2026 Newborn RN CMS: Comprehensive
Practice Questions &
Rationales Comprehensive Questions and
Answers with Rationales | 2026 Update |
100% Correct.
Newborn Assessment & APGAR Scoring
1. A nurse is assessing a newborn 1 minute after birth. The newborn has a heart
rate of 110 bpm, a strong cry, active movement, cries when the soles of the
feet are stimulated, and has a pink body with blue extremities. What APGAR
score should the nurse assign?
A. 7
B. 8
C. 9
D. 10
Correct Answer: B. 8
Rationale: The APGAR score is assessed at 1 and 5 minutes after birth and
evaluates five categories: heart rate, respiratory effort, muscle tone, reflex
irritability, and color. Each category is scored 0, 1, or 2. This newborn has a heart
rate of 110 bpm (score 2), strong cry (score 2), active movement (score 2), cries
with stimulation (score 2), and pink body with blue extremities (score 1 for
acrocyanosis). Total score = 2+2+2+2+1 = 8. A score of 7-10 indicates the newborn
,is in good condition. Option A (7) is incorrect because it underestimates the score.
Option C (9) would require a color score of 2 (completely pink). Option D (10)
requires a perfect score in all categories.
2. A nurse is assessing a newborn 5 minutes after birth. The newborn's heart
rate is 90 bpm, respirations are slow and irregular, muscle tone is some
flexion, reflex irritability shows a grimace, and the newborn is pale all over.
What APGAR score should the nurse assign?
A. 3
B. 4
C. 5
D. 6
Correct Answer: B. 4
Rationale: APGAR scoring: Heart rate 90 bpm = 1 point (below 100 but above 0).
Respiratory effort slow/irregular = 1 point. Muscle tone some flexion = 1 point.
Reflex irritability grimace = 1 point. Color pale all over = 0 points. Total = 4. A score
of 4 indicates the newborn is in fair condition and requires resuscitation. Option A
(3) is too low. Option C (5) and Option D (6) overestimate the score. This newborn
requires immediate intervention.
,3. A nurse is preparing to administer the APGAR assessment. Which of the
following is the correct timing for this assessment?
A. Immediately after birth and at 10 minutes of life
B. At 1 minute and 5 minutes after birth
C. At 5 minutes and 10 minutes after birth
D. Only at 1 minute after birth
Correct Answer: B. At 1 minute and 5 minutes after birth
Rationale: The APGAR score is routinely performed at 1 minute and 5 minutes after
birth. The 1-minute score reflects how well the newborn tolerated the birth
process, while the 5-minute score indicates how well the newborn is adapting to
extrauterine life. If the 5-minute score is less than 7, additional scoring should be
done at 10-minute intervals. Option A is incorrect because 10 minutes is only used
if the 5-minute score is low. Option C is incorrect because the first assessment is
at 1 minute. Option D is incorrect because only performing it at 1 minute does not
provide adequate information about adaptation.
4. A nurse is assessing a newborn's reflexes. Which of the following findings
would indicate an abnormal Moro reflex?
A. The newborn extends arms and legs symmetrically and then brings them back in
B. The newborn's arms and legs extend asymmetrically
C. The newborn flexes arms and legs toward the body
D. The newborn remains still with no movement
, Correct Answer: B. The newborn's arms and legs extend asymmetrically
Rationale: The Moro reflex (startle reflex) is elicited by startling the newborn. The
expected response is symmetric extension and abduction of the arms and legs,
followed by flexion and adduction (bringing them back to the body). An asymmetric
response may indicate a fractured clavicle, brachial plexus injury (Erb's palsy), or
other neurologic impairment. Option A describes a normal Moro reflex. Option C
describes a flexion response, which is not the Moro reflex. Option D describes no
response, which could indicate neurologic depression but asymmetry is more
specific for injury.
5. A nurse is assessing the fontanels of a full-term newborn. Which finding is
considered normal?
A. Anterior fontanel is triangular and closes by 2 months
B. Posterior fontanel is diamond-shaped and closes by 12-18 months
C. Anterior fontanel is diamond-shaped and closes by 12-18 months
D. Both fontanels are closed at birth
Correct Answer: C. Anterior fontanel is diamond-shaped and closes by 12-18
months
Rationale: The anterior fontanel is diamond-shaped and typically closes between
12-18 months of age. The posterior fontanel is triangular and closes by 2-3 months
of age. Fontanels should be soft and flat; a bulging fontanel indicates increased
Practice Questions &
Rationales Comprehensive Questions and
Answers with Rationales | 2026 Update |
100% Correct.
Newborn Assessment & APGAR Scoring
1. A nurse is assessing a newborn 1 minute after birth. The newborn has a heart
rate of 110 bpm, a strong cry, active movement, cries when the soles of the
feet are stimulated, and has a pink body with blue extremities. What APGAR
score should the nurse assign?
A. 7
B. 8
C. 9
D. 10
Correct Answer: B. 8
Rationale: The APGAR score is assessed at 1 and 5 minutes after birth and
evaluates five categories: heart rate, respiratory effort, muscle tone, reflex
irritability, and color. Each category is scored 0, 1, or 2. This newborn has a heart
rate of 110 bpm (score 2), strong cry (score 2), active movement (score 2), cries
with stimulation (score 2), and pink body with blue extremities (score 1 for
acrocyanosis). Total score = 2+2+2+2+1 = 8. A score of 7-10 indicates the newborn
,is in good condition. Option A (7) is incorrect because it underestimates the score.
Option C (9) would require a color score of 2 (completely pink). Option D (10)
requires a perfect score in all categories.
2. A nurse is assessing a newborn 5 minutes after birth. The newborn's heart
rate is 90 bpm, respirations are slow and irregular, muscle tone is some
flexion, reflex irritability shows a grimace, and the newborn is pale all over.
What APGAR score should the nurse assign?
A. 3
B. 4
C. 5
D. 6
Correct Answer: B. 4
Rationale: APGAR scoring: Heart rate 90 bpm = 1 point (below 100 but above 0).
Respiratory effort slow/irregular = 1 point. Muscle tone some flexion = 1 point.
Reflex irritability grimace = 1 point. Color pale all over = 0 points. Total = 4. A score
of 4 indicates the newborn is in fair condition and requires resuscitation. Option A
(3) is too low. Option C (5) and Option D (6) overestimate the score. This newborn
requires immediate intervention.
,3. A nurse is preparing to administer the APGAR assessment. Which of the
following is the correct timing for this assessment?
A. Immediately after birth and at 10 minutes of life
B. At 1 minute and 5 minutes after birth
C. At 5 minutes and 10 minutes after birth
D. Only at 1 minute after birth
Correct Answer: B. At 1 minute and 5 minutes after birth
Rationale: The APGAR score is routinely performed at 1 minute and 5 minutes after
birth. The 1-minute score reflects how well the newborn tolerated the birth
process, while the 5-minute score indicates how well the newborn is adapting to
extrauterine life. If the 5-minute score is less than 7, additional scoring should be
done at 10-minute intervals. Option A is incorrect because 10 minutes is only used
if the 5-minute score is low. Option C is incorrect because the first assessment is
at 1 minute. Option D is incorrect because only performing it at 1 minute does not
provide adequate information about adaptation.
4. A nurse is assessing a newborn's reflexes. Which of the following findings
would indicate an abnormal Moro reflex?
A. The newborn extends arms and legs symmetrically and then brings them back in
B. The newborn's arms and legs extend asymmetrically
C. The newborn flexes arms and legs toward the body
D. The newborn remains still with no movement
, Correct Answer: B. The newborn's arms and legs extend asymmetrically
Rationale: The Moro reflex (startle reflex) is elicited by startling the newborn. The
expected response is symmetric extension and abduction of the arms and legs,
followed by flexion and adduction (bringing them back to the body). An asymmetric
response may indicate a fractured clavicle, brachial plexus injury (Erb's palsy), or
other neurologic impairment. Option A describes a normal Moro reflex. Option C
describes a flexion response, which is not the Moro reflex. Option D describes no
response, which could indicate neurologic depression but asymmetry is more
specific for injury.
5. A nurse is assessing the fontanels of a full-term newborn. Which finding is
considered normal?
A. Anterior fontanel is triangular and closes by 2 months
B. Posterior fontanel is diamond-shaped and closes by 12-18 months
C. Anterior fontanel is diamond-shaped and closes by 12-18 months
D. Both fontanels are closed at birth
Correct Answer: C. Anterior fontanel is diamond-shaped and closes by 12-18
months
Rationale: The anterior fontanel is diamond-shaped and typically closes between
12-18 months of age. The posterior fontanel is triangular and closes by 2-3 months
of age. Fontanels should be soft and flat; a bulging fontanel indicates increased
