NU 335 EXAM 3 PRACTICE QUESTIONS 2026/2027 – NURSING STUDY GUIDE,
EXAM REVIEW & TEST PREP
1) The nurse is caring for a newborn 30 minutes after birth. After assessing respiratory function, the
nurse would report which findings as abnormal?
Note: Credit will be given only if all correct and no incorrect choices are selected.
Select all that apply.
1. Respiratory rate of 66 breaths per minute
2. Periodic breathing with pauses of 25 seconds
3. Synchronous chest and abdomen movements
4. Grunting on expiration
5. Nasal flaring - ANS ✔✔2. Periodic breathing with pauses of 25 seconds
4. Grunting on expiration
5. Nasal flaring
2) A 2-day-old newborn is asleep, and the nurse assesses the apical pulse to be 88 beats/min. What
would be the most appropriate nursing action based on this assessment finding?
1. Call the physician.
2. Administer oxygen.
3. Document the finding.
4. Place the newborn under the radiant warmer. - ANS ✔✔3. Document the finding.
3) The nurse is assessing a newborn at 1 hour of age. Which finding requires an immediate intervention?
1. Respiratory rate 60 and irregular in depth and rhythm
2. Pulse rate 145, cardiac murmur heard
3. Mean blood pressure 55 mm Hg
4. Pauses in respiration lasting 30 seconds - ANS ✔✔4. Pauses in respiration lasting 30 seconds
4) The nurse has assessed four newborns' respiratory rates immediately following birth. Which
respiratory rate would require further assessment by the nurse?
1. 60 breaths per minute
2. 70 breaths per minute
3. 64 breaths per minute
4. 20 breaths per minute - ANS ✔✔4. 20 breaths per minute
5) Marked changes occur in the cardiopulmonary system at birth include which of the following?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
1. Closure of the foramen ovale
2. Closure of the ductus venosus
3. Mean blood pressure of 31 to 61 mmHg in full-term resting newborns
4. Increased systemic vascular resistance and decreased pulmonary vascular resistance
5. Opening of the ductus arteriosus - ANS ✔✔1. Closure of the foramen ovale
2. Closure of the ductus venosus
4. Increased systemic vascular resistance and decreased pulmonary vascular resistance
,6) The pediatric clinic nurse is reviewing lab results with a 2-month-old infant's mother. The infant's
hemoglobin has decreased since birth. Which statement by the mother indicates the need for additional
teaching?
1. "My baby isn't getting enough iron from my breast milk."
2. "Babies undergo physiologic anemia of infancy."
3. "This results from dilution because of the increased plasma volume."
4. "Delaying the cord clamping did not cause this to happen." - ANS ✔✔1. "My baby isn't getting enough
iron from my breast milk."
7) Which of the following is a benefit of delayed umbilical cord clamping for the preterm infant?
1. Fewer infants require blood transfusion for anemia
2. Fewer infants require blood transfusion for high blood pressure
3. Increase in the incidence of intraventricular hemorrhage
4. Increase in incidence of infant breastfeeding - ANS ✔✔1. Fewer infants require blood transfusion for
anemia
8) In utero, what is the organ responsible for gas exchange?
1. Umbilical vein
2. Placenta
3. Inferior vena cava
4. Right atrium - ANS ✔✔2. Placenta
9) A postpartum mother questions whether the environmental temperature should be warmer in the
baby's room at home. The nurse responds that the environmental temperature should be warmer for
the newborn. This response is based on which newborn characteristics that affect the establishment of
thermal stability?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
1. Newborns have less subcutaneous fat than do adults.
2. Infants have a thick epidermis layer.
3. Newborns have a large body surface to weight ratio.
4. Infants have increased total body water.
5. Newborns have more subcutaneous fat than do adults. - ANS ✔✔1. Newborns have less subcutaneous
fat than do adults.
3. Newborns have a large body surface to weight ratio.
4. Infants have increased total body water.
10) The nurse is teaching new parents how to dress their newborn. Which statements indicate that
teaching has been effective?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
1. "We should keep our home air-conditioned so the baby doesn't overheat."
2. "It is important that we dry the baby off as soon as we give him a bath or shampoo his hair."
3. "When we change the baby's diaper, we should change any wet clothing or blankets, too."
4. "If the baby's body temperature gets too low, he will warm himself up without any shivering."
5. "Our baby will have a much faster rate of breathing if he is not dressed warmly enough." - ANS ✔✔2.
"It is important that we dry the baby off as soon as we give him a bath or shampoo his hair."
,3. "When we change the baby's diaper, we should change any wet clothing or blankets, too."
4. "If the baby's body temperature gets too low, he will warm himself up without any shivering."
5. "Our baby will have a much faster rate of breathing if he is not dressed warmly enough."
11) The nurse is planning care for a newborn. Which nursing intervention would best protect the
newborn from the most common form of heat loss?
1. Placing the newborn away from air currents
2. Pre-warming the examination table
3. Drying the newborn thoroughly
4. Removing wet linens from the isolette - ANS ✔✔3. Drying the newborn thoroughly
12) The nurse is planning an educational presentation on hyperbilirubinemia for nursery nurses. Which
statement is most important to include in the presentation?
1. Conjugated bilirubin is eliminated in the conjugated state.
2. Unconjugated bilirubin is neurotoxic, and cannot cross the placenta.
3. Total bilirubin is the sum of the direct and indirect levels.
4. Hyperbilirubinemia is a decreased total serum bilirubin level. - ANS ✔✔3. Total bilirubin is the sum of
the direct and indirect levels.
13) A telephone triage nurse gets a call from a postpartum client who is concerned about jaundice. The
client's newborn is 37 hours old. What data point should the nurse gather first?
1. Stool characteristics
2. Fluid intake
3. Skin color
4. Bilirubin level - ANS ✔✔3. Skin color
14) The mother of a 3-day-old infant calls the clinic and reports that her baby's skin is turning slightly
yellow. What should the nurse explain to the mother?
1. Physiologic jaundice is normal, and peaks at this age.
2. The newborn's liver is not working as well as it should.
3. The baby is yellow because the bowels are not excreting bilirubin.
4. The yellow color indicates that brain damage might be occurring. - ANS ✔✔1. Physiologic jaundice is
normal, and peaks at this age.
15) A newborn is determined to have physiological jaundice. The nurse explains the steps involved in
conjugation and excretion of bilirubin to the parents. Which factors would the nurse include in the
explanation?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
1. At birth, the newborn's liver begins to conjugate bilirubin or convert it from a yellow lipid-soluble
pigment to a water-soluble pigment.
2. Unconjugated bilirubin can leave the bloodstream and enter the tissues, causing a yellow hue to the
skin and sclera.
3. Unconjugated bilirubin results from the destruction of white blood cells.
4. The infant is able to excrete conjugated bilirubin, but not unconjugated bilirubin.
5. The newborn's liver has greater metabolic and enzymatic activity at birth than does an adult liver,
increasing the newborn's susceptibility to jaundice. - ANS ✔✔1. At birth, the newborn's liver begins to
conjugate bilirubin or convert it from a yellow lipid-soluble pigment to a water-soluble pigment.
, 2. Unconjugated bilirubin can leave the bloodstream and enter the tissues, causing a yellow hue to the
skin and sclera.
4. The infant is able to excrete conjugated bilirubin, but not unconjugated bilirubin.
16) The visiting nurse evaluates a 2-day-old breastfed newborn at home and notes that the baby appears
jaundiced. When explaining jaundice to the parents, what would the nurse tell them?
1. "Jaundice is uncommon in newborns."
2. "Some newborns require phototherapy."
3. "Jaundice is a medical emergency."
4. "Jaundice is always a sign of liver disease." - ANS ✔✔2. "Some newborns require phototherapy."
17) Which of the following would be a newborn care procedure that will decrease the probability of high
bilirubin levels?
1. Monitor urine for amount and characteristics.
2. Encourage late feedings to promote intestinal elimination.
3. All infants should be routinely monitored for iron intake.
4. Maintain the newborn's skin temperature at 36.5°C (97.8°F) or above. - ANS ✔✔4. Maintain the
newborn's skin temperature at 36.5°C (97.8°F) or above.
18) Clinical risk factors for severe hyperbilirubinemia include which of the following?
Note: Credit will be given only if all correct and no incorrect choices are selected.
Select all that apply.
1. African American ethnicity
2. Female gender
3. Cephalohematoma
4. Bruising
5. Assisted delivery with vacuum or forceps - ANS ✔✔3. Cephalohematoma
4. Bruising
5. Assisted delivery with vacuum or forceps
19) The home care nurse is examining a 3-day-old infant. The child's skin on the sternum is yellow when
blanched with a finger. The parents ask the nurse why jaundice occurs. What is the best response from
the nurse?
1. "The liver of an infant is not fully mature, and doesn't conjugate the bilirubin for excretion."
2. "The infant received too many red blood cells after delivery because the cord was not clamped
immediately."
3. "The yellow color of your baby's skin indicates that you are breastfeeding too often."
4. "This is an abnormal finding related to your baby's bowels not excreting bilirubin as they should." -
ANS ✔✔1. "The liver of an infant is not fully mature, and doesn't conjugate the bilirubin for excretion."
20) Which of the following is the primary carbohydrate in the breastfeeding newborn?
1. Glucose
2. Fructose
3. Lactose
4. Maltose - ANS ✔✔3. Lactose
21) At birth, an infant weighed 6 pounds 12 ounces. Three days later, he weighs 5 pounds 2 ounces.
What conclusion should the nurse draw regarding this newborn's weight?
EXAM REVIEW & TEST PREP
1) The nurse is caring for a newborn 30 minutes after birth. After assessing respiratory function, the
nurse would report which findings as abnormal?
Note: Credit will be given only if all correct and no incorrect choices are selected.
Select all that apply.
1. Respiratory rate of 66 breaths per minute
2. Periodic breathing with pauses of 25 seconds
3. Synchronous chest and abdomen movements
4. Grunting on expiration
5. Nasal flaring - ANS ✔✔2. Periodic breathing with pauses of 25 seconds
4. Grunting on expiration
5. Nasal flaring
2) A 2-day-old newborn is asleep, and the nurse assesses the apical pulse to be 88 beats/min. What
would be the most appropriate nursing action based on this assessment finding?
1. Call the physician.
2. Administer oxygen.
3. Document the finding.
4. Place the newborn under the radiant warmer. - ANS ✔✔3. Document the finding.
3) The nurse is assessing a newborn at 1 hour of age. Which finding requires an immediate intervention?
1. Respiratory rate 60 and irregular in depth and rhythm
2. Pulse rate 145, cardiac murmur heard
3. Mean blood pressure 55 mm Hg
4. Pauses in respiration lasting 30 seconds - ANS ✔✔4. Pauses in respiration lasting 30 seconds
4) The nurse has assessed four newborns' respiratory rates immediately following birth. Which
respiratory rate would require further assessment by the nurse?
1. 60 breaths per minute
2. 70 breaths per minute
3. 64 breaths per minute
4. 20 breaths per minute - ANS ✔✔4. 20 breaths per minute
5) Marked changes occur in the cardiopulmonary system at birth include which of the following?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
1. Closure of the foramen ovale
2. Closure of the ductus venosus
3. Mean blood pressure of 31 to 61 mmHg in full-term resting newborns
4. Increased systemic vascular resistance and decreased pulmonary vascular resistance
5. Opening of the ductus arteriosus - ANS ✔✔1. Closure of the foramen ovale
2. Closure of the ductus venosus
4. Increased systemic vascular resistance and decreased pulmonary vascular resistance
,6) The pediatric clinic nurse is reviewing lab results with a 2-month-old infant's mother. The infant's
hemoglobin has decreased since birth. Which statement by the mother indicates the need for additional
teaching?
1. "My baby isn't getting enough iron from my breast milk."
2. "Babies undergo physiologic anemia of infancy."
3. "This results from dilution because of the increased plasma volume."
4. "Delaying the cord clamping did not cause this to happen." - ANS ✔✔1. "My baby isn't getting enough
iron from my breast milk."
7) Which of the following is a benefit of delayed umbilical cord clamping for the preterm infant?
1. Fewer infants require blood transfusion for anemia
2. Fewer infants require blood transfusion for high blood pressure
3. Increase in the incidence of intraventricular hemorrhage
4. Increase in incidence of infant breastfeeding - ANS ✔✔1. Fewer infants require blood transfusion for
anemia
8) In utero, what is the organ responsible for gas exchange?
1. Umbilical vein
2. Placenta
3. Inferior vena cava
4. Right atrium - ANS ✔✔2. Placenta
9) A postpartum mother questions whether the environmental temperature should be warmer in the
baby's room at home. The nurse responds that the environmental temperature should be warmer for
the newborn. This response is based on which newborn characteristics that affect the establishment of
thermal stability?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
1. Newborns have less subcutaneous fat than do adults.
2. Infants have a thick epidermis layer.
3. Newborns have a large body surface to weight ratio.
4. Infants have increased total body water.
5. Newborns have more subcutaneous fat than do adults. - ANS ✔✔1. Newborns have less subcutaneous
fat than do adults.
3. Newborns have a large body surface to weight ratio.
4. Infants have increased total body water.
10) The nurse is teaching new parents how to dress their newborn. Which statements indicate that
teaching has been effective?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
1. "We should keep our home air-conditioned so the baby doesn't overheat."
2. "It is important that we dry the baby off as soon as we give him a bath or shampoo his hair."
3. "When we change the baby's diaper, we should change any wet clothing or blankets, too."
4. "If the baby's body temperature gets too low, he will warm himself up without any shivering."
5. "Our baby will have a much faster rate of breathing if he is not dressed warmly enough." - ANS ✔✔2.
"It is important that we dry the baby off as soon as we give him a bath or shampoo his hair."
,3. "When we change the baby's diaper, we should change any wet clothing or blankets, too."
4. "If the baby's body temperature gets too low, he will warm himself up without any shivering."
5. "Our baby will have a much faster rate of breathing if he is not dressed warmly enough."
11) The nurse is planning care for a newborn. Which nursing intervention would best protect the
newborn from the most common form of heat loss?
1. Placing the newborn away from air currents
2. Pre-warming the examination table
3. Drying the newborn thoroughly
4. Removing wet linens from the isolette - ANS ✔✔3. Drying the newborn thoroughly
12) The nurse is planning an educational presentation on hyperbilirubinemia for nursery nurses. Which
statement is most important to include in the presentation?
1. Conjugated bilirubin is eliminated in the conjugated state.
2. Unconjugated bilirubin is neurotoxic, and cannot cross the placenta.
3. Total bilirubin is the sum of the direct and indirect levels.
4. Hyperbilirubinemia is a decreased total serum bilirubin level. - ANS ✔✔3. Total bilirubin is the sum of
the direct and indirect levels.
13) A telephone triage nurse gets a call from a postpartum client who is concerned about jaundice. The
client's newborn is 37 hours old. What data point should the nurse gather first?
1. Stool characteristics
2. Fluid intake
3. Skin color
4. Bilirubin level - ANS ✔✔3. Skin color
14) The mother of a 3-day-old infant calls the clinic and reports that her baby's skin is turning slightly
yellow. What should the nurse explain to the mother?
1. Physiologic jaundice is normal, and peaks at this age.
2. The newborn's liver is not working as well as it should.
3. The baby is yellow because the bowels are not excreting bilirubin.
4. The yellow color indicates that brain damage might be occurring. - ANS ✔✔1. Physiologic jaundice is
normal, and peaks at this age.
15) A newborn is determined to have physiological jaundice. The nurse explains the steps involved in
conjugation and excretion of bilirubin to the parents. Which factors would the nurse include in the
explanation?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
1. At birth, the newborn's liver begins to conjugate bilirubin or convert it from a yellow lipid-soluble
pigment to a water-soluble pigment.
2. Unconjugated bilirubin can leave the bloodstream and enter the tissues, causing a yellow hue to the
skin and sclera.
3. Unconjugated bilirubin results from the destruction of white blood cells.
4. The infant is able to excrete conjugated bilirubin, but not unconjugated bilirubin.
5. The newborn's liver has greater metabolic and enzymatic activity at birth than does an adult liver,
increasing the newborn's susceptibility to jaundice. - ANS ✔✔1. At birth, the newborn's liver begins to
conjugate bilirubin or convert it from a yellow lipid-soluble pigment to a water-soluble pigment.
, 2. Unconjugated bilirubin can leave the bloodstream and enter the tissues, causing a yellow hue to the
skin and sclera.
4. The infant is able to excrete conjugated bilirubin, but not unconjugated bilirubin.
16) The visiting nurse evaluates a 2-day-old breastfed newborn at home and notes that the baby appears
jaundiced. When explaining jaundice to the parents, what would the nurse tell them?
1. "Jaundice is uncommon in newborns."
2. "Some newborns require phototherapy."
3. "Jaundice is a medical emergency."
4. "Jaundice is always a sign of liver disease." - ANS ✔✔2. "Some newborns require phototherapy."
17) Which of the following would be a newborn care procedure that will decrease the probability of high
bilirubin levels?
1. Monitor urine for amount and characteristics.
2. Encourage late feedings to promote intestinal elimination.
3. All infants should be routinely monitored for iron intake.
4. Maintain the newborn's skin temperature at 36.5°C (97.8°F) or above. - ANS ✔✔4. Maintain the
newborn's skin temperature at 36.5°C (97.8°F) or above.
18) Clinical risk factors for severe hyperbilirubinemia include which of the following?
Note: Credit will be given only if all correct and no incorrect choices are selected.
Select all that apply.
1. African American ethnicity
2. Female gender
3. Cephalohematoma
4. Bruising
5. Assisted delivery with vacuum or forceps - ANS ✔✔3. Cephalohematoma
4. Bruising
5. Assisted delivery with vacuum or forceps
19) The home care nurse is examining a 3-day-old infant. The child's skin on the sternum is yellow when
blanched with a finger. The parents ask the nurse why jaundice occurs. What is the best response from
the nurse?
1. "The liver of an infant is not fully mature, and doesn't conjugate the bilirubin for excretion."
2. "The infant received too many red blood cells after delivery because the cord was not clamped
immediately."
3. "The yellow color of your baby's skin indicates that you are breastfeeding too often."
4. "This is an abnormal finding related to your baby's bowels not excreting bilirubin as they should." -
ANS ✔✔1. "The liver of an infant is not fully mature, and doesn't conjugate the bilirubin for excretion."
20) Which of the following is the primary carbohydrate in the breastfeeding newborn?
1. Glucose
2. Fructose
3. Lactose
4. Maltose - ANS ✔✔3. Lactose
21) At birth, an infant weighed 6 pounds 12 ounces. Three days later, he weighs 5 pounds 2 ounces.
What conclusion should the nurse draw regarding this newborn's weight?
