2026 – Neonatal Physical Assessment Practice
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Question 1
During the initial physical assessment of a term newborn, which
finding requires the nurse to investigate further rather than
document it as an expected normal finding?
A. Acrocyanosis of the hands and feet shortly after birth
B. Small amount of vernix in the skin folds
C. Central cyanosis involving the tongue and mucous
membranes
D. Mild molding of the skull after vaginal delivery
Answer: C. Central cyanosis involving the tongue and mucous
membranes
,Central cyanosis is abnormal in a newborn and may indicate
inadequate oxygenation associated with cardiac disease,
pulmonary disease, or another serious condition. Acrocyanosis
of the extremities can occur normally during the early transition
after birth, but cyanosis involving the tongue or oral mucosa
suggests that oxygenation is impaired more centrally. Mild
molding and vernix are common findings in otherwise healthy
newborns.
Question 2
A newborn's respiratory rate is being assessed. Which
technique provides the most accurate measurement?
A. Count respirations for 15 seconds and multiply by four
B. Count respirations for 30 seconds and multiply by two
C. Count respirations for a full 60 seconds
D. Count respirations for 10 seconds and multiply by six
Answer: C. Count respirations for a full 60 seconds
Newborn respirations can be irregular, with brief variations in
rate and depth. Counting for a complete minute reduces the risk
of inaccurately estimating the respiratory rate from a short
observation period. A normal newborn respiratory rate is
commonly approximately 40 to 60 breaths per minute.
,Question 3
While assessing a newborn's scalp, the nurse identifies a soft,
diffuse area of edema that crosses suture lines. Which finding is
most consistent with this observation?
A. Cephalohematoma
B. Caput succedaneum
C. Craniosynostosis
D. Subdural hemorrhage
Answer: B. Caput succedaneum
Caput succedaneum is edema of the scalp soft tissues
associated with pressure during labor and delivery. Because it is
located above the periosteum, it can cross suture lines and
often has a diffuse appearance. A cephalohematoma is a
collection of blood beneath the periosteum and therefore does
not cross the boundaries of the affected skull bone.
Question 4
Which assessment finding is most suggestive of a
cephalohematoma?
A. Diffuse scalp swelling that crosses several sutures
B. Generalized scalp edema present immediately after delivery
, C. Localized swelling that does not cross a suture line
D. Symmetric soft tissue swelling over the entire scalp
Answer: C. Localized swelling that does not cross a suture line
Cephalohematoma results from bleeding between the skull
bone and its periosteum. Because the periosteum is attached to
the margins of individual bones, the swelling is confined to that
bone and does not cross suture lines. The finding may become
more apparent after generalized birth-related scalp edema
decreases.
Question 5
Which cardiovascular assessment is particularly important
when screening a newborn for possible coarctation of the
aorta?
A. Comparing apical and radial pulse rates
B. Assessing capillary refill in both hands
C. Comparing femoral pulses with brachial pulses
D. Measuring blood pressure only in the right arm
Answer: C. Comparing femoral pulses with brachial pulses
Weak or delayed femoral pulses compared with upper-
extremity pulses can suggest obstruction of systemic blood flow
in the region of the aortic arch or descending aorta, including