Neonatal Assessment Nursing Exam 2026 –
Full Official Name Practice Exam 2026/2027
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Exam-Style Questions with Correct Detailed
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Question 1
A term newborn is assessed shortly after birth. The infant has a
heart rate of 148/min, spontaneous respirations, active
movement, flexed extremities, a strong cry, and acrocyanosis.
Which finding requires the nurse to intervene first?
A. Heart rate of 148/min
B. Acrocyanosis of the hands and feet
C. Strong cry
D. Spontaneous respirations
Correct Answer: B. Acrocyanosis of the hands and feet
Acrocyanosis is common during the immediate transition after
birth, so by itself it is generally a normal finding rather than an
indication for emergency intervention. However, among the
,choices, the nurse should recognize that the finding requiring
continued assessment is the color change. Central cyanosis
involving the tongue and trunk would be more concerning for
inadequate oxygenation and would require prompt evaluation.
The other findings—heart rate of 148/min, spontaneous
respirations, and a strong cry—are reassuring signs of neonatal
adaptation. The question tests the distinction between normal
peripheral cyanosis during transition and clinically significant
central cyanosis.
Question 2
During a newborn assessment, the nurse notes a respiratory
rate of 72/min. The infant has intermittent grunting and mild
intercostal retractions. What is the nurse's priority action?
A. Place the newborn prone and reassess in 30 minutes
B. Continue routine assessment because newborn respirations
are normally irregular
C. Assess oxygenation and notify the neonatal provider
promptly
D. Offer oral feeding to determine whether the respiratory
pattern improves
Correct Answer: C. Assess oxygenation and notify the
neonatal provider promptly
,Persistent tachypnea accompanied by grunting and retractions
indicates increased work of breathing and may represent
neonatal respiratory distress. The nurse should immediately
assess oxygen saturation, respiratory effort, color, perfusion,
and other signs of compromise while escalating care. Newborn
respirations can be irregular, but a sustained rate above the
expected range with accessory muscle use or grunting is not
considered a normal variation. Oral feeding is unsafe when
significant respiratory distress is present because tachypnea
and poor respiratory coordination increase the risk of
aspiration.
Question 3
A newborn's axillary temperature is 36.1°C (97.0°F). The infant
is alert but has cool extremities. Which intervention is most
appropriate initially?
A. Place the infant under a radiant warmer and reassess
temperature
B. Administer an immediate glucose bolus
C. Bathe the newborn in warm water
D. Begin phototherapy
Correct Answer: A. Place the infant under a radiant warmer
and reassess temperature
, Cold stress increases oxygen and glucose consumption and can
contribute to hypoglycemia, metabolic acidosis, and respiratory
compromise. A temperature of 36.1°C is below the expected
neonatal range and should be corrected promptly using an
appropriate warming method such as a radiant warmer.
Bathing would increase heat loss and is inappropriate while the
infant is cold. Glucose assessment may also be appropriate
because hypothermia can increase glucose utilization, but a
glucose bolus should not be administered without evidence of
clinically significant hypoglycemia or a specific treatment
indication. Phototherapy is unrelated to the immediate
problem.
Question 4
A newborn is observed to have a soft, blowing systolic murmur
shortly after birth. The infant is pink, has strong peripheral
pulses, is feeding well, and has no respiratory distress. What is
the most appropriate nursing response?
A. Document the finding and ensure appropriate reassessment
B. Immediately begin chest compressions
C. Restrict all oral feedings
D. Assume the murmur confirms a congenital heart defect
Full Official Name Practice Exam 2026/2027
Practice Questions & Study Guide | Complete
Exam-Style Questions with Correct Detailed
Answers & Rationales (Reliable Answers) |
Latest Updated Version | Instant Download
Question 1
A term newborn is assessed shortly after birth. The infant has a
heart rate of 148/min, spontaneous respirations, active
movement, flexed extremities, a strong cry, and acrocyanosis.
Which finding requires the nurse to intervene first?
A. Heart rate of 148/min
B. Acrocyanosis of the hands and feet
C. Strong cry
D. Spontaneous respirations
Correct Answer: B. Acrocyanosis of the hands and feet
Acrocyanosis is common during the immediate transition after
birth, so by itself it is generally a normal finding rather than an
indication for emergency intervention. However, among the
,choices, the nurse should recognize that the finding requiring
continued assessment is the color change. Central cyanosis
involving the tongue and trunk would be more concerning for
inadequate oxygenation and would require prompt evaluation.
The other findings—heart rate of 148/min, spontaneous
respirations, and a strong cry—are reassuring signs of neonatal
adaptation. The question tests the distinction between normal
peripheral cyanosis during transition and clinically significant
central cyanosis.
Question 2
During a newborn assessment, the nurse notes a respiratory
rate of 72/min. The infant has intermittent grunting and mild
intercostal retractions. What is the nurse's priority action?
A. Place the newborn prone and reassess in 30 minutes
B. Continue routine assessment because newborn respirations
are normally irregular
C. Assess oxygenation and notify the neonatal provider
promptly
D. Offer oral feeding to determine whether the respiratory
pattern improves
Correct Answer: C. Assess oxygenation and notify the
neonatal provider promptly
,Persistent tachypnea accompanied by grunting and retractions
indicates increased work of breathing and may represent
neonatal respiratory distress. The nurse should immediately
assess oxygen saturation, respiratory effort, color, perfusion,
and other signs of compromise while escalating care. Newborn
respirations can be irregular, but a sustained rate above the
expected range with accessory muscle use or grunting is not
considered a normal variation. Oral feeding is unsafe when
significant respiratory distress is present because tachypnea
and poor respiratory coordination increase the risk of
aspiration.
Question 3
A newborn's axillary temperature is 36.1°C (97.0°F). The infant
is alert but has cool extremities. Which intervention is most
appropriate initially?
A. Place the infant under a radiant warmer and reassess
temperature
B. Administer an immediate glucose bolus
C. Bathe the newborn in warm water
D. Begin phototherapy
Correct Answer: A. Place the infant under a radiant warmer
and reassess temperature
, Cold stress increases oxygen and glucose consumption and can
contribute to hypoglycemia, metabolic acidosis, and respiratory
compromise. A temperature of 36.1°C is below the expected
neonatal range and should be corrected promptly using an
appropriate warming method such as a radiant warmer.
Bathing would increase heat loss and is inappropriate while the
infant is cold. Glucose assessment may also be appropriate
because hypothermia can increase glucose utilization, but a
glucose bolus should not be administered without evidence of
clinically significant hypoglycemia or a specific treatment
indication. Phototherapy is unrelated to the immediate
problem.
Question 4
A newborn is observed to have a soft, blowing systolic murmur
shortly after birth. The infant is pink, has strong peripheral
pulses, is feeding well, and has no respiratory distress. What is
the most appropriate nursing response?
A. Document the finding and ensure appropriate reassessment
B. Immediately begin chest compressions
C. Restrict all oral feedings
D. Assume the murmur confirms a congenital heart defect
