ASSESSMENT, VITAL SIGNS, AND A HEAD TO TOE EXAM TO DETECT CONGEN UPDATED ACTUAL QUESTIONS AND CORRECT ANSWERS

ASSESSMENT, VITAL SIGNS, AND A HEAD TO TOE EXAM
TO DETECT CONGEN UPDATED ACTUAL QUESTIONS AND
CORRECT ANSWERS

Question:
What is Newborn Assessment?
Answer:
The systematic evaluation of a neonate immediately after birth and during the nursery stay, including Apgar
scoring, gestational age assessment, vital signs, and a head-to-toe exam to detect congenital anomalies and
transition problems.

Question:
What does the Apgar score assess and when is it recorded?
Answer:
Appearance (color), Pulse (heart rate), Grimace (reflex irritability), Activity (muscle tone), and Respiration;
recorded at 1 and 5 minutes, with additional scores every 5 minutes if the 5-minute score is <7.

Question:
A newborn has a heart rate of 90, weak grimace, blue extremities with pink trunk, some flexion, and a slow
irregular cry—what is the Apgar score?
Answer:
6 (HR <100 = 1, weak grimace = 1, acrocyanosis = 1, some flexion = 1, weak/irregular cry = 1).

Question:
What newborn reflexes should be present at birth and when do they typically disappear?
Answer:
Moro, palmar grasp, and rooting/sucking are present at birth; Moro and palmar grasp disappear by ~4-6
months; absence or persistence beyond expected age suggests neurologic pathology.

Question:
What is the significance of a single palmar (simian) crease on newborn exam?
Answer:
It can be a normal variant but is associated with Down syndrome and other chromosomal abnormalities,
prompting closer evaluation.

Question:
What are the newborn screening components mandated in the US?
Answer:
A heel-stick blood spot for metabolic/genetic disorders (e.g., PKU, congenital hypothyroidism, galactosemia,
sickle cell, CF), critical congenital heart disease pulse oximetry screening, and hearing screening.

Question:
What is caput succedaneum versus cephalohematoma?
Answer:
Caput succedaneum is diffuse scalp edema that crosses suture lines and resolves quickly; cephalohematoma is
a subperiosteal bleed that does NOT cross suture lines and resolves over weeks (risk of jaundice).

, Question:
What physical finding differentiates developmental dysplasia of the hip on newborn exam?
Answer:
Positive Barlow (dislocatable hip) and Ortolani (relocatable hip) maneuvers; ultrasound is the imaging of
choice before ~4-6 months of age.

Question:
What is Sudden Unexplained Infant Death (SUID)?
Answer:
The sudden and unexpected death of an infant <1 year of age whose cause is not immediately obvious,
encompassing SIDS, accidental suffocation/strangulation in bed, and other undetermined causes.

Question:
At what age is the peak incidence of SIDS?
Answer:
Between 2 and 4 months of age, with most cases occurring before 6 months.

Question:
What are the major modifiable risk factors for SIDS?
Answer:
Prone/side sleeping, soft bedding, bed-sharing, maternal smoking, prematurity/low birth weight, and
overheating.

Question:
What are the AAP "safe sleep" recommendations to reduce SIDS risk?
Answer:
Place infants supine (on their back) on a firm flat surface, room-sharing without bed-sharing, no soft
objects/loose bedding, avoid overheating, offer a pacifier at sleep, and avoid smoke exposure.

Question:
Does pacifier use increase or decrease SIDS risk?
Answer:
Pacifier use at sleep onset is associated with a decreased risk of SIDS.

Question:
How does breastfeeding relate to SIDS risk?
Answer:
Breastfeeding is associated with a reduced risk of SIDS, and the protective effect increases with exclusivity and
duration.

Question:
What is Teething?
Answer:
The normal eruption of primary (deciduous) teeth through the gums, typically beginning around 6 months of
age.