ALL CHAPTERS Tappero and Honeyfield’s Physical Assessment of the Newborn 7th Edition Witt
, ALL CHAPTERS Tappero and Honeyfield’s Physical Assessment of the Newborn 7th Edition Witt
Chapter 1 – Principles of Physical Assessment (Newborn)
Question 1
A 2-hour-old newborn is placed in the nursery after an uncomplicated vaginal
birth at 39 weeks’ gestation. The nurse prepares to perform a complete
physical assessment. What is the primary purpose of this initial assessment?
A. To evaluate parental bonding and attachment
B. To establish baseline health status and identify immediate concerns
C. To predict long-term developmental outcomes
D. To determine the infant’s response to vaccines
✅ Correct Answer: B
Rationale:
The initial newborn assessment is performed to establish baseline health
status, detect abnormalities, and identify conditions requiring immediate
intervention, such as respiratory distress, hypoglycemia, or congenital
anomalies. Parental bonding, developmental outcomes, and vaccine response
are important but are secondary to immediate assessment.
Keywords: System: Neonatal; Procedure: Physical Assessment; Concept:
Health Promotion & Safety
Question 2
During the newborn assessment, the nurse uses inspection, palpation,
percussion, and auscultation. Which principle should guide the order of
these techniques?
A. Perform auscultation first to prevent movement artifacts
B. Proceed from least to most invasive to minimize infant stress
C. Begin with palpation to identify internal abnormalities quickly
D. Randomize the sequence based on nurse preference
, ALL CHAPTERS Tappero and Honeyfield’s Physical Assessment of the Newborn 7th Edition Witt
✅ Correct Answer: B
Rationale:
Neonatal assessment should follow the sequence from least to most
invasive—inspection, auscultation, palpation, and then percussion. This
approach reduces stress for the newborn and allows for more accurate
observations.
Keywords: System: Neonatal; Procedure: Assessment Technique; Concept:
Patient Comfort & Safety
Question 3
A newborn in the NICU requires routine assessment, but infection control
precautions are necessary due to maternal GBS colonization. Which action
best reduces the risk of infection during the assessment?
A. Wearing sterile gloves for every procedure
B. Performing hand hygiene before and after contact with the newborn
C. Using alcohol swabs on the newborn’s skin before touching
D. Placing the newborn in a separate isolation room
✅ Correct Answer: B
Rationale:
Hand hygiene before and after contact is the most effective way to prevent
healthcare-associated infections in neonates. Sterile gloves are not needed for
routine assessment, and alcohol swabs or isolation are unnecessary unless
indicated.
Keywords: System: Neonatal; Procedure: Infection Control; Concept: Safety
& Prevention
Question 4
A nurse notes that a newborn is sleeping deeply during the assessment. How
, ALL CHAPTERS Tappero and Honeyfield’s Physical Assessment of the Newborn 7th Edition Witt
should the nurse proceed to obtain accurate vital signs and physical
findings?
A. Wait until the infant awakens naturally
B. Gently wake the infant to complete the assessment
C. Skip the assessment until the next scheduled check
D. Record findings based on observation alone
✅ Correct Answer: B
Rationale:
Gently waking the newborn allows the nurse to complete an accurate
assessment while minimizing stress. Waiting too long may delay
identification of critical issues; observation alone may not provide complete
data.
Keywords: System: Neonatal; Procedure: Physical Assessment; Concept:
Accuracy & Clinical Decision-Making
Question 5
During a newborn assessment, the nurse observes mild acrocyanosis (bluish
hands and feet) but the infant is pink centrally. How should the nurse
interpret this finding?
A. Immediate respiratory distress requiring intervention
B. A normal transitional finding in the first 24 hours
C. Evidence of congenital heart disease
D. Sign of hypoglycemia
✅ Correct Answer: B
Rationale:
Acrocyanosis is common in healthy newborns during the first 24 hours and
usually resolves as circulation stabilizes. Central pink coloration indicates
adequate oxygenation. Immediate intervention is not needed unless
accompanied by other symptoms.
, ALL CHAPTERS Tappero and Honeyfield’s Physical Assessment of the Newborn 7th Edition Witt
Keywords: System: Cardiovascular/Neonatal; Procedure: Observation;
Concept: Normal Variation
Question 6
Which approach ensures ethical practice during the newborn assessment?
A. Conducting the assessment without parental presence to avoid distraction
B. Explaining each step to parents and obtaining consent when appropriate
C. Only documenting findings if abnormalities are detected
D. Performing assessments as quickly as possible to save time
✅ Correct Answer: B
Rationale:
Ethical practice includes explaining procedures to parents, ensuring informed
consent, and maintaining transparency. Parental presence should be
supported; documentation is always required, and speed should not
compromise quality.
Keywords: System: Neonatal; Procedure: Ethics & Communication;
Concept: Professionalism & Patient Rights
Question 7
A nurse plans to assess a newborn’s abdomen using palpation and percussion.
Which strategy minimizes infant discomfort while ensuring accurate
assessment?
A. Apply firm, rapid palpation to detect organ enlargement quickly
B. Palpate after auscultating bowel sounds and use gentle, slow movements
C. Skip palpation if the newborn cries
D. Use only percussion to avoid touching the abdomen
✅ Correct Answer: B
, ALL CHAPTERS Tappero and Honeyfield’s Physical Assessment of the Newborn 7th Edition Witt
Rationale:
Gentle palpation after auscultation allows assessment of organ size and
tenderness without causing unnecessary stress. Firm, rapid palpation can
distress the infant and may produce inaccurate findings.
Keywords: System: Gastrointestinal/Neonatal; Procedure: Palpation &
Percussion; Concept: Pain Management & Accuracy
Question 8
During a newborn assessment, the nurse notices that the infant is becoming
fussy and is difficult to console. What is the best course of action?
A. Continue the assessment quickly to complete it
B. Pause, soothe the infant, and resume after calming
C. Cancel the assessment and report inability to obtain data
D. Restrain the infant to finish the examination
✅ Correct Answer: B
Rationale:
Pausing and soothing reduces stress, allows for more accurate assessment,
and promotes positive parent-infant experience. Continuing or restraining
may cause unnecessary distress and unreliable findings.
Keywords: System: Neonatal; Procedure: Stress Management; Concept:
Patient Comfort & Clinical Judgment
Question 9
A newborn’s initial assessment includes auscultation of the lungs. Which
method ensures the most accurate assessment of breath sounds?
A. Place the stethoscope on a single chest area for 30 seconds
B. Listen systematically over multiple lung fields for at least one full
respiratory cycle
, ALL CHAPTERS Tappero and Honeyfield’s Physical Assessment of the Newborn 7th Edition Witt
Chapter 1 – Principles of Physical Assessment (Newborn)
Question 1
A 2-hour-old newborn is placed in the nursery after an uncomplicated vaginal
birth at 39 weeks’ gestation. The nurse prepares to perform a complete
physical assessment. What is the primary purpose of this initial assessment?
A. To evaluate parental bonding and attachment
B. To establish baseline health status and identify immediate concerns
C. To predict long-term developmental outcomes
D. To determine the infant’s response to vaccines
✅ Correct Answer: B
Rationale:
The initial newborn assessment is performed to establish baseline health
status, detect abnormalities, and identify conditions requiring immediate
intervention, such as respiratory distress, hypoglycemia, or congenital
anomalies. Parental bonding, developmental outcomes, and vaccine response
are important but are secondary to immediate assessment.
Keywords: System: Neonatal; Procedure: Physical Assessment; Concept:
Health Promotion & Safety
Question 2
During the newborn assessment, the nurse uses inspection, palpation,
percussion, and auscultation. Which principle should guide the order of
these techniques?
A. Perform auscultation first to prevent movement artifacts
B. Proceed from least to most invasive to minimize infant stress
C. Begin with palpation to identify internal abnormalities quickly
D. Randomize the sequence based on nurse preference
, ALL CHAPTERS Tappero and Honeyfield’s Physical Assessment of the Newborn 7th Edition Witt
✅ Correct Answer: B
Rationale:
Neonatal assessment should follow the sequence from least to most
invasive—inspection, auscultation, palpation, and then percussion. This
approach reduces stress for the newborn and allows for more accurate
observations.
Keywords: System: Neonatal; Procedure: Assessment Technique; Concept:
Patient Comfort & Safety
Question 3
A newborn in the NICU requires routine assessment, but infection control
precautions are necessary due to maternal GBS colonization. Which action
best reduces the risk of infection during the assessment?
A. Wearing sterile gloves for every procedure
B. Performing hand hygiene before and after contact with the newborn
C. Using alcohol swabs on the newborn’s skin before touching
D. Placing the newborn in a separate isolation room
✅ Correct Answer: B
Rationale:
Hand hygiene before and after contact is the most effective way to prevent
healthcare-associated infections in neonates. Sterile gloves are not needed for
routine assessment, and alcohol swabs or isolation are unnecessary unless
indicated.
Keywords: System: Neonatal; Procedure: Infection Control; Concept: Safety
& Prevention
Question 4
A nurse notes that a newborn is sleeping deeply during the assessment. How
, ALL CHAPTERS Tappero and Honeyfield’s Physical Assessment of the Newborn 7th Edition Witt
should the nurse proceed to obtain accurate vital signs and physical
findings?
A. Wait until the infant awakens naturally
B. Gently wake the infant to complete the assessment
C. Skip the assessment until the next scheduled check
D. Record findings based on observation alone
✅ Correct Answer: B
Rationale:
Gently waking the newborn allows the nurse to complete an accurate
assessment while minimizing stress. Waiting too long may delay
identification of critical issues; observation alone may not provide complete
data.
Keywords: System: Neonatal; Procedure: Physical Assessment; Concept:
Accuracy & Clinical Decision-Making
Question 5
During a newborn assessment, the nurse observes mild acrocyanosis (bluish
hands and feet) but the infant is pink centrally. How should the nurse
interpret this finding?
A. Immediate respiratory distress requiring intervention
B. A normal transitional finding in the first 24 hours
C. Evidence of congenital heart disease
D. Sign of hypoglycemia
✅ Correct Answer: B
Rationale:
Acrocyanosis is common in healthy newborns during the first 24 hours and
usually resolves as circulation stabilizes. Central pink coloration indicates
adequate oxygenation. Immediate intervention is not needed unless
accompanied by other symptoms.
, ALL CHAPTERS Tappero and Honeyfield’s Physical Assessment of the Newborn 7th Edition Witt
Keywords: System: Cardiovascular/Neonatal; Procedure: Observation;
Concept: Normal Variation
Question 6
Which approach ensures ethical practice during the newborn assessment?
A. Conducting the assessment without parental presence to avoid distraction
B. Explaining each step to parents and obtaining consent when appropriate
C. Only documenting findings if abnormalities are detected
D. Performing assessments as quickly as possible to save time
✅ Correct Answer: B
Rationale:
Ethical practice includes explaining procedures to parents, ensuring informed
consent, and maintaining transparency. Parental presence should be
supported; documentation is always required, and speed should not
compromise quality.
Keywords: System: Neonatal; Procedure: Ethics & Communication;
Concept: Professionalism & Patient Rights
Question 7
A nurse plans to assess a newborn’s abdomen using palpation and percussion.
Which strategy minimizes infant discomfort while ensuring accurate
assessment?
A. Apply firm, rapid palpation to detect organ enlargement quickly
B. Palpate after auscultating bowel sounds and use gentle, slow movements
C. Skip palpation if the newborn cries
D. Use only percussion to avoid touching the abdomen
✅ Correct Answer: B
, ALL CHAPTERS Tappero and Honeyfield’s Physical Assessment of the Newborn 7th Edition Witt
Rationale:
Gentle palpation after auscultation allows assessment of organ size and
tenderness without causing unnecessary stress. Firm, rapid palpation can
distress the infant and may produce inaccurate findings.
Keywords: System: Gastrointestinal/Neonatal; Procedure: Palpation &
Percussion; Concept: Pain Management & Accuracy
Question 8
During a newborn assessment, the nurse notices that the infant is becoming
fussy and is difficult to console. What is the best course of action?
A. Continue the assessment quickly to complete it
B. Pause, soothe the infant, and resume after calming
C. Cancel the assessment and report inability to obtain data
D. Restrain the infant to finish the examination
✅ Correct Answer: B
Rationale:
Pausing and soothing reduces stress, allows for more accurate assessment,
and promotes positive parent-infant experience. Continuing or restraining
may cause unnecessary distress and unreliable findings.
Keywords: System: Neonatal; Procedure: Stress Management; Concept:
Patient Comfort & Clinical Judgment
Question 9
A newborn’s initial assessment includes auscultation of the lungs. Which
method ensures the most accurate assessment of breath sounds?
A. Place the stethoscope on a single chest area for 30 seconds
B. Listen systematically over multiple lung fields for at least one full
respiratory cycle
