NCLEX-RN Neonatal Nursing Exam
Practice Questions And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A Instant Download Pdf
1. A nurse is assessing a newborn immediately after birth. Which finding
requires immediate intervention?
A. Heart rate of 140 beats/min
B. Acrocyanosis of hands and feet
C. Respiratory rate of 42 breaths/min
D. Central cyanosis
Answer: Central cyanosis
Rationale: Central cyanosis indicates inadequate oxygenation and requires
immediate assessment and intervention. Acrocyanosis is a common normal
finding in newborns during transition.
2. Which medication is routinely administered to newborns shortly after birth to
prevent bleeding?
A. Vitamin K
B. Vitamin C
C. Iron supplement
D. Calcium gluconate
,Answer: Vitamin K
Rationale: Newborns have low vitamin K stores, increasing the risk of bleeding.
Vitamin K promotes clotting factor production and prevents hemorrhagic
disease of the newborn.
3. A nurse is caring for a premature infant in the neonatal intensive care unit
(NICU). Which complication is the infant at greatest risk for?
A. Hypertension
B. Respiratory distress syndrome
C. Hyperactivity
D. Obesity
Answer: Respiratory distress syndrome
Rationale: Premature infants have immature lungs and decreased surfactant
production, increasing the risk of respiratory distress syndrome.
4. Which assessment finding indicates respiratory distress in a newborn?
A. Sneezing
B. Hiccups
C. Nasal flaring
D. Periodic breathing
Answer: Nasal flaring
Rationale: Nasal flaring is a sign of increased respiratory effort in newborns.
Other signs include grunting, retractions, and cyanosis.
5. The nurse understands that surfactant in the newborn primarily functions to:
A. Increase blood glucose
B. Maintain alveolar stability
,C. Prevent infection
D. Improve digestion
Answer: Maintain alveolar stability
Rationale: Surfactant reduces surface tension in the lungs and prevents alveolar
collapse during expiration.
6. Which newborn temperature requires nursing intervention?
A. 36.9°C (98.4°F)
B. 37.2°C (99°F)
C. 35.8°C (96.4°F)
D. 37.5°C (99.5°F)
Answer: 35.8°C (96.4°F)
Rationale: Hypothermia increases oxygen and glucose consumption and may
lead to respiratory distress and hypoglycemia.
7. A nurse is teaching parents about newborn feeding. Which statement
indicates understanding?
A. “I should feed my newborn only every 6 hours.”
B. “I will wake my newborn for feeds if needed.”
C. “Crying is the only hunger sign.”
D. “Newborns do not need nighttime feedings.”
Answer: “I will wake my newborn for feeds if needed.”
Rationale: Newborns, especially premature infants, may need scheduled feeds
to maintain adequate nutrition and glucose levels.
8. Which newborn is at greatest risk for hypoglycemia?
, A. Term infant weighing 3.5 kg
B. Infant of a mother with diabetes
C. Infant breastfed within one hour
D. Infant with normal temperature
Answer: Infant of a mother with diabetes
Rationale: Infants of diabetic mothers are at increased risk for hypoglycemia due
to excessive insulin production.
9. The nurse recognizes which finding as a sign of neonatal hypoglycemia?
A. Jitteriness
B. Increased appetite
C. Warm skin
D. Strong cry
Answer: Jitteriness
Rationale: Jitteriness, lethargy, poor feeding, apnea, and seizures may indicate
neonatal hypoglycemia.
10. Which intervention helps prevent heat loss in a newborn?
A. Leaving the newborn uncovered
B. Placing the newborn under a fan
C. Drying the newborn immediately after birth
D. Bathing immediately after delivery
Answer: Drying the newborn immediately after birth
Rationale: Drying removes moisture that causes evaporative heat loss and helps
maintain newborn temperature.
Practice Questions And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A Instant Download Pdf
1. A nurse is assessing a newborn immediately after birth. Which finding
requires immediate intervention?
A. Heart rate of 140 beats/min
B. Acrocyanosis of hands and feet
C. Respiratory rate of 42 breaths/min
D. Central cyanosis
Answer: Central cyanosis
Rationale: Central cyanosis indicates inadequate oxygenation and requires
immediate assessment and intervention. Acrocyanosis is a common normal
finding in newborns during transition.
2. Which medication is routinely administered to newborns shortly after birth to
prevent bleeding?
A. Vitamin K
B. Vitamin C
C. Iron supplement
D. Calcium gluconate
,Answer: Vitamin K
Rationale: Newborns have low vitamin K stores, increasing the risk of bleeding.
Vitamin K promotes clotting factor production and prevents hemorrhagic
disease of the newborn.
3. A nurse is caring for a premature infant in the neonatal intensive care unit
(NICU). Which complication is the infant at greatest risk for?
A. Hypertension
B. Respiratory distress syndrome
C. Hyperactivity
D. Obesity
Answer: Respiratory distress syndrome
Rationale: Premature infants have immature lungs and decreased surfactant
production, increasing the risk of respiratory distress syndrome.
4. Which assessment finding indicates respiratory distress in a newborn?
A. Sneezing
B. Hiccups
C. Nasal flaring
D. Periodic breathing
Answer: Nasal flaring
Rationale: Nasal flaring is a sign of increased respiratory effort in newborns.
Other signs include grunting, retractions, and cyanosis.
5. The nurse understands that surfactant in the newborn primarily functions to:
A. Increase blood glucose
B. Maintain alveolar stability
,C. Prevent infection
D. Improve digestion
Answer: Maintain alveolar stability
Rationale: Surfactant reduces surface tension in the lungs and prevents alveolar
collapse during expiration.
6. Which newborn temperature requires nursing intervention?
A. 36.9°C (98.4°F)
B. 37.2°C (99°F)
C. 35.8°C (96.4°F)
D. 37.5°C (99.5°F)
Answer: 35.8°C (96.4°F)
Rationale: Hypothermia increases oxygen and glucose consumption and may
lead to respiratory distress and hypoglycemia.
7. A nurse is teaching parents about newborn feeding. Which statement
indicates understanding?
A. “I should feed my newborn only every 6 hours.”
B. “I will wake my newborn for feeds if needed.”
C. “Crying is the only hunger sign.”
D. “Newborns do not need nighttime feedings.”
Answer: “I will wake my newborn for feeds if needed.”
Rationale: Newborns, especially premature infants, may need scheduled feeds
to maintain adequate nutrition and glucose levels.
8. Which newborn is at greatest risk for hypoglycemia?
, A. Term infant weighing 3.5 kg
B. Infant of a mother with diabetes
C. Infant breastfed within one hour
D. Infant with normal temperature
Answer: Infant of a mother with diabetes
Rationale: Infants of diabetic mothers are at increased risk for hypoglycemia due
to excessive insulin production.
9. The nurse recognizes which finding as a sign of neonatal hypoglycemia?
A. Jitteriness
B. Increased appetite
C. Warm skin
D. Strong cry
Answer: Jitteriness
Rationale: Jitteriness, lethargy, poor feeding, apnea, and seizures may indicate
neonatal hypoglycemia.
10. Which intervention helps prevent heat loss in a newborn?
A. Leaving the newborn uncovered
B. Placing the newborn under a fan
C. Drying the newborn immediately after birth
D. Bathing immediately after delivery
Answer: Drying the newborn immediately after birth
Rationale: Drying removes moisture that causes evaporative heat loss and helps
maintain newborn temperature.
