24 hours.

Question 35

The first sign of hypothermia in newborn is?

Accepted Answer

Answer reason: Newborns do not rely on shivering for heat production; they use non‑shivering thermogenesis, so shivering is uncommon. Early hypothermia presents with peripheral vasoconstriction leading to cool extremities—classically cold feet—as the first sign. Fever is the opposite of hypothermia, and cough is unrelated. Therefore, cold feet is the earliest indicator.

Question 36

Immediate care after birth includes?

Accepted Answer

Answer reason: Immediate neonatal care prioritizes thermoregulation to prevent hypothermia. The infant should be dried and wrapped in a warm cloth or placed skin-to-skin. Bathing is delayed to avoid heat loss and to preserve protective vernix. Cow’s milk is inappropriate for newborns, and massage is not part of standard immediate post-birth care.

Question 37

The safest sleeping position for a newborn is?

Accepted Answer

Answer reason: Infants should be placed on their backs (supine) for every sleep to reduce the risk of sudden infant death syndrome (SIDS), per AAP safe sleep guidelines. Supine positioning minimizes airway obstruction and rebreathing of CO2. Prone and side positions increase SIDS risk and are not recommended. Sitting devices are unsafe for routine sleep due to risk of airway compromise and positional asphyxia.

Question 38

The umbilical cord normally falls off by?

Accepted Answer

Answer reason: After birth the umbilical stump dries, mummifies, and separates, typically within 7–10 days under normal care. Separation earlier than this (e.g., 2–5 days) is uncommon, while persistence beyond about 2 weeks may suggest delayed separation or infection. Parents are advised to keep the stump clean and dry and to report redness, foul discharge, or bleeding.

Question 39

Which vitamin is given to newborns to prevent bleeding?

Accepted Answer

Answer reason: Newborns have low vitamin K stores due to limited placental transfer and a sterile gut, which reduces synthesis of vitamin K–dependent clotting factors. An intramuscular dose of vitamin K (phytonadione) after birth prevents vitamin K deficiency bleeding by enabling activation of factors II, VII, IX, and X. Vitamins A, D, and E do not correct coagulation deficits and are not used for this prophylaxis.

Question 40

The main danger sign in newborn is?

Accepted Answer

Answer reason: In neonatal assessment, inability or poor ability to feed is a key general danger sign indicating potential sepsis, hypoglycemia, dehydration, or neurologic compromise and warrants urgent evaluation. Fever can be a danger sign but is not as consistently present in serious neonatal illness. Crying and hiccups are common, usually benign behaviors in healthy newborns.

Question 41

Rooming-in means?

Accepted Answer

Answer reason: Rooming-in refers to keeping the newborn in the same room with the mother continuously after birth. This practice promotes bonding, facilitates early and on-demand breastfeeding, and supports parental confidence in newborn care. It also reduces unnecessary nursery separation and may decrease infection risk from nursery exposure.

Question 42

Newborn’s first cry indicates?

Accepted Answer

Answer reason: The first cry reflects successful initiation of breathing and lung expansion, helping clear fetal lung fluid and establish effective ventilation. It increases oxygenation and contributes to physiologic transitions such as closure of fetal shunts. Hunger, pain, or sleepiness are not the primary indicators immediately at birth.

Question 43

A newborn is considered low birth weight if weight is below?

Accepted Answer

Answer reason: By WHO definition, low birth weight is a birth weight of less than 2,500 grams (2.5 kg) regardless of gestational age. Infants under this threshold have higher risks for morbidity such as hypothermia, hypoglycemia, and infection. Therefore, the cutoff for being considered low birth weight is below 2.5 kg.

Question 44

The best indicator of newborn health is?

Accepted Answer

Answer reason: The APGAR score assesses five critical parameters—Appearance, Pulse, Grimace, Activity, and Respiration—at 1 and 5 minutes after birth, providing a standardized composite measure of a newborn’s immediate physiologic status and adaptation to extrauterine life. It correlates with the need for resuscitation and short‑term outcomes. Weight, cry, and activity are single observations and do not capture overall cardiopulmonary and neurologic function as comprehensively as APGAR.

Question 45

A normal newborn sleeps for?

Accepted Answer

Answer reason: Healthy term newborns typically sleep a total of about 16–18 hours per 24-hour period, sometimes up to 20 hours, in short cycles of 2–4 hours. This fragmented sleep supports rapid brain growth and frequent feeding needs. Values like 5–12 hours are characteristic of older infants or children, whereas 24 hours is impossible. Thus, 16–20 hours/day best reflects normal newborn sleep duration.

Question 46

Normal temperature of a newborn is?

Accepted Answer

Answer reason: Normal axillary temperature for a term newborn is 36.5–37.5°C, which supports thermoregulation in the neutral thermal environment. Temperatures ≤36.4°C indicate hypothermia and risk for cold stress, hypoglycemia, and acidosis. A temperature of 38°C suggests fever and possible infection or dehydration. Values of 34–35°C are significantly hypothermic and unsafe.

Question 47

Kangaroo mother care is used for?

Accepted Answer

Answer reason: Kangaroo Mother Care (skin-to-skin contact) is primarily indicated for low birth weight and preterm infants who are clinically stable. It improves thermoregulation, promotes breastfeeding, and reduces infection and mortality in this group. It is not intended for unstable sick neonates, and while term infants may benefit, KMC is specifically recommended for LBW/preterm babies. It is not limited to preterm twins only.

Question 48

Weight loss after birth is normal up to?

Accepted Answer

Answer reason: Term newborns commonly lose up to about 10% of their birth weight in the first 3–5 days due to diuresis of extracellular fluid, passage of meconium, and limited early intake. Losses greater than this suggest dehydration, feeding difficulties, or illness and require evaluation. Most infants regain birth weight by 10–14 days with adequate feeding.

Question 49

Exclusive breastfeeding is recommended for?

Accepted Answer

Answer reason: Major guidelines (WHO, AAP) recommend exclusive breastfeeding for about the first 6 months of life. Exclusive means no other liquids or solids except medications or vitamins. Complementary foods are introduced around 6 months while breastfeeding continues to 12 months or longer. Two or four months are too short, and one year refers to continued breastfeeding with complementary foods, not exclusive feeding.

Question 50

Eye care after birth prevents?

Accepted Answer

Answer reason: Routine newborn eye prophylaxis with erythromycin or tetracycline ointment prevents ophthalmia neonatorum, a bacterial conjunctivitis from organisms such as Neisseria gonorrhoeae or Chlamydia trachomatis. Preventing this infection averts corneal injury that can progress to blindness, but the primary prevention target is conjunctivitis. It does not prevent respiratory problems like cough or the common cold.

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