G&D Final Review
1. One minute after birth, a term newborn has HR 130, lusty cry, active flexion, sneezes when suctioned,
and pink trunk with blue hands/feet. What Apgar score should the nurse assign?
A. 7
✅
B. 8
C. 9
D. 10
Rationale: HR>100 (2), strong cry (2), active flexion (2), reflex “grimace”/sneeze (2), acrocyanosis (1)
= 9. Acrocyanosis (blue hands/feet) commonly lowers “Appearance” to 1 at 1 minute.
2. New parents ask about the “white, cheesy coating” on their newborn’s skin. The best response is:
✅
A. “It indicates a fungal infection and should be removed.”
B. “It’s protective vernix caseosa and is normal.”
C. “It’s a sign of dehydration.”
D. “It means we need to bathe the baby immediately.”
Rationale: Vernix caseosa is a normal protective coating of the newborn skin; no urgent removal is
indicated.
3. Which finding is expected in a healthy term newborn’s physical appearance?
✅
A. Small head proportionate to the body
B. Large head (~¼ of body length) and open fontanels
C. Thick scalp hair indicates infection
D. No lanugo present is required for discharge
Rationale: Normal newborns have a relatively large head and palpable fontanels; lanugo may be
present.
4. During assessment the nurse strokes a newborn’s cheek; the infant turns toward the stimulus and opens
the mouth. This reflex is:
A. Moro
✅
B. Stepping
C. Rooting
D. Babinski
Rationale: Rooting helps infants locate the nipple; Babinski = toe fanning; Moro = startle; stepping =
walking-like.
, 5. Stroking the lateral sole of the foot causes the newborn’s toes to fan outward. The nurse documents:
✅
A. Palmar grasp
B. Babinski
C. Plantar reflex
D. Tonic neck
Rationale: Babinski (toes fan) is normal in newborns and early infancy.
6. A 2-month-old’s caregiver asks about social milestones. Which behavior is expected at this age?
✅
A. Separation anxiety
B. Social smile
C. Parallel play
D. Stranger anxiety
Rationale: Social smiling appears by ~6–8 weeks; stranger anxiety ~6–8 months; separation anxiety
~8–12 months.
7. The nurse anticipates stranger anxiety most commonly appears around:
A. 2–3 months
✅
B. 4–5 months
C. 6–8 months
D. 12–15 months
Rationale: Stranger wariness emerges ~6–8 months; separation anxiety ~8–12 months.
8. An infant looks at the mother’s face when a loud noise occurs, then calms when the mother smiles and
nods. This behavior is best described as:
✅
A. Separation anxiety
B. Social referencing
C. Attachment failure
D. Disorganized behavior
Rationale: Social referencing = using caregiver’s emotional cues to guide behavior.
9. SATA. Which are evidence-based benefits of breastfeeding the nurse should include in discharge
✅
teaching? (Select all that apply.)
✅
A. Provides ideal nutrition
✅
B. Conveys maternal antibodies
C. Reduces infant infections/GI illness
✅
D. Increases food allergies
E. Strengthens bonding
Rationale: Human milk provides optimal nutrition, immune protection, and bonding; it is associated
with fewer infections.
10. A parent asks why their newborn’s hands and feet sometimes look bluish. The best response is:
✅
A. “It’s central cyanosis and requires oxygen.”
B. “It’s acrocyanosis and often normal in the first hours.”
C. “It’s a hematologic disorder.”
D. “It means your baby is cold-stressed and septic.”
1. One minute after birth, a term newborn has HR 130, lusty cry, active flexion, sneezes when suctioned,
and pink trunk with blue hands/feet. What Apgar score should the nurse assign?
A. 7
✅
B. 8
C. 9
D. 10
Rationale: HR>100 (2), strong cry (2), active flexion (2), reflex “grimace”/sneeze (2), acrocyanosis (1)
= 9. Acrocyanosis (blue hands/feet) commonly lowers “Appearance” to 1 at 1 minute.
2. New parents ask about the “white, cheesy coating” on their newborn’s skin. The best response is:
✅
A. “It indicates a fungal infection and should be removed.”
B. “It’s protective vernix caseosa and is normal.”
C. “It’s a sign of dehydration.”
D. “It means we need to bathe the baby immediately.”
Rationale: Vernix caseosa is a normal protective coating of the newborn skin; no urgent removal is
indicated.
3. Which finding is expected in a healthy term newborn’s physical appearance?
✅
A. Small head proportionate to the body
B. Large head (~¼ of body length) and open fontanels
C. Thick scalp hair indicates infection
D. No lanugo present is required for discharge
Rationale: Normal newborns have a relatively large head and palpable fontanels; lanugo may be
present.
4. During assessment the nurse strokes a newborn’s cheek; the infant turns toward the stimulus and opens
the mouth. This reflex is:
A. Moro
✅
B. Stepping
C. Rooting
D. Babinski
Rationale: Rooting helps infants locate the nipple; Babinski = toe fanning; Moro = startle; stepping =
walking-like.
, 5. Stroking the lateral sole of the foot causes the newborn’s toes to fan outward. The nurse documents:
✅
A. Palmar grasp
B. Babinski
C. Plantar reflex
D. Tonic neck
Rationale: Babinski (toes fan) is normal in newborns and early infancy.
6. A 2-month-old’s caregiver asks about social milestones. Which behavior is expected at this age?
✅
A. Separation anxiety
B. Social smile
C. Parallel play
D. Stranger anxiety
Rationale: Social smiling appears by ~6–8 weeks; stranger anxiety ~6–8 months; separation anxiety
~8–12 months.
7. The nurse anticipates stranger anxiety most commonly appears around:
A. 2–3 months
✅
B. 4–5 months
C. 6–8 months
D. 12–15 months
Rationale: Stranger wariness emerges ~6–8 months; separation anxiety ~8–12 months.
8. An infant looks at the mother’s face when a loud noise occurs, then calms when the mother smiles and
nods. This behavior is best described as:
✅
A. Separation anxiety
B. Social referencing
C. Attachment failure
D. Disorganized behavior
Rationale: Social referencing = using caregiver’s emotional cues to guide behavior.
9. SATA. Which are evidence-based benefits of breastfeeding the nurse should include in discharge
✅
teaching? (Select all that apply.)
✅
A. Provides ideal nutrition
✅
B. Conveys maternal antibodies
C. Reduces infant infections/GI illness
✅
D. Increases food allergies
E. Strengthens bonding
Rationale: Human milk provides optimal nutrition, immune protection, and bonding; it is associated
with fewer infections.
10. A parent asks why their newborn’s hands and feet sometimes look bluish. The best response is:
✅
A. “It’s central cyanosis and requires oxygen.”
B. “It’s acrocyanosis and often normal in the first hours.”
C. “It’s a hematologic disorder.”
D. “It means your baby is cold-stressed and septic.”
