Newborn Transition: Exam 1 - Questions with Correct Answers
100 questions
1. Delayed cord clamping in a term newborn increases:
A. Placental transfusion, improving iron stores and blood volume
B. The risk of hypothermia in all cases
C. Rates of cerebral palsy
D. Lung fluid
Correct Answer: A. Placental transfusion, improving iron stores and blood volume
Rationale: Additional blood from the placenta improves iron status in infancy and supports
transition. It may modestly increase jaundice but does not cause cerebral palsy.
2. The umbilical cord normally contains:
A. Two arteries and one vein
B. One artery and two veins
C. Three arteries
D. Two veins only
Correct Answer: A. Two arteries and one vein
Rationale: The two umbilical arteries carry deoxygenated blood to the placenta, and the single
vein carries oxygenated blood to the fetus. A two-vessel cord may be associated with other
anomalies.
3. The umbilical vein carries:
A. Deoxygenated blood from the fetus to the placenta
B. Urine to the placenta
C. Lymph to the fetus
D. Oxygenated, nutrient-rich blood from the placenta to the fetus
Correct Answer: D. Oxygenated, nutrient-rich blood from the placenta to the fetus
Rationale: Unlike adult veins, the umbilical vein carries the most oxygenated blood. The arteries
carry deoxygenated blood away from the fetus.
,4. A newborn whose oxygen saturation rises quickly with crying but drops at rest may have:
A. Normal transition in all infants
B. High surfactant
C. A closed ductus
D. Hypoventilation at rest or a condition affecting breathing that warrants assessment
Correct Answer: D. Hypoventilation at rest or a condition affecting breathing that warrants
assessment
Rationale: Crying improves ventilation and can temporarily raise saturation, while unstable
saturation at rest suggests a problem. Further evaluation is needed.
5. A newborn's respiratory rate should be counted:
A. For 10 seconds and multiplied by 6
B. Only while the infant is crying
C. Only by pulse oximeter
D. For a full minute by observing abdominal movement while the infant is quiet
Correct Answer: D. For a full minute by observing abdominal movement while the infant is
quiet
Rationale: Irregular breathing requires a full minute for accuracy. Crying alters the rate, and
oximeters do not count breaths.
6. Clamping the umbilical cord increases systemic vascular resistance because:
A. Lung resistance rises
B. The low-resistance placental circulation is removed
C. The ductus venosus opens
D. The heart stops
Correct Answer: B. The low-resistance placental circulation is removed
Rationale: Removing the placenta raises systemic resistance and left-sided pressures, helping
close fetal shunts. Pulmonary resistance falls at the same time.
,7. Oxygen saturation in a healthy newborn after birth:
A. Is 100 percent immediately at birth
B. Rises gradually, reaching about 85 to 95 percent by 10 minutes of age
C. Stays at 60 percent for the first day
D. Falls steadily after birth
Correct Answer: B. Rises gradually, reaching about 85 to 95 percent by 10 minutes of age
Rationale: Saturation starts low and increases over the first minutes as the lungs aerate, so
targets are time-specific. Immediate 100 percent is not expected.
8. Effective transition is indicated by a newborn who has:
A. Gasping respirations
B. Heart rate below 60
C. Regular breathing, heart rate above 100, improving color and good tone
D. Persistent central cyanosis
Correct Answer: C. Regular breathing, heart rate above 100, improving color and good tone
Rationale: These signs show successful cardiopulmonary adaptation. Gasping, bradycardia and
central cyanosis require intervention.
9. Nonshivering thermogenesis in newborns involves:
A. Rapid muscle shivering
B. Sweating
C. Increased crying only
D. Metabolism of brown adipose tissue to produce heat
Correct Answer: D. Metabolism of brown adipose tissue to produce heat
Rationale: Brown fat contains many mitochondria and generates heat when stimulated by
norepinephrine. Shivering is minimal in newborns, and sweating cools rather than warms.
, 10. Warming the heel before a heel stick helps by:
A. Increasing blood flow for easier sampling
B. Preventing infection
C. Lowering glucose
D. Increasing pain
Correct Answer: A. Increasing blood flow for easier sampling
Rationale: Warmth dilates vessels, making collection easier. It does not prevent infection or
alter glucose.
11. Heat loss by evaporation occurs when:
A. The infant is placed on a cold scale
B. Cold air blows over the infant
C. The infant is near a cold window without touching it
D. Amniotic fluid or bath water evaporates from the newborn's wet skin
Correct Answer: D. Amniotic fluid or bath water evaporates from the newborn's wet skin
Rationale: Drying the infant immediately after birth and after bathing reduces evaporative loss.
The other options describe conduction, convection and radiation.
12. Humidified incubators are used for extremely preterm infants mainly to:
A. Increase oxygen levels
B. Reduce transepidermal water loss and help maintain temperature
C. Prevent jaundice
D. Speed up feeding
Correct Answer: B. Reduce transepidermal water loss and help maintain temperature
Rationale: Very immature skin loses large amounts of water and heat, and humidity reduces
these losses. It does not deliver oxygen or treat jaundice.
100 questions
1. Delayed cord clamping in a term newborn increases:
A. Placental transfusion, improving iron stores and blood volume
B. The risk of hypothermia in all cases
C. Rates of cerebral palsy
D. Lung fluid
Correct Answer: A. Placental transfusion, improving iron stores and blood volume
Rationale: Additional blood from the placenta improves iron status in infancy and supports
transition. It may modestly increase jaundice but does not cause cerebral palsy.
2. The umbilical cord normally contains:
A. Two arteries and one vein
B. One artery and two veins
C. Three arteries
D. Two veins only
Correct Answer: A. Two arteries and one vein
Rationale: The two umbilical arteries carry deoxygenated blood to the placenta, and the single
vein carries oxygenated blood to the fetus. A two-vessel cord may be associated with other
anomalies.
3. The umbilical vein carries:
A. Deoxygenated blood from the fetus to the placenta
B. Urine to the placenta
C. Lymph to the fetus
D. Oxygenated, nutrient-rich blood from the placenta to the fetus
Correct Answer: D. Oxygenated, nutrient-rich blood from the placenta to the fetus
Rationale: Unlike adult veins, the umbilical vein carries the most oxygenated blood. The arteries
carry deoxygenated blood away from the fetus.
,4. A newborn whose oxygen saturation rises quickly with crying but drops at rest may have:
A. Normal transition in all infants
B. High surfactant
C. A closed ductus
D. Hypoventilation at rest or a condition affecting breathing that warrants assessment
Correct Answer: D. Hypoventilation at rest or a condition affecting breathing that warrants
assessment
Rationale: Crying improves ventilation and can temporarily raise saturation, while unstable
saturation at rest suggests a problem. Further evaluation is needed.
5. A newborn's respiratory rate should be counted:
A. For 10 seconds and multiplied by 6
B. Only while the infant is crying
C. Only by pulse oximeter
D. For a full minute by observing abdominal movement while the infant is quiet
Correct Answer: D. For a full minute by observing abdominal movement while the infant is
quiet
Rationale: Irregular breathing requires a full minute for accuracy. Crying alters the rate, and
oximeters do not count breaths.
6. Clamping the umbilical cord increases systemic vascular resistance because:
A. Lung resistance rises
B. The low-resistance placental circulation is removed
C. The ductus venosus opens
D. The heart stops
Correct Answer: B. The low-resistance placental circulation is removed
Rationale: Removing the placenta raises systemic resistance and left-sided pressures, helping
close fetal shunts. Pulmonary resistance falls at the same time.
,7. Oxygen saturation in a healthy newborn after birth:
A. Is 100 percent immediately at birth
B. Rises gradually, reaching about 85 to 95 percent by 10 minutes of age
C. Stays at 60 percent for the first day
D. Falls steadily after birth
Correct Answer: B. Rises gradually, reaching about 85 to 95 percent by 10 minutes of age
Rationale: Saturation starts low and increases over the first minutes as the lungs aerate, so
targets are time-specific. Immediate 100 percent is not expected.
8. Effective transition is indicated by a newborn who has:
A. Gasping respirations
B. Heart rate below 60
C. Regular breathing, heart rate above 100, improving color and good tone
D. Persistent central cyanosis
Correct Answer: C. Regular breathing, heart rate above 100, improving color and good tone
Rationale: These signs show successful cardiopulmonary adaptation. Gasping, bradycardia and
central cyanosis require intervention.
9. Nonshivering thermogenesis in newborns involves:
A. Rapid muscle shivering
B. Sweating
C. Increased crying only
D. Metabolism of brown adipose tissue to produce heat
Correct Answer: D. Metabolism of brown adipose tissue to produce heat
Rationale: Brown fat contains many mitochondria and generates heat when stimulated by
norepinephrine. Shivering is minimal in newborns, and sweating cools rather than warms.
, 10. Warming the heel before a heel stick helps by:
A. Increasing blood flow for easier sampling
B. Preventing infection
C. Lowering glucose
D. Increasing pain
Correct Answer: A. Increasing blood flow for easier sampling
Rationale: Warmth dilates vessels, making collection easier. It does not prevent infection or
alter glucose.
11. Heat loss by evaporation occurs when:
A. The infant is placed on a cold scale
B. Cold air blows over the infant
C. The infant is near a cold window without touching it
D. Amniotic fluid or bath water evaporates from the newborn's wet skin
Correct Answer: D. Amniotic fluid or bath water evaporates from the newborn's wet skin
Rationale: Drying the infant immediately after birth and after bathing reduces evaporative loss.
The other options describe conduction, convection and radiation.
12. Humidified incubators are used for extremely preterm infants mainly to:
A. Increase oxygen levels
B. Reduce transepidermal water loss and help maintain temperature
C. Prevent jaundice
D. Speed up feeding
Correct Answer: B. Reduce transepidermal water loss and help maintain temperature
Rationale: Very immature skin loses large amounts of water and heat, and humidity reduces
these losses. It does not deliver oxygen or treat jaundice.
