NR 327 MATERNAL-CHILD HEALTH NURSING NEWBORN
ASSESSMENT EXAM SCRIPT FINAL PAPER 2026/2027
SOLVED
Comprehensive Newborn Assessment & Nursing Management | Key Domains: Immediate
Newborn Transition & Stabilization, Apgar Scoring, Gestational Age Assessment (Ballard),
Comprehensive Physical Assessment (Vital Signs, Reflexes, Systems), Identification of
Normal vs. Abnormal Findings, Newborn Nutrition (Breastfeeding/Bottle-feeding),
Common Newborn Conditions (Jaundice, Hypoglycemia), and Parental Education &
Bonding | Expert-Aligned Structure | Solved Exam Script Format
Introduction
This structured NR 327 Newborn Assessment Final Paper for 2026/2027 provides a
complete solved exam script, including questions, correct answers, and rationales. It is
designed to test and reinforce mastery of systematic newborn assessment, interpretation of
findings, identification of priorities, and the delivery of safe, evidence-based care to the
neonate and family in the immediate postpartum period.
Exam Structure:
• Solved Final Exam Script: (60 COMPREHENSIVE QUESTIONS)
Answer Format
All correct answers must appear in bold and cyan blue, accompanied by concise rationales
explaining the physiological rationale for a normal assessment finding, the clinical
implication of an abnormal finding that requires intervention (e.g., choanal atresia, Erb's
palsy), the correct sequence of assessment steps, the appropriate nursing action based on
assessment data, and why alternative answers are incorrect or represent a
misunderstanding of newborn physiology or assessment protocol.
1.
,Immediately after birth, the nurse notes the newborn has acrocyanosis. What is the nurse’s
best action?
A) Administer oxygen via nasal cannula
B) Begin positive pressure ventilation
C) Continue routine care and monitor
D) Notify the provider immediately
C) Continue routine care and monitor
Acrocyanosis (blue hands and feet with pink trunk) is a normal finding in the first 24–48
hours due to immature peripheral circulation and vasomotor instability. It does not require
oxygen, resuscitation, or provider notification unless central cyanosis is present.
2.
A newborn’s 1-minute Apgar score is 8. Which finding contributed to this score?
A) Central and peripheral cyanosis
B) Heart rate of 80 beats per minute
C) Weak cry and flexed arms
D) Pink body with blue extremities, strong cry, HR 120, active motion, grimace to
stimulation
D) Pink body with blue extremities, strong cry, HR 120, active motion, grimace to
stimulation
This combination yields: Appearance = 1 (acrocyanosis), Pulse = 2 (HR >100), Grimace = 2,
Activity = 2, Respiration = 2 → Total = 9. However, if appearance is scored as 1 (which is
,typical for acrocyanosis), total is 8–9. Option D best describes a healthy transition. Options A,
B, and C reflect lower scores due to poor oxygenation, bradycardia, or weak tone.
3.
Which assessment finding indicates effective thermoregulation in the newborn?
A) Axillary temperature of 36.2°C (97.2°F)
B) Capillary refill of 4 seconds
C) Axillary temperature of 37.0°C (98.6°F)
D) Cool, mottled skin
C) Axillary temperature of 37.0°C (98.6°F)
Normal newborn axillary temperature ranges from 36.5°C to 37.5°C (97.7°F–99.5°F). A
temperature of 37.0°C is within range. 36.2°C (A) indicates hypothermia. Capillary refill >3 sec
(B) and mottling (D) suggest poor perfusion or cold stress.
4.
The nurse is assessing gestational age using the Ballard Score. Which physical sign is
consistent with a term newborn (39–40 weeks)?
A) Smooth, shiny skin with abundant lanugo
B) Breast bud less than 3 mm
C) Plantar creases covering the entire sole
D) Ear pinna flat and slow to recoil
C) Plantar creases covering the entire sole
, Full plantar creases are a sign of term maturity. Preterm infants have creases only on the
anterior portion. Smooth skin with lanugo (A), small breast buds (B), and floppy ears (D) are
signs of prematurity.
5.
A newborn exhibits asymmetric Moro reflex—arms extend but only one arm flexes back.
What condition should the nurse suspect?
A) Cerebral palsy
B) Erb’s palsy
C) Down syndrome
D) Hydrocephalus
B) Erb’s palsy
Asymmetric Moro reflex suggests brachial plexus injury, commonly Erb’s palsy (C5–C6 nerve
damage), often from shoulder dystocia during birth. The affected arm remains extended and
internally rotated (“waiter’s tip”). Cerebral palsy (A) presents later; Down syndrome (C) shows
hypotonia; hydrocephalus (D) causes bulging fontanelle.
6.
Which finding during newborn head assessment requires further evaluation?
A) Caput succedaneum
B) Cephalohematoma
C) Sunken anterior fontanelle
D) Molding
ASSESSMENT EXAM SCRIPT FINAL PAPER 2026/2027
SOLVED
Comprehensive Newborn Assessment & Nursing Management | Key Domains: Immediate
Newborn Transition & Stabilization, Apgar Scoring, Gestational Age Assessment (Ballard),
Comprehensive Physical Assessment (Vital Signs, Reflexes, Systems), Identification of
Normal vs. Abnormal Findings, Newborn Nutrition (Breastfeeding/Bottle-feeding),
Common Newborn Conditions (Jaundice, Hypoglycemia), and Parental Education &
Bonding | Expert-Aligned Structure | Solved Exam Script Format
Introduction
This structured NR 327 Newborn Assessment Final Paper for 2026/2027 provides a
complete solved exam script, including questions, correct answers, and rationales. It is
designed to test and reinforce mastery of systematic newborn assessment, interpretation of
findings, identification of priorities, and the delivery of safe, evidence-based care to the
neonate and family in the immediate postpartum period.
Exam Structure:
• Solved Final Exam Script: (60 COMPREHENSIVE QUESTIONS)
Answer Format
All correct answers must appear in bold and cyan blue, accompanied by concise rationales
explaining the physiological rationale for a normal assessment finding, the clinical
implication of an abnormal finding that requires intervention (e.g., choanal atresia, Erb's
palsy), the correct sequence of assessment steps, the appropriate nursing action based on
assessment data, and why alternative answers are incorrect or represent a
misunderstanding of newborn physiology or assessment protocol.
1.
,Immediately after birth, the nurse notes the newborn has acrocyanosis. What is the nurse’s
best action?
A) Administer oxygen via nasal cannula
B) Begin positive pressure ventilation
C) Continue routine care and monitor
D) Notify the provider immediately
C) Continue routine care and monitor
Acrocyanosis (blue hands and feet with pink trunk) is a normal finding in the first 24–48
hours due to immature peripheral circulation and vasomotor instability. It does not require
oxygen, resuscitation, or provider notification unless central cyanosis is present.
2.
A newborn’s 1-minute Apgar score is 8. Which finding contributed to this score?
A) Central and peripheral cyanosis
B) Heart rate of 80 beats per minute
C) Weak cry and flexed arms
D) Pink body with blue extremities, strong cry, HR 120, active motion, grimace to
stimulation
D) Pink body with blue extremities, strong cry, HR 120, active motion, grimace to
stimulation
This combination yields: Appearance = 1 (acrocyanosis), Pulse = 2 (HR >100), Grimace = 2,
Activity = 2, Respiration = 2 → Total = 9. However, if appearance is scored as 1 (which is
,typical for acrocyanosis), total is 8–9. Option D best describes a healthy transition. Options A,
B, and C reflect lower scores due to poor oxygenation, bradycardia, or weak tone.
3.
Which assessment finding indicates effective thermoregulation in the newborn?
A) Axillary temperature of 36.2°C (97.2°F)
B) Capillary refill of 4 seconds
C) Axillary temperature of 37.0°C (98.6°F)
D) Cool, mottled skin
C) Axillary temperature of 37.0°C (98.6°F)
Normal newborn axillary temperature ranges from 36.5°C to 37.5°C (97.7°F–99.5°F). A
temperature of 37.0°C is within range. 36.2°C (A) indicates hypothermia. Capillary refill >3 sec
(B) and mottling (D) suggest poor perfusion or cold stress.
4.
The nurse is assessing gestational age using the Ballard Score. Which physical sign is
consistent with a term newborn (39–40 weeks)?
A) Smooth, shiny skin with abundant lanugo
B) Breast bud less than 3 mm
C) Plantar creases covering the entire sole
D) Ear pinna flat and slow to recoil
C) Plantar creases covering the entire sole
, Full plantar creases are a sign of term maturity. Preterm infants have creases only on the
anterior portion. Smooth skin with lanugo (A), small breast buds (B), and floppy ears (D) are
signs of prematurity.
5.
A newborn exhibits asymmetric Moro reflex—arms extend but only one arm flexes back.
What condition should the nurse suspect?
A) Cerebral palsy
B) Erb’s palsy
C) Down syndrome
D) Hydrocephalus
B) Erb’s palsy
Asymmetric Moro reflex suggests brachial plexus injury, commonly Erb’s palsy (C5–C6 nerve
damage), often from shoulder dystocia during birth. The affected arm remains extended and
internally rotated (“waiter’s tip”). Cerebral palsy (A) presents later; Down syndrome (C) shows
hypotonia; hydrocephalus (D) causes bulging fontanelle.
6.
Which finding during newborn head assessment requires further evaluation?
A) Caput succedaneum
B) Cephalohematoma
C) Sunken anterior fontanelle
D) Molding
