NUR 335 EXAM 4 QUESTIONS NAD
ANSWERS WITH COMOPLETE
SOLUTIONS 100% CORRECT RATED A+
NEWLY UPDATED 2026
What does the APGAR acronym stand for, when is this scoring system utilized,
and what cumulative score serves as an immediate indicator that a newborn
requires resuscitation?
✔✔ The APGAR scale evaluates Appearance (skin color), Pulse (heart rate),
Grimace (reflex irritability), Activity (muscle tone), and Respiration
(respiratory effort). It is calculated at 1 minute and 5 minutes post-delivery,
with each parameter scored from 0 to 2. A total score less than 6 indicates
neonatal distress and the need for immediate active resuscitation.
Question 2
What are the primitive, involuntary neurological reflexes that a healthy newborn
infant should demonstrate during a standard physical assessment?
✔✔ A healthy newborn should exhibit the following foundational reflexes:
Rooting and Sucking (for feeding readiness)
Tonic neck (fencing) and Moro (startle) reflexes
Palmar and Plantar grasps
Babinski reflex (extension/fanning of the toes)
Stepping (dancing) reflex
What are the three things that initial respirations in the neonate?
Chemical stimuli: mild hypoxia
Mechanical stimuli: compression of chest during labor
,Sensory stimuli: thermal, tactile, auditory, and light stimuli (leads to crying which
requires inspiration)
What are the 2 factors that negatively impact the transition to breathing
independently for a neonate?
- Decreased lung surfactant as a result of immature lungs (often in premature
infants)
- Severe or persistent hypoxemia and acidosis (hypoxia can result in hypotonia
which can increase the difficulty of respirations)
What are the signs of respiratory distress in a neonate?
Central cyanosis (around mouth and nose)
Tachypnea or apnea for more than 10 seconds
Grunting
Nostril flaring
Chest retractions
Hypotonia
What are the three heart shunts that close as a neonate transitions to relying on it's
own circulatory system?
Ductus venosus: allows the oxygenated blood from the umbilical cord to bypass
the liver and go directly to the inferior vena cava
Foramen ovale: opening between the right and left atria
,Ductus arteriosus: connects the pulmonary artery and the aorta
What is the neonatal response to cold?
Increased metabolic rate and increased O2 consumption
Increased muscle activity and flexion
Increased peripheral vasoconstriction
Metabolism of brown adipose tissue
** all of these can result in hypoglycemia
What is the function of brown adipose tissue?
heat production
What is cold stress?
heat loss through convection, conduction, evaporation and radiation that results in
a temperature decrease, which requires the body to consume more energy
What are the risk factors of developing cold stress?
Being born prematurely
SGA
Hypoglycemia
Prolonged resuscitation
, Sepsis
Problems with the infant's neuro, endocrine, or cardiorespiratory systems
What are the four types of energy loss and examples in neonates?
- Evaporation: transfer of heat when water on infant's skin is converted into water
vapor; sweating (especially on radiant warmers), crying
- Conduction: transfer of heat from infant to a cooler surface; placing infant on
warmer that is not preheated
- Convection: transfer of heat through drafts passing over infant's skin; AC hitting
uncovered infant
- Radiation: Occurs through transfer of heat to the cooler air; heat leaves infant's
head is uncovered
What are the signs and symptoms of cold stress?
Axillary temperature at or below 36.5°C (97.7°F)
Cool skin
Lethargy
Pallor/Mottled skin/Acrocyanosis
Tachypnea
Grunting
Hypoglycemia
Hypotonia
Jitteriness
Weak suck
ANSWERS WITH COMOPLETE
SOLUTIONS 100% CORRECT RATED A+
NEWLY UPDATED 2026
What does the APGAR acronym stand for, when is this scoring system utilized,
and what cumulative score serves as an immediate indicator that a newborn
requires resuscitation?
✔✔ The APGAR scale evaluates Appearance (skin color), Pulse (heart rate),
Grimace (reflex irritability), Activity (muscle tone), and Respiration
(respiratory effort). It is calculated at 1 minute and 5 minutes post-delivery,
with each parameter scored from 0 to 2. A total score less than 6 indicates
neonatal distress and the need for immediate active resuscitation.
Question 2
What are the primitive, involuntary neurological reflexes that a healthy newborn
infant should demonstrate during a standard physical assessment?
✔✔ A healthy newborn should exhibit the following foundational reflexes:
Rooting and Sucking (for feeding readiness)
Tonic neck (fencing) and Moro (startle) reflexes
Palmar and Plantar grasps
Babinski reflex (extension/fanning of the toes)
Stepping (dancing) reflex
What are the three things that initial respirations in the neonate?
Chemical stimuli: mild hypoxia
Mechanical stimuli: compression of chest during labor
,Sensory stimuli: thermal, tactile, auditory, and light stimuli (leads to crying which
requires inspiration)
What are the 2 factors that negatively impact the transition to breathing
independently for a neonate?
- Decreased lung surfactant as a result of immature lungs (often in premature
infants)
- Severe or persistent hypoxemia and acidosis (hypoxia can result in hypotonia
which can increase the difficulty of respirations)
What are the signs of respiratory distress in a neonate?
Central cyanosis (around mouth and nose)
Tachypnea or apnea for more than 10 seconds
Grunting
Nostril flaring
Chest retractions
Hypotonia
What are the three heart shunts that close as a neonate transitions to relying on it's
own circulatory system?
Ductus venosus: allows the oxygenated blood from the umbilical cord to bypass
the liver and go directly to the inferior vena cava
Foramen ovale: opening between the right and left atria
,Ductus arteriosus: connects the pulmonary artery and the aorta
What is the neonatal response to cold?
Increased metabolic rate and increased O2 consumption
Increased muscle activity and flexion
Increased peripheral vasoconstriction
Metabolism of brown adipose tissue
** all of these can result in hypoglycemia
What is the function of brown adipose tissue?
heat production
What is cold stress?
heat loss through convection, conduction, evaporation and radiation that results in
a temperature decrease, which requires the body to consume more energy
What are the risk factors of developing cold stress?
Being born prematurely
SGA
Hypoglycemia
Prolonged resuscitation
, Sepsis
Problems with the infant's neuro, endocrine, or cardiorespiratory systems
What are the four types of energy loss and examples in neonates?
- Evaporation: transfer of heat when water on infant's skin is converted into water
vapor; sweating (especially on radiant warmers), crying
- Conduction: transfer of heat from infant to a cooler surface; placing infant on
warmer that is not preheated
- Convection: transfer of heat through drafts passing over infant's skin; AC hitting
uncovered infant
- Radiation: Occurs through transfer of heat to the cooler air; heat leaves infant's
head is uncovered
What are the signs and symptoms of cold stress?
Axillary temperature at or below 36.5°C (97.7°F)
Cool skin
Lethargy
Pallor/Mottled skin/Acrocyanosis
Tachypnea
Grunting
Hypoglycemia
Hypotonia
Jitteriness
Weak suck
