NM717 NEWBORN EXAM Actual Exam Complete
Questions and Answers Detailed Rationales Pass
Guaranteed - A+ Graded
TABLE OF CONTENTS
Section 1 | Transition & Immediate Newborn Assessment | Q1 – Q10
Section 2 | Newborn Physical Exam & Gestational Age | Q11 – Q20
Section 3 | Newborn Nutrition & Feeding | Q21 – Q30
Section 4 | Common Newborn Conditions | Q31 – Q40
Section 5 | High-Risk Newborns, NICU & Parent Education | Q41 – Q50
Instructions: Choose the single best answer. Pass: 80% in 90 minutes.
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SECTION 1: TRANSITION TO EXTRAUTERINE LIFE & IMMEDIATE NEWBORN
ASSESSMENT Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A term newborn delivered by elective repeat cesarean section at 39 weeks gestation
weighs 3,400 g and has Apgar scores of 8 and 9. At 30 minutes of age, the infant is
tachypneic with a respiratory rate of 68, mild subcostal retractions, and nasal flaring.
Oxygen saturation is 92% on room air, and breath sounds are equal bilaterally. A chest
X-ray shows prominent perihilar streaking and fluid in the minor fissure.
A. Transient tachypnea of the newborn due to delayed clearance of fetal lung fluid ✓
CORRECT
B. Early-onset neonatal pneumonia from ascending intrauterine infection
C. Respiratory distress syndrome from surfactant deficiency
D. Spontaneous pneumothorax causing mild respiratory compromise
Correct Answer: A
,Rationale: Transient tachypnea of the newborn is the most common cause of
respiratory distress in term infants delivered by cesarean section, characterized by
retained fetal lung fluid that typically resolves within 24 to 72 hours. Early-onset
pneumonia usually presents with more systemic signs such as temperature instability
and requires risk factors like prolonged rupture of membranes, which this infant lacks.
RDS is uncommon in term infants without underlying risk factors, and a pneumothorax
would typically show asymmetric breath sounds and a more acute deterioration.
Question 2 of 50
A 38-week gestation infant born vaginally weighing 3,100 g is placed immediately
skin-to-skin with the mother after delivery. Thirty minutes later, the axillary temperature
is 36.1°C and the infant is mildly jittery with acrocyanosis. The delivery room is cool, and
the infant's skin is still moist with amniotic fluid.
A. Transfer the infant immediately to the nursery for a sepsis workup and antibiotics
B. Dry the infant thoroughly and place under a radiant warmer to restore thermal
stability ✓ CORRECT
C. Initiate intravenous dextrose because jitteriness indicates symptomatic
hypoglycemia
D. Administer supplemental oxygen via blow-by for the acrocyanosis and low
temperature
Correct Answer: B
Rationale: An axillary temperature of 36.1°C indicates mild hypothermia, and the infant's
jitteriness is most likely a response to cold stress rather than hypoglycemia at this early
age. Drying the infant completely and providing a radiant heat source is the standard
first step to prevent further heat loss and stabilize the newborn. A sepsis workup is
unnecessary without maternal risk factors or systemic signs, and glucose should be
checked but not empirically treated before feeding is attempted.
Question 3 of 50
,A 34-week gestation infant is born weighing 1,800 g with Apgar scores of 6 and 8. At 2
hours of age, the infant becomes lethargic with weak suck, high-pitched cry, and fine
tremors of the extremities. A bedside glucose check reveals a blood glucose level of 25
mg/dL.
A. Initiate oral feeding with formula or expressed breast milk immediately
B. Apply a radiant warmer and recheck the glucose in 30 minutes after warming
C. Administer intravenous dextrose immediately because the infant is symptomatic ✓
CORRECT
D. Provide intramuscular glucagon and observe for rebound hypoglycemia
Correct Answer: C
Rationale: A glucose level of 25 mg/dL in a symptomatic preterm infant meets the
threshold for immediate intravenous dextrose administration to prevent neurological
injury. Oral feeding is unsafe in a lethargic infant with poor suck and does not raise
glucose rapidly enough. Warming alone will not correct documented hypoglycemia, and
glucagon is reserved for refractory cases rather than first-line treatment in neonates.
Question 4 of 50
An infant is born at 40 weeks gestation via vaginal delivery with thick meconium-stained
amniotic fluid. The infant cries immediately after birth, has a heart rate of 150, good
muscle tone, and respirations of 50. The airway is clear with no meconium below the
vocal cords.
A. Perform immediate endotracheal intubation and suction the trachea for meconium
removal
B. Administer positive pressure ventilation because meconium exposure mandates
respiratory support
C. Transfer to the NICU for observation regardless of the infant's vigorous status
D. Provide routine postnatal care with drying, stimulation, and skin-to-skin contact ✓
CORRECT
, Correct Answer: D
Rationale: Current neonatal resuscitation guidelines no longer recommend routine
intubation for meconium-stained fluid when the infant is vigorous at birth, as tracheal
suctioning does not improve outcomes and may cause harm. Intubation is reserved for
non-vigorous infants with depressed respirations, tone, or heart rate below 100. This
infant's strong respiratory effort and tone indicate successful transition without
additional intervention.
Question 5 of 50
A term newborn delivered at 39 weeks gestation weighs 3,200 g. At 1 hour of age, the
vital signs are heart rate 110, respiratory rate 45, axillary temperature 36.5°C, and
oxygen saturation 97% on room air. The infant is pink with mild acrocyanosis of the
hands and feet, has active tone, and breastfed for 10 minutes.
A. These findings represent normal newborn transition and require only routine
observation ✓ CORRECT
B. The respiratory rate of 45 indicates impending respiratory failure and requires a chest
X-ray
C. The mild acrocyanosis suggests congenital heart disease and mandates an
echocardiogram
D. The axillary temperature of 36.5°C is below normal and requires a radiant warmer
Correct Answer: A
Rationale: A heart rate of 110, respiratory rate of 45, temperature of 36.5°C, and oxygen
saturation of 97% are all within normal limits for a 1-hour-old term infant during
extrauterine transition. Acrocyanosis is a benign finding in the first 24 to 48 hours of life
and does not indicate cardiac pathology. A respiratory rate up to 60 can be normal in
newborns, and 36.5°C axillary is an acceptable temperature for a stable infant in
skin-to-skin contact.
Question 6 of 50
Questions and Answers Detailed Rationales Pass
Guaranteed - A+ Graded
TABLE OF CONTENTS
Section 1 | Transition & Immediate Newborn Assessment | Q1 – Q10
Section 2 | Newborn Physical Exam & Gestational Age | Q11 – Q20
Section 3 | Newborn Nutrition & Feeding | Q21 – Q30
Section 4 | Common Newborn Conditions | Q31 – Q40
Section 5 | High-Risk Newborns, NICU & Parent Education | Q41 – Q50
Instructions: Choose the single best answer. Pass: 80% in 90 minutes.
══════════════════════════════════════
SECTION 1: TRANSITION TO EXTRAUTERINE LIFE & IMMEDIATE NEWBORN
ASSESSMENT Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A term newborn delivered by elective repeat cesarean section at 39 weeks gestation
weighs 3,400 g and has Apgar scores of 8 and 9. At 30 minutes of age, the infant is
tachypneic with a respiratory rate of 68, mild subcostal retractions, and nasal flaring.
Oxygen saturation is 92% on room air, and breath sounds are equal bilaterally. A chest
X-ray shows prominent perihilar streaking and fluid in the minor fissure.
A. Transient tachypnea of the newborn due to delayed clearance of fetal lung fluid ✓
CORRECT
B. Early-onset neonatal pneumonia from ascending intrauterine infection
C. Respiratory distress syndrome from surfactant deficiency
D. Spontaneous pneumothorax causing mild respiratory compromise
Correct Answer: A
,Rationale: Transient tachypnea of the newborn is the most common cause of
respiratory distress in term infants delivered by cesarean section, characterized by
retained fetal lung fluid that typically resolves within 24 to 72 hours. Early-onset
pneumonia usually presents with more systemic signs such as temperature instability
and requires risk factors like prolonged rupture of membranes, which this infant lacks.
RDS is uncommon in term infants without underlying risk factors, and a pneumothorax
would typically show asymmetric breath sounds and a more acute deterioration.
Question 2 of 50
A 38-week gestation infant born vaginally weighing 3,100 g is placed immediately
skin-to-skin with the mother after delivery. Thirty minutes later, the axillary temperature
is 36.1°C and the infant is mildly jittery with acrocyanosis. The delivery room is cool, and
the infant's skin is still moist with amniotic fluid.
A. Transfer the infant immediately to the nursery for a sepsis workup and antibiotics
B. Dry the infant thoroughly and place under a radiant warmer to restore thermal
stability ✓ CORRECT
C. Initiate intravenous dextrose because jitteriness indicates symptomatic
hypoglycemia
D. Administer supplemental oxygen via blow-by for the acrocyanosis and low
temperature
Correct Answer: B
Rationale: An axillary temperature of 36.1°C indicates mild hypothermia, and the infant's
jitteriness is most likely a response to cold stress rather than hypoglycemia at this early
age. Drying the infant completely and providing a radiant heat source is the standard
first step to prevent further heat loss and stabilize the newborn. A sepsis workup is
unnecessary without maternal risk factors or systemic signs, and glucose should be
checked but not empirically treated before feeding is attempted.
Question 3 of 50
,A 34-week gestation infant is born weighing 1,800 g with Apgar scores of 6 and 8. At 2
hours of age, the infant becomes lethargic with weak suck, high-pitched cry, and fine
tremors of the extremities. A bedside glucose check reveals a blood glucose level of 25
mg/dL.
A. Initiate oral feeding with formula or expressed breast milk immediately
B. Apply a radiant warmer and recheck the glucose in 30 minutes after warming
C. Administer intravenous dextrose immediately because the infant is symptomatic ✓
CORRECT
D. Provide intramuscular glucagon and observe for rebound hypoglycemia
Correct Answer: C
Rationale: A glucose level of 25 mg/dL in a symptomatic preterm infant meets the
threshold for immediate intravenous dextrose administration to prevent neurological
injury. Oral feeding is unsafe in a lethargic infant with poor suck and does not raise
glucose rapidly enough. Warming alone will not correct documented hypoglycemia, and
glucagon is reserved for refractory cases rather than first-line treatment in neonates.
Question 4 of 50
An infant is born at 40 weeks gestation via vaginal delivery with thick meconium-stained
amniotic fluid. The infant cries immediately after birth, has a heart rate of 150, good
muscle tone, and respirations of 50. The airway is clear with no meconium below the
vocal cords.
A. Perform immediate endotracheal intubation and suction the trachea for meconium
removal
B. Administer positive pressure ventilation because meconium exposure mandates
respiratory support
C. Transfer to the NICU for observation regardless of the infant's vigorous status
D. Provide routine postnatal care with drying, stimulation, and skin-to-skin contact ✓
CORRECT
, Correct Answer: D
Rationale: Current neonatal resuscitation guidelines no longer recommend routine
intubation for meconium-stained fluid when the infant is vigorous at birth, as tracheal
suctioning does not improve outcomes and may cause harm. Intubation is reserved for
non-vigorous infants with depressed respirations, tone, or heart rate below 100. This
infant's strong respiratory effort and tone indicate successful transition without
additional intervention.
Question 5 of 50
A term newborn delivered at 39 weeks gestation weighs 3,200 g. At 1 hour of age, the
vital signs are heart rate 110, respiratory rate 45, axillary temperature 36.5°C, and
oxygen saturation 97% on room air. The infant is pink with mild acrocyanosis of the
hands and feet, has active tone, and breastfed for 10 minutes.
A. These findings represent normal newborn transition and require only routine
observation ✓ CORRECT
B. The respiratory rate of 45 indicates impending respiratory failure and requires a chest
X-ray
C. The mild acrocyanosis suggests congenital heart disease and mandates an
echocardiogram
D. The axillary temperature of 36.5°C is below normal and requires a radiant warmer
Correct Answer: A
Rationale: A heart rate of 110, respiratory rate of 45, temperature of 36.5°C, and oxygen
saturation of 97% are all within normal limits for a 1-hour-old term infant during
extrauterine transition. Acrocyanosis is a benign finding in the first 24 to 48 hours of life
and does not indicate cardiac pathology. A respiratory rate up to 60 can be normal in
newborns, and 36.5°C axillary is an acceptable temperature for a stable infant in
skin-to-skin contact.
Question 6 of 50
