ALL CHAPTERS Test bank Tappero and Honeyfield’s Physical Assessment of the Newborn 7th Edition Witt
,ALL CHAPTERS Test bank Tappero and Honeyfield’s Physical Assessment of the Newborn 7th Edition Witt
Chapter 1 – Principles of Physical Assessment: Test Bank (20 Questions)
1. A full-term newborn is admitted to the nursery immediately after birth.
Which is the primary purpose of performing a comprehensive physical
assessment at this time?
A. To predict future growth patterns
B. To detect any immediate health concerns and congenital anomalies
C. To evaluate the effectiveness of maternal labor
D. To document maternal satisfaction with the birth process
✅ Answer: B
Rationale: The primary purpose of a newborn physical assessment is to
identify any immediate health concerns, congenital anomalies, or adaptations
to extrauterine life. While growth prediction and maternal satisfaction are
important, they are secondary to immediate clinical evaluation.
Keywords: System: Neonatal; Procedure: Physical assessment; Concept:
Early detection
2. During a newborn assessment, the nurse follows a systematic approach
starting with inspection, followed by palpation, percussion, and auscultation.
Why is this sequence recommended?
A. It minimizes infant distress and avoids altering natural findings
B. It ensures percussion is performed before inspection
C. It focuses only on cardiovascular assessment first
D. It allows auscultation to be skipped if unnecessary
✅ Answer: A
Rationale: Inspection first allows observation of natural appearance and
behavior. Palpation, percussion, and auscultation may disturb the newborn, so
performing them afterward avoids altering clinical findings.
,ALL CHAPTERS Test bank Tappero and Honeyfield’s Physical Assessment of the Newborn 7th Edition Witt
Keywords: System: All; Procedure: Assessment sequence; Concept: Clinical
reasoning
3. A nurse preparing to assess a newborn’s vital signs notices that the infant
has vernix covering parts of the skin. What is the best next step?
A. Wipe all vernix off immediately
B. Assess through the vernix without removal
C. Gently wipe only where tactile assessment is required
D. Delay assessment until vernix disappears naturally
✅ Answer: C
Rationale: Vernix protects the skin and can be left in place except where
direct tactile examination (palpation) is needed. Immediate full removal is
unnecessary and could irritate the skin.
Keywords: System: Integumentary; Procedure: Physical assessment;
Concept: Infection control & neonatal skin care
4. A newborn presents with mild cyanosis in the hands and feet. Which
assessment technique is most appropriate to determine the underlying cause?
A. Inspection and auscultation of the heart and lungs
B. Percussion of the abdomen only
C. Palpation of fontanels
D. Observation of crying patterns
✅ Answer: A
Rationale: Cyanosis may indicate cardiovascular or respiratory compromise.
Inspection and auscultation help detect murmurs, irregular heartbeats, or
abnormal breath sounds. Peripheral cyanosis alone is often benign but should
be evaluated in context.
Keywords: System: Cardiopulmonary; Procedure: Inspection & auscultation;
Concept: Early recognition
,ALL CHAPTERS Test bank Tappero and Honeyfield’s Physical Assessment of the Newborn 7th Edition Witt
5. During a newborn assessment, the nurse washes hands, dons gloves, and
ensures the infant is on a clean, warm surface. Which principle does this
reflect?
A. Evidence-based practice
B. Infection control
C. Gestational age assessment
D. Pain management
✅ Answer: B
Rationale: Proper hand hygiene, protective barriers, and maintaining a clean
environment are core infection control measures to prevent neonatal
infection.
Keywords: System: Neonatal; Procedure: Infection control; Concept: Safety
6. A nurse is conducting percussion of a newborn’s chest. What is the
primary purpose of this technique in a healthy term infant?
A. To measure the infant’s height
B. To assess air-filled structures and underlying tissue density
C. To evaluate cranial sutures
D. To determine urine output
✅ Answer: B
Rationale: Percussion produces sounds that help determine if underlying
structures are air-filled (lungs) or solid (heart, liver). It is rarely used in detail
in healthy newborns but may assist in detecting abnormalities.
Keywords: System: Respiratory; Procedure: Percussion; Concept: Tissue
characterization
7. A 38-week gestation newborn is being assessed for tone and reflexes.
Which technique best evaluates neuromuscular maturity?
,ALL CHAPTERS Test bank Tappero and Honeyfield’s Physical Assessment of the Newborn 7th Edition Witt
A. Auscultation of breath sounds
B. Palpation of fontanels
C. Observation of spontaneous movements and reflexes
D. Percussion of the abdomen
✅ Answer: C
Rationale: Spontaneous movements and reflexes (e.g., Moro, grasp) provide
information about neuromuscular maturity and overall neurological status.
Keywords: System: Neurologic; Procedure: Observation & palpation;
Concept: Developmental assessment
8. While preparing to auscultate a newborn’s heart, the nurse hears an
irregular rhythm. What is the most appropriate next step?
A. Ignore, as irregular rhythms are normal
B. Reassess after the infant is calm and report findings
C. Immediately start resuscitation
D. Palpate the abdomen instead
✅ Answer: B
Rationale: Many irregularities are transient; reassessment after the newborn
is calm provides more accurate data. Persistent irregularities should be
reported and further evaluated.
Keywords: System: Cardiovascular; Procedure: Auscultation; Concept:
Clinical decision-making
9. During a routine newborn assessment, the nurse observes a small bruise on
the scalp from vacuum-assisted delivery. What ethical principle guides the
nurse’s action?
A. Autonomy
B. Nonmaleficence
C. Justice
D. Veracity
, ALL CHAPTERS Test bank Tappero and Honeyfield’s Physical Assessment of the Newborn 7th Edition Witt
✅ Answer: B
Rationale: Nonmaleficence emphasizes avoiding harm. Documenting,
monitoring, and explaining findings to parents reflect ethical practice while
ensuring safety.
Keywords: System: All; Procedure: Observation; Concept: Ethics & patient
safety
10. A newborn in the nursery is restless during the physical assessment.
Which strategy is most effective to reduce distress while completing the
exam?
A. Proceed quickly without pauses
B. Swaddle and assess in segments, allowing rest
C. Perform only inspection
D. Delay assessment until 24 hours
✅ Answer: B
Rationale: Segmenting the exam and swaddling the newborn reduces stress,
supports thermoregulation, and allows accurate assessment.
Keywords: System: All; Procedure: Examination approach; Concept: Infant-
centered care
11. A preterm newborn is being assessed. Why is timing of the initial
physical exam especially important?
A. To allow parents to rest first
B. To identify early complications and provide timely interventions
C. To complete documentation faster
D. To ensure the newborn sleeps continuously
✅ Answer: B
Rationale: Preterm infants are at higher risk for respiratory, cardiovascular,
and metabolic complications; early assessment ensures prompt recognition
and treatment.
,ALL CHAPTERS Test bank Tappero and Honeyfield’s Physical Assessment of the Newborn 7th Edition Witt
Chapter 1 – Principles of Physical Assessment: Test Bank (20 Questions)
1. A full-term newborn is admitted to the nursery immediately after birth.
Which is the primary purpose of performing a comprehensive physical
assessment at this time?
A. To predict future growth patterns
B. To detect any immediate health concerns and congenital anomalies
C. To evaluate the effectiveness of maternal labor
D. To document maternal satisfaction with the birth process
✅ Answer: B
Rationale: The primary purpose of a newborn physical assessment is to
identify any immediate health concerns, congenital anomalies, or adaptations
to extrauterine life. While growth prediction and maternal satisfaction are
important, they are secondary to immediate clinical evaluation.
Keywords: System: Neonatal; Procedure: Physical assessment; Concept:
Early detection
2. During a newborn assessment, the nurse follows a systematic approach
starting with inspection, followed by palpation, percussion, and auscultation.
Why is this sequence recommended?
A. It minimizes infant distress and avoids altering natural findings
B. It ensures percussion is performed before inspection
C. It focuses only on cardiovascular assessment first
D. It allows auscultation to be skipped if unnecessary
✅ Answer: A
Rationale: Inspection first allows observation of natural appearance and
behavior. Palpation, percussion, and auscultation may disturb the newborn, so
performing them afterward avoids altering clinical findings.
,ALL CHAPTERS Test bank Tappero and Honeyfield’s Physical Assessment of the Newborn 7th Edition Witt
Keywords: System: All; Procedure: Assessment sequence; Concept: Clinical
reasoning
3. A nurse preparing to assess a newborn’s vital signs notices that the infant
has vernix covering parts of the skin. What is the best next step?
A. Wipe all vernix off immediately
B. Assess through the vernix without removal
C. Gently wipe only where tactile assessment is required
D. Delay assessment until vernix disappears naturally
✅ Answer: C
Rationale: Vernix protects the skin and can be left in place except where
direct tactile examination (palpation) is needed. Immediate full removal is
unnecessary and could irritate the skin.
Keywords: System: Integumentary; Procedure: Physical assessment;
Concept: Infection control & neonatal skin care
4. A newborn presents with mild cyanosis in the hands and feet. Which
assessment technique is most appropriate to determine the underlying cause?
A. Inspection and auscultation of the heart and lungs
B. Percussion of the abdomen only
C. Palpation of fontanels
D. Observation of crying patterns
✅ Answer: A
Rationale: Cyanosis may indicate cardiovascular or respiratory compromise.
Inspection and auscultation help detect murmurs, irregular heartbeats, or
abnormal breath sounds. Peripheral cyanosis alone is often benign but should
be evaluated in context.
Keywords: System: Cardiopulmonary; Procedure: Inspection & auscultation;
Concept: Early recognition
,ALL CHAPTERS Test bank Tappero and Honeyfield’s Physical Assessment of the Newborn 7th Edition Witt
5. During a newborn assessment, the nurse washes hands, dons gloves, and
ensures the infant is on a clean, warm surface. Which principle does this
reflect?
A. Evidence-based practice
B. Infection control
C. Gestational age assessment
D. Pain management
✅ Answer: B
Rationale: Proper hand hygiene, protective barriers, and maintaining a clean
environment are core infection control measures to prevent neonatal
infection.
Keywords: System: Neonatal; Procedure: Infection control; Concept: Safety
6. A nurse is conducting percussion of a newborn’s chest. What is the
primary purpose of this technique in a healthy term infant?
A. To measure the infant’s height
B. To assess air-filled structures and underlying tissue density
C. To evaluate cranial sutures
D. To determine urine output
✅ Answer: B
Rationale: Percussion produces sounds that help determine if underlying
structures are air-filled (lungs) or solid (heart, liver). It is rarely used in detail
in healthy newborns but may assist in detecting abnormalities.
Keywords: System: Respiratory; Procedure: Percussion; Concept: Tissue
characterization
7. A 38-week gestation newborn is being assessed for tone and reflexes.
Which technique best evaluates neuromuscular maturity?
,ALL CHAPTERS Test bank Tappero and Honeyfield’s Physical Assessment of the Newborn 7th Edition Witt
A. Auscultation of breath sounds
B. Palpation of fontanels
C. Observation of spontaneous movements and reflexes
D. Percussion of the abdomen
✅ Answer: C
Rationale: Spontaneous movements and reflexes (e.g., Moro, grasp) provide
information about neuromuscular maturity and overall neurological status.
Keywords: System: Neurologic; Procedure: Observation & palpation;
Concept: Developmental assessment
8. While preparing to auscultate a newborn’s heart, the nurse hears an
irregular rhythm. What is the most appropriate next step?
A. Ignore, as irregular rhythms are normal
B. Reassess after the infant is calm and report findings
C. Immediately start resuscitation
D. Palpate the abdomen instead
✅ Answer: B
Rationale: Many irregularities are transient; reassessment after the newborn
is calm provides more accurate data. Persistent irregularities should be
reported and further evaluated.
Keywords: System: Cardiovascular; Procedure: Auscultation; Concept:
Clinical decision-making
9. During a routine newborn assessment, the nurse observes a small bruise on
the scalp from vacuum-assisted delivery. What ethical principle guides the
nurse’s action?
A. Autonomy
B. Nonmaleficence
C. Justice
D. Veracity
, ALL CHAPTERS Test bank Tappero and Honeyfield’s Physical Assessment of the Newborn 7th Edition Witt
✅ Answer: B
Rationale: Nonmaleficence emphasizes avoiding harm. Documenting,
monitoring, and explaining findings to parents reflect ethical practice while
ensuring safety.
Keywords: System: All; Procedure: Observation; Concept: Ethics & patient
safety
10. A newborn in the nursery is restless during the physical assessment.
Which strategy is most effective to reduce distress while completing the
exam?
A. Proceed quickly without pauses
B. Swaddle and assess in segments, allowing rest
C. Perform only inspection
D. Delay assessment until 24 hours
✅ Answer: B
Rationale: Segmenting the exam and swaddling the newborn reduces stress,
supports thermoregulation, and allows accurate assessment.
Keywords: System: All; Procedure: Examination approach; Concept: Infant-
centered care
11. A preterm newborn is being assessed. Why is timing of the initial
physical exam especially important?
A. To allow parents to rest first
B. To identify early complications and provide timely interventions
C. To complete documentation faster
D. To ensure the newborn sleeps continuously
✅ Answer: B
Rationale: Preterm infants are at higher risk for respiratory, cardiovascular,
and metabolic complications; early assessment ensures prompt recognition
and treatment.
