NEWBORN ASSESSMENT EXAM WITH WELL
ELLABORATED 100 PRACTICE QUESTIONS AND
CORRECT VERIFIED ANSWERS PLUS RATIONALES
RATED A+ GRADE INSTANT DOWNLOAD PDF
Question 1
The nurse is performing a newborn assessment immediately after birth. Which
finding would require immediate intervention?
A) Acrocyanosis
B) Heart rate of 140 beats per minute
C) Grunting respirations
D) Respiratory rate of 40 breaths per minute
Correct Answer: C) Grunting respirations
Rationale: Grunting respirations indicate respiratory distress and require
immediate intervention. Acrocyanosis (bluish discoloration of hands and feet) is
a normal finding in newborns. Heart rate of 140 bpm and respiratory rate of 40
breaths per minute are within normal ranges for a newborn.
Question 2
The nurse is assessing a newborn's Apgar score at 1 minute of life. The newborn
has a heart rate of 130 bpm, is crying vigorously, has active movement, and has
pink skin with blue extremities. What Apgar score should the nurse assign?
A) 6
B) 7
C) 8
D) 9
Correct Answer: C) 8
Rationale: This newborn receives 2 points for heart rate (>100 bpm), 2 points for
,respiratory effort (crying), 2 points for muscle tone (active movement), 1 point
for reflex irritability (crying), and 1 point for color (pink body with blue
extremities). Total = 8 points. A score of 8 indicates a vigorous newborn.
Question 3
The nurse is assessing a newborn's anterior fontanel. Which finding would be
considered normal?
A) Fontanel is closed
B) Fontanel is bulging
C) Fontanel is flat and soft
D) Fontanel is depressed
Correct Answer: C) Fontanel is flat and soft
Rationale: The anterior fontanel should be flat and soft in a healthy newborn.
Closure of the anterior fontanel typically occurs between 12-18 months, so it
should be open at birth. A bulging fontanel indicates increased intracranial
pressure. A depressed (sunken) fontanel indicates dehydration.
Question 4
The nurse is assessing a newborn's head circumference. The measurement is 35
cm. Which finding would be concerning?
A) Head circumference of 35 cm with a chest circumference of 33 cm
B) Head circumference of 35 cm with a chest circumference of 35 cm
C) Head circumference of 35 cm with a chest circumference of 37 cm
D) Head circumference of 35 cm with a chest circumference of 32 cm
Correct Answer: C) Head circumference of 35 cm with a chest circumference of
37 cm
Rationale: In a newborn, head circumference is typically 2-3 cm larger than
chest circumference. Head circumference of 35 cm with chest circumference of
37 cm is abnormal. This finding may indicate microcephaly or other
abnormalities. The normal relationship is head circumference exceeding chest
circumference.
,Question 5
The nurse is performing a newborn assessment and notes the presence of a
Mongolian spot on the sacrum. This finding is:
A) A sign of child abuse
B) A normal finding
C) A sign of a bleeding disorder
D) A sign of a genetic disorder
Correct Answer: B) A normal finding
Rationale: Mongolian spots are blue-gray, flat, pigmented areas commonly
found on the sacrum, buttocks, and back of newborns. They are more common
in darker-skinned infants and typically fade by school age. They are a normal
finding and not associated with any pathology.
Question 6
The nurse is assessing a newborn's umbilical cord. Which finding would be
considered normal?
A) Moist, pink, with minimal drainage
B) Dry, black, and beginning to separate
C) Foul-smelling drainage
D) Erythema at the base
Correct Answer: B) Dry, black, and beginning to separate
Rationale: A normal umbilical cord stump becomes dry, black, and falls off
within 1-3 weeks. Moist, pink tissue, foul-smelling drainage, and erythema at
the base are signs of infection requiring evaluation.
Question 7
The nurse is assessing a newborn's primitive reflexes. Which reflex should be
present at birth?
A) Parachute reflex
B) Tonic neck reflex
C) Protective extension
D) Pincer grasp
, Correct Answer: B) Tonic neck reflex
Rationale: The asymmetric tonic neck reflex (ATNR) is present at birth and
typically disappears by 4-6 months. The parachute reflex and protective
extension develop at 6-9 months. The pincer grasp is a voluntary fine motor skill
that develops at 9-10 months.
Question 8
The nurse is assessing a newborn's hips for developmental dysplasia. Which
finding would be most concerning?
A) Symmetrical gluteal folds
B) Full abduction of the hips
C) Positive Ortolani maneuver
D) Negative Barlow maneuver
Correct Answer: C) Positive Ortolani maneuver
Rationale: A positive Ortolani maneuver (palpable clunk as the femoral head
reduces into the acetabulum) indicates developmental dysplasia of the hip and
requires further evaluation. Symmetrical gluteal folds, full abduction, and
negative Barlow maneuver are normal findings.
Question 9
The nurse is assessing a newborn's gestational age using the Ballard score. Which
physical characteristic indicates a more mature gestational age?
A) Abundant lanugo
B) Large amounts of vernix
C) Sparse lanugo
D) Thin, transparent skin
Correct Answer: C) Sparse lanugo
Rationale: Sparse lanugo (fine hair) is a sign of more mature gestational age.
Premature infants have abundant lanugo. Large amounts of vernix, thin
transparent skin, and flat areolae are all characteristics of less mature (preterm)
infants.
ELLABORATED 100 PRACTICE QUESTIONS AND
CORRECT VERIFIED ANSWERS PLUS RATIONALES
RATED A+ GRADE INSTANT DOWNLOAD PDF
Question 1
The nurse is performing a newborn assessment immediately after birth. Which
finding would require immediate intervention?
A) Acrocyanosis
B) Heart rate of 140 beats per minute
C) Grunting respirations
D) Respiratory rate of 40 breaths per minute
Correct Answer: C) Grunting respirations
Rationale: Grunting respirations indicate respiratory distress and require
immediate intervention. Acrocyanosis (bluish discoloration of hands and feet) is
a normal finding in newborns. Heart rate of 140 bpm and respiratory rate of 40
breaths per minute are within normal ranges for a newborn.
Question 2
The nurse is assessing a newborn's Apgar score at 1 minute of life. The newborn
has a heart rate of 130 bpm, is crying vigorously, has active movement, and has
pink skin with blue extremities. What Apgar score should the nurse assign?
A) 6
B) 7
C) 8
D) 9
Correct Answer: C) 8
Rationale: This newborn receives 2 points for heart rate (>100 bpm), 2 points for
,respiratory effort (crying), 2 points for muscle tone (active movement), 1 point
for reflex irritability (crying), and 1 point for color (pink body with blue
extremities). Total = 8 points. A score of 8 indicates a vigorous newborn.
Question 3
The nurse is assessing a newborn's anterior fontanel. Which finding would be
considered normal?
A) Fontanel is closed
B) Fontanel is bulging
C) Fontanel is flat and soft
D) Fontanel is depressed
Correct Answer: C) Fontanel is flat and soft
Rationale: The anterior fontanel should be flat and soft in a healthy newborn.
Closure of the anterior fontanel typically occurs between 12-18 months, so it
should be open at birth. A bulging fontanel indicates increased intracranial
pressure. A depressed (sunken) fontanel indicates dehydration.
Question 4
The nurse is assessing a newborn's head circumference. The measurement is 35
cm. Which finding would be concerning?
A) Head circumference of 35 cm with a chest circumference of 33 cm
B) Head circumference of 35 cm with a chest circumference of 35 cm
C) Head circumference of 35 cm with a chest circumference of 37 cm
D) Head circumference of 35 cm with a chest circumference of 32 cm
Correct Answer: C) Head circumference of 35 cm with a chest circumference of
37 cm
Rationale: In a newborn, head circumference is typically 2-3 cm larger than
chest circumference. Head circumference of 35 cm with chest circumference of
37 cm is abnormal. This finding may indicate microcephaly or other
abnormalities. The normal relationship is head circumference exceeding chest
circumference.
,Question 5
The nurse is performing a newborn assessment and notes the presence of a
Mongolian spot on the sacrum. This finding is:
A) A sign of child abuse
B) A normal finding
C) A sign of a bleeding disorder
D) A sign of a genetic disorder
Correct Answer: B) A normal finding
Rationale: Mongolian spots are blue-gray, flat, pigmented areas commonly
found on the sacrum, buttocks, and back of newborns. They are more common
in darker-skinned infants and typically fade by school age. They are a normal
finding and not associated with any pathology.
Question 6
The nurse is assessing a newborn's umbilical cord. Which finding would be
considered normal?
A) Moist, pink, with minimal drainage
B) Dry, black, and beginning to separate
C) Foul-smelling drainage
D) Erythema at the base
Correct Answer: B) Dry, black, and beginning to separate
Rationale: A normal umbilical cord stump becomes dry, black, and falls off
within 1-3 weeks. Moist, pink tissue, foul-smelling drainage, and erythema at
the base are signs of infection requiring evaluation.
Question 7
The nurse is assessing a newborn's primitive reflexes. Which reflex should be
present at birth?
A) Parachute reflex
B) Tonic neck reflex
C) Protective extension
D) Pincer grasp
, Correct Answer: B) Tonic neck reflex
Rationale: The asymmetric tonic neck reflex (ATNR) is present at birth and
typically disappears by 4-6 months. The parachute reflex and protective
extension develop at 6-9 months. The pincer grasp is a voluntary fine motor skill
that develops at 9-10 months.
Question 8
The nurse is assessing a newborn's hips for developmental dysplasia. Which
finding would be most concerning?
A) Symmetrical gluteal folds
B) Full abduction of the hips
C) Positive Ortolani maneuver
D) Negative Barlow maneuver
Correct Answer: C) Positive Ortolani maneuver
Rationale: A positive Ortolani maneuver (palpable clunk as the femoral head
reduces into the acetabulum) indicates developmental dysplasia of the hip and
requires further evaluation. Symmetrical gluteal folds, full abduction, and
negative Barlow maneuver are normal findings.
Question 9
The nurse is assessing a newborn's gestational age using the Ballard score. Which
physical characteristic indicates a more mature gestational age?
A) Abundant lanugo
B) Large amounts of vernix
C) Sparse lanugo
D) Thin, transparent skin
Correct Answer: C) Sparse lanugo
Rationale: Sparse lanugo (fine hair) is a sign of more mature gestational age.
Premature infants have abundant lanugo. Large amounts of vernix, thin
transparent skin, and flat areolae are all characteristics of less mature (preterm)
infants.
