Newborn Transition: Final Exam (Comprehensive) - Questions
with Correct Answers
100 questions
1. Neonatal hypocalcemia may occur in the first days of life, especially in infants who are:
A. Preterm, infants of diabetic mothers or those who had birth asphyxia
B. Term breastfed infants with no risk factors
C. Over 1 year old
D. Postmature only
Correct Answer: A. Preterm, infants of diabetic mothers or those who had birth asphyxia
Rationale: Abrupt loss of maternal calcium supply and immature parathyroid function
contribute. It can cause jitteriness and seizures.
2. Excessive heat from a radiant warmer can cause:
A. Hypothermia
B. Increased glucose stores
C. Increased insensible water loss, dehydration and hyperthermia
D. Improved breathing in all cases
Correct Answer: C. Increased insensible water loss, dehydration and hyperthermia
Rationale: Overheating increases evaporative losses and metabolic demand. Warmers must be
servo-controlled and monitored.
3. Routine weighing and measuring of a stable newborn can be:
A. Done before any contact with the mother
B. Skipped entirely
C. Delayed until after the first breastfeed and skin-to-skin period
D. Done while the infant is wet and uncovered
Correct Answer: C. Delayed until after the first breastfeed and skin-to-skin period
Rationale: Delaying routine measurements supports early bonding without affecting safety.
They must still be done.
,4. A newborn's initial temperature should be taken:
A. Only at discharge
B. Within the first hour and then regularly during transition
C. Only if the infant feels cold
D. Once a week
Correct Answer: B. Within the first hour and then regularly during transition
Rationale: Frequent temperature checks during transition detect cold stress early. Waiting for
symptoms delays intervention.
5. The neonatal resuscitation team should include at least one person:
A. Who also cares for the mother simultaneously
B. Who arrives after the birth
C. Who has no training
D. Whose only responsibility is the newborn and who can begin PPV, with additional skilled staff
available for high-risk births
Correct Answer: D. Whose only responsibility is the newborn and who can begin PPV, with
additional skilled staff available for high-risk births
Rationale: Dedicated personnel ensure immediate care. High-risk births need a full team
capable of intubation and medications.
6. CPAP is recommended in the delivery room for:
A. Apneic infants
B. Infants with heart rate below 60
C. Spontaneously breathing preterm infants with respiratory distress
D. All vigorous term infants
Correct Answer: C. Spontaneously breathing preterm infants with respiratory distress
Rationale: CPAP supports lung expansion and can avoid intubation. Apneic or bradycardic
infants need PPV.
,7. A high-pitched, shrill cry in a newborn may indicate:
A. Neurologic problems, hypoglycemia, withdrawal or increased intracranial pressure
B. Normal hunger
C. Teething
D. Contentment
Correct Answer: A. Neurologic problems, hypoglycemia, withdrawal or increased intracranial
pressure
Rationale: An abnormal cry pattern warrants assessment. Normal hunger cries are vigorous but
not high-pitched.
8. The tonic neck reflex in a newborn is seen when:
A. The cheek is stroked
B. The head is turned to one side, extending the arm on that side and flexing the opposite arm
C. The palm is pressed
D. The infant is held upright
Correct Answer: B. The head is turned to one side, extending the arm on that side and flexing
the opposite arm
Rationale: The fencing position is normal in young infants. Other stimuli elicit different reflexes.
9. Asymmetric gluteal or thigh skin folds in a newborn may suggest:
A. Normal variation always
B. Jaundice
C. Developmental dysplasia of the hip
D. Heart disease
Correct Answer: C. Developmental dysplasia of the hip
Rationale: Asymmetry can accompany hip dysplasia but is also found in normal infants, so a
careful hip examination is needed. It is not linked to jaundice or heart disease.
, 10. Normal length for a term newborn is approximately:
A. 30 to 35 cm
B. 60 to 65 cm
C. 70 cm
D. 45 to 55 cm (18 to 22 inches)
Correct Answer: D. 45 to 55 cm (18 to 22 inches)
Rationale: Length is measured from crown to heel with the legs extended. The other values are
outside the normal range.
11. Petechiae over the presenting part of the newborn, such as the face after a face
presentation, are:
A. Always a sign of sepsis
B. Normal everywhere on the body
C. A sign of jaundice
D. Usually due to birth pressure and fade within days, but widespread petechiae need
evaluation
Correct Answer: D. Usually due to birth pressure and fade within days, but widespread
petechiae need evaluation
Rationale: Localized petechiae from pressure are common. Generalized petechiae may indicate
low platelets or infection.
12. Breast tissue in a term newborn typically shows:
A. No areola
B. A flat, barely visible areola
C. Adult breast development
D. A raised areola with a palpable breast bud of several millimeters
Correct Answer: D. A raised areola with a palpable breast bud of several millimeters
Rationale: Breast bud size increases with gestation. A flat areola without a bud suggests
prematurity.
with Correct Answers
100 questions
1. Neonatal hypocalcemia may occur in the first days of life, especially in infants who are:
A. Preterm, infants of diabetic mothers or those who had birth asphyxia
B. Term breastfed infants with no risk factors
C. Over 1 year old
D. Postmature only
Correct Answer: A. Preterm, infants of diabetic mothers or those who had birth asphyxia
Rationale: Abrupt loss of maternal calcium supply and immature parathyroid function
contribute. It can cause jitteriness and seizures.
2. Excessive heat from a radiant warmer can cause:
A. Hypothermia
B. Increased glucose stores
C. Increased insensible water loss, dehydration and hyperthermia
D. Improved breathing in all cases
Correct Answer: C. Increased insensible water loss, dehydration and hyperthermia
Rationale: Overheating increases evaporative losses and metabolic demand. Warmers must be
servo-controlled and monitored.
3. Routine weighing and measuring of a stable newborn can be:
A. Done before any contact with the mother
B. Skipped entirely
C. Delayed until after the first breastfeed and skin-to-skin period
D. Done while the infant is wet and uncovered
Correct Answer: C. Delayed until after the first breastfeed and skin-to-skin period
Rationale: Delaying routine measurements supports early bonding without affecting safety.
They must still be done.
,4. A newborn's initial temperature should be taken:
A. Only at discharge
B. Within the first hour and then regularly during transition
C. Only if the infant feels cold
D. Once a week
Correct Answer: B. Within the first hour and then regularly during transition
Rationale: Frequent temperature checks during transition detect cold stress early. Waiting for
symptoms delays intervention.
5. The neonatal resuscitation team should include at least one person:
A. Who also cares for the mother simultaneously
B. Who arrives after the birth
C. Who has no training
D. Whose only responsibility is the newborn and who can begin PPV, with additional skilled staff
available for high-risk births
Correct Answer: D. Whose only responsibility is the newborn and who can begin PPV, with
additional skilled staff available for high-risk births
Rationale: Dedicated personnel ensure immediate care. High-risk births need a full team
capable of intubation and medications.
6. CPAP is recommended in the delivery room for:
A. Apneic infants
B. Infants with heart rate below 60
C. Spontaneously breathing preterm infants with respiratory distress
D. All vigorous term infants
Correct Answer: C. Spontaneously breathing preterm infants with respiratory distress
Rationale: CPAP supports lung expansion and can avoid intubation. Apneic or bradycardic
infants need PPV.
,7. A high-pitched, shrill cry in a newborn may indicate:
A. Neurologic problems, hypoglycemia, withdrawal or increased intracranial pressure
B. Normal hunger
C. Teething
D. Contentment
Correct Answer: A. Neurologic problems, hypoglycemia, withdrawal or increased intracranial
pressure
Rationale: An abnormal cry pattern warrants assessment. Normal hunger cries are vigorous but
not high-pitched.
8. The tonic neck reflex in a newborn is seen when:
A. The cheek is stroked
B. The head is turned to one side, extending the arm on that side and flexing the opposite arm
C. The palm is pressed
D. The infant is held upright
Correct Answer: B. The head is turned to one side, extending the arm on that side and flexing
the opposite arm
Rationale: The fencing position is normal in young infants. Other stimuli elicit different reflexes.
9. Asymmetric gluteal or thigh skin folds in a newborn may suggest:
A. Normal variation always
B. Jaundice
C. Developmental dysplasia of the hip
D. Heart disease
Correct Answer: C. Developmental dysplasia of the hip
Rationale: Asymmetry can accompany hip dysplasia but is also found in normal infants, so a
careful hip examination is needed. It is not linked to jaundice or heart disease.
, 10. Normal length for a term newborn is approximately:
A. 30 to 35 cm
B. 60 to 65 cm
C. 70 cm
D. 45 to 55 cm (18 to 22 inches)
Correct Answer: D. 45 to 55 cm (18 to 22 inches)
Rationale: Length is measured from crown to heel with the legs extended. The other values are
outside the normal range.
11. Petechiae over the presenting part of the newborn, such as the face after a face
presentation, are:
A. Always a sign of sepsis
B. Normal everywhere on the body
C. A sign of jaundice
D. Usually due to birth pressure and fade within days, but widespread petechiae need
evaluation
Correct Answer: D. Usually due to birth pressure and fade within days, but widespread
petechiae need evaluation
Rationale: Localized petechiae from pressure are common. Generalized petechiae may indicate
low platelets or infection.
12. Breast tissue in a term newborn typically shows:
A. No areola
B. A flat, barely visible areola
C. Adult breast development
D. A raised areola with a palpable breast bud of several millimeters
Correct Answer: D. A raised areola with a palpable breast bud of several millimeters
Rationale: Breast bud size increases with gestation. A flat areola without a bud suggests
prematurity.
