HESI Newborn Disorders
Examination (2026 Update)|| Questions
And Answers With Rationales/Graded
A+/2026 Update/100% Correct
/Instant Download
Section 1: Respiratory Disorders in the Newborn
1. A newborn at 35 weeks gestation shows nasal flaring, grunting, and
retractions. Which intervention is priority?
• A. Administer oxygen via nasal cannula
• B. Initiate CPAP
• C. Prepare for intubation
• D. Place in Trendelenburg position
Rationale: CPAP is first-line for respiratory distress syndrome (RDS) in preterm
infants to prevent alveolar collapse.
2. Which finding differentiates transient tachypnea of the newborn (TTN)
from RDS?
• A. Persistent hypoxemia despite O2
• B. Rapid improvement within 24-48 hours
• C. Surfactant deficiency
• D. Associated maternal chorioamnionitis
Rationale: TTN resolves quickly as fetal lung fluid absorbs; RDS worsens
initially.
,3. A newborn with meconium aspiration syndrome (MAS) is on a ventilator.
Which assessment finding indicates worsening condition?
• A. PaO2 75 mmHg
• B. pH 7.35
• C. Rising PaCO2 with air leak
• D. Oxygen saturation 92%
Rationale: Rising PaCO2 and air leak (pneumothorax) suggest worsening MAS
requiring intervention.
4. The nurse administers surfactant to a preterm infant. Which immediate
response is expected?
• A. Decreased blood pressure
• B. Improved oxygenation
• C. Increased heart rate
• D. Decreased urine output
Rationale: Surfactant reduces surface tension, improving lung compliance and
oxygenation.
5. Which maternal history is most associated with persistent pulmonary
hypertension of the newborn (PPHN)?
• A. Gestational diabetes
• B. Late-term delivery (>41 weeks)
• C. Maternal anemia
• D. Fetal growth restriction
Rationale: Post-term delivery increases risk of PPHN due to chronic intrauterine
hypoxia.
Section 2: Hypoglycemia & Metabolic Disorders
6. A newborn of a diabetic mother (IDM) has jitteriness and a blood glucose of
35 mg/dL. What is the initial action?
, • A. Start IV dextrose 10%
• B. Feed 2 oz formula
• C. Administer glucagon IM
• D. Repeat glucose in 30 minutes
Rationale: Symptomatic hypoglycemia (<40 mg/dL) requires IV dextrose; oral
feeding is too slow.
7. Which finding in the first 24 hours suggests neonatal hyperglycemia?
• A. Irritability
• B. Polyuria and dehydration
• C. Hypothermia
• D. Bradycardia
Rationale: Hyperglycemia causes osmotic diuresis → polyuria, dehydration.
8. A newborn screens positive for galactosemia. Which feeding is
contraindicated?
• A. Breast milk
• B. Soy formula
• C. Casein hydrolysate formula
• D. Electrolyte solution
Rationale: Breast milk contains lactose (galactose + glucose); galactosemia
requires lactose-free formula.
9. An infant with maple syrup urine disease (MSUD) presents with poor
feeding, vomiting, and a distinct odor. Which odor is characteristic?
• A. Musty
• B. Sweet, maple syrup-like
• C. Acetone
• D. Fruity
Examination (2026 Update)|| Questions
And Answers With Rationales/Graded
A+/2026 Update/100% Correct
/Instant Download
Section 1: Respiratory Disorders in the Newborn
1. A newborn at 35 weeks gestation shows nasal flaring, grunting, and
retractions. Which intervention is priority?
• A. Administer oxygen via nasal cannula
• B. Initiate CPAP
• C. Prepare for intubation
• D. Place in Trendelenburg position
Rationale: CPAP is first-line for respiratory distress syndrome (RDS) in preterm
infants to prevent alveolar collapse.
2. Which finding differentiates transient tachypnea of the newborn (TTN)
from RDS?
• A. Persistent hypoxemia despite O2
• B. Rapid improvement within 24-48 hours
• C. Surfactant deficiency
• D. Associated maternal chorioamnionitis
Rationale: TTN resolves quickly as fetal lung fluid absorbs; RDS worsens
initially.
,3. A newborn with meconium aspiration syndrome (MAS) is on a ventilator.
Which assessment finding indicates worsening condition?
• A. PaO2 75 mmHg
• B. pH 7.35
• C. Rising PaCO2 with air leak
• D. Oxygen saturation 92%
Rationale: Rising PaCO2 and air leak (pneumothorax) suggest worsening MAS
requiring intervention.
4. The nurse administers surfactant to a preterm infant. Which immediate
response is expected?
• A. Decreased blood pressure
• B. Improved oxygenation
• C. Increased heart rate
• D. Decreased urine output
Rationale: Surfactant reduces surface tension, improving lung compliance and
oxygenation.
5. Which maternal history is most associated with persistent pulmonary
hypertension of the newborn (PPHN)?
• A. Gestational diabetes
• B. Late-term delivery (>41 weeks)
• C. Maternal anemia
• D. Fetal growth restriction
Rationale: Post-term delivery increases risk of PPHN due to chronic intrauterine
hypoxia.
Section 2: Hypoglycemia & Metabolic Disorders
6. A newborn of a diabetic mother (IDM) has jitteriness and a blood glucose of
35 mg/dL. What is the initial action?
, • A. Start IV dextrose 10%
• B. Feed 2 oz formula
• C. Administer glucagon IM
• D. Repeat glucose in 30 minutes
Rationale: Symptomatic hypoglycemia (<40 mg/dL) requires IV dextrose; oral
feeding is too slow.
7. Which finding in the first 24 hours suggests neonatal hyperglycemia?
• A. Irritability
• B. Polyuria and dehydration
• C. Hypothermia
• D. Bradycardia
Rationale: Hyperglycemia causes osmotic diuresis → polyuria, dehydration.
8. A newborn screens positive for galactosemia. Which feeding is
contraindicated?
• A. Breast milk
• B. Soy formula
• C. Casein hydrolysate formula
• D. Electrolyte solution
Rationale: Breast milk contains lactose (galactose + glucose); galactosemia
requires lactose-free formula.
9. An infant with maple syrup urine disease (MSUD) presents with poor
feeding, vomiting, and a distinct odor. Which odor is characteristic?
• A. Musty
• B. Sweet, maple syrup-like
• C. Acetone
• D. Fruity
