RN MATERNAL NEWBORN STUDY GUIDE 2025/2026
QUESTIONS WITH ANSWERS RATED A+
✔✔How do you assess newborn posture? - ✔✔Assess posture for the degree of flexion
of the extremities. At term, a newborn's legs and arms are moderately flexed at rest.
Preterm newborns show lesser degrees of flexion: the younger the gestational age, the
less flexion the newborn demonstrates.
✔✔Square window Ballard Score exam - ✔✔Assess square window by grasping the
newborn's forearm and gently flexing the wrist toward the inner arm. Do not allow
rotation of the wrist.
Measure the angle that forms where the hand meets the wrist. At term, the hand should
touch the wrist, resulting in a 0-degree angle.
Preterm newborns show greater angles of flexion at the wrist: the younger the
gestational age, the less flexibility at the wrist. Very preterm newborns have an angle of
wrist flexion of 90 degrees or more.
✔✔Arm recoil Ballard Score Exam - ✔✔Measure arm recoil by first flexing and holding
both forearms for 5 seconds, then extending the arms and hands fully at the newborn's
side.
Next, release the hands and allow the arms to recoil (return to flexion).
Term newborns demonstrate full recoil to a position of flexion while preterm newborns
show less flexion (the image here shows a preterm newborn with no recoil). Measure
the angle of flexion at the elbow to determine the arm recoil score.
✔✔Popliteal angle Ballard Score Exam - ✔✔With the newborn's thigh pressed against
his abdomen, measure the popliteal angle by moving the foot gently toward the head
until you meet resistance. At this point, measure the angle behind the knee in the
popliteal area. Term newborns are less flexible, with about a 90-degree angle. With very
preterm newborns, the leg straightens to a 180-degree angle.
✔✔Scarf Sign Ballard Score Exam - ✔✔Assess the scarf sign by grasping the
newborn's hand and attempting to cross the arm over his body at the neck. The arms of
term newborns meet resistance before crossing midline, while preterm newborns cross
the elbow past midline
✔✔Heel to ear Ballard Score Exam - ✔✔Assess heel to ear by raising the newborn's
heel toward his head in an attempt to bring the foot to the ear. Do not raise the
newborn's buttocks off of the examination surface. Stop when you meet resistance and
measure the degree of extension of the leg. With preterm newborns (see image), you'll
come close to touching the heel to the ear, while you'll meet resistance almost
immediately with term newborns.
, ✔✔What are the components of physical maturity portion of the Ballard Score Exam? -
✔✔skin, lanugo, plantar surface, breast, eye/ear, and genitals. Base your scores for
these parameters on your assessment findings.
✔✔Skin assessment Ballard Score Exam - ✔✔The skin ranges from translucent and
friable in preterm newborns to leathery, cracked, and wrinkled in post-term newborns.
Assess the skin for transparency, cracks, veins, peeling, and wrinkles.
✔✔Lanugo Ballard Score Exam - ✔✔Lanugo is very fine body hair. Extremely
premature newborns have none. During the middle of the third trimester, most fetuses
have plentiful lanugo. Closer to term, this body hair begins to thin. Terms newborns
have very little, and it is nearly absent in post-term newborns
✔✔Plantar Surface Ballard Score Exam - ✔✔Inspect the plantar surface of the foot for
creases. Term newborns have creases over the entire plantar surface, while the
creases of a preterm newborn range from absent to faint red markings.
✔✔Breast exam Ballard Score Exam - ✔✔Inspect the breast to assess the size of the
breast bud in millimeters and the development of the areola. Preterm newborns lack
developed breast tissue. Term newborns have a raised to a full areola with breast buds
that are 3 to 10 millimeters in diameter.
✔✔Ear/Eye exam Ballard Score Exam - ✔✔The eye/ear assessment is an analysis of
the ear cartilage and shape of the pinna. The pinna is less curved in preterm newborns,
while term newborns have a well-curved pinna with firm cartilage. Determine ear recoil
by folding the pinna down and assessing how quickly it returns to its previous position.
Also, very preterm newborns may have fused eyelids. You'll score the degree of fusion
for these newborns.
✔✔Genitals exam Ballard Score Exam - ✔✔Observe the genitals for physical maturity.
With males, the testes usually descend near term and rugae (ridges or folds) are visible
on the scrotum. Palpate the testes to determine if they have descended and note the
rugae. With extreme prematurity, the scrotum is flat and smooth. With female newborns
at term, the labia majora are larger than the clitoris and the labia minora. Preterm
newborns (image on the right) have a prominent clitoris and small labia minora. Base
your scores on the degree of development of the labia.
✔✔Leopold Maneuvers determine what 7 things.. - ✔✔the number of fetuses, the
presenting part, the fetal lie, the fetal attitude, the fetal position, the degree of the
descent into the pelvis, and the best location for auscultating fetal heart tones.
✔✔How do you position a patient for Leopold Maneuver? - ✔✔Empty bladder, a rolled
towel under one hip to shift her uterus off major arteries, to decrease supine
hypotension. Stand on pts right side
QUESTIONS WITH ANSWERS RATED A+
✔✔How do you assess newborn posture? - ✔✔Assess posture for the degree of flexion
of the extremities. At term, a newborn's legs and arms are moderately flexed at rest.
Preterm newborns show lesser degrees of flexion: the younger the gestational age, the
less flexion the newborn demonstrates.
✔✔Square window Ballard Score exam - ✔✔Assess square window by grasping the
newborn's forearm and gently flexing the wrist toward the inner arm. Do not allow
rotation of the wrist.
Measure the angle that forms where the hand meets the wrist. At term, the hand should
touch the wrist, resulting in a 0-degree angle.
Preterm newborns show greater angles of flexion at the wrist: the younger the
gestational age, the less flexibility at the wrist. Very preterm newborns have an angle of
wrist flexion of 90 degrees or more.
✔✔Arm recoil Ballard Score Exam - ✔✔Measure arm recoil by first flexing and holding
both forearms for 5 seconds, then extending the arms and hands fully at the newborn's
side.
Next, release the hands and allow the arms to recoil (return to flexion).
Term newborns demonstrate full recoil to a position of flexion while preterm newborns
show less flexion (the image here shows a preterm newborn with no recoil). Measure
the angle of flexion at the elbow to determine the arm recoil score.
✔✔Popliteal angle Ballard Score Exam - ✔✔With the newborn's thigh pressed against
his abdomen, measure the popliteal angle by moving the foot gently toward the head
until you meet resistance. At this point, measure the angle behind the knee in the
popliteal area. Term newborns are less flexible, with about a 90-degree angle. With very
preterm newborns, the leg straightens to a 180-degree angle.
✔✔Scarf Sign Ballard Score Exam - ✔✔Assess the scarf sign by grasping the
newborn's hand and attempting to cross the arm over his body at the neck. The arms of
term newborns meet resistance before crossing midline, while preterm newborns cross
the elbow past midline
✔✔Heel to ear Ballard Score Exam - ✔✔Assess heel to ear by raising the newborn's
heel toward his head in an attempt to bring the foot to the ear. Do not raise the
newborn's buttocks off of the examination surface. Stop when you meet resistance and
measure the degree of extension of the leg. With preterm newborns (see image), you'll
come close to touching the heel to the ear, while you'll meet resistance almost
immediately with term newborns.
, ✔✔What are the components of physical maturity portion of the Ballard Score Exam? -
✔✔skin, lanugo, plantar surface, breast, eye/ear, and genitals. Base your scores for
these parameters on your assessment findings.
✔✔Skin assessment Ballard Score Exam - ✔✔The skin ranges from translucent and
friable in preterm newborns to leathery, cracked, and wrinkled in post-term newborns.
Assess the skin for transparency, cracks, veins, peeling, and wrinkles.
✔✔Lanugo Ballard Score Exam - ✔✔Lanugo is very fine body hair. Extremely
premature newborns have none. During the middle of the third trimester, most fetuses
have plentiful lanugo. Closer to term, this body hair begins to thin. Terms newborns
have very little, and it is nearly absent in post-term newborns
✔✔Plantar Surface Ballard Score Exam - ✔✔Inspect the plantar surface of the foot for
creases. Term newborns have creases over the entire plantar surface, while the
creases of a preterm newborn range from absent to faint red markings.
✔✔Breast exam Ballard Score Exam - ✔✔Inspect the breast to assess the size of the
breast bud in millimeters and the development of the areola. Preterm newborns lack
developed breast tissue. Term newborns have a raised to a full areola with breast buds
that are 3 to 10 millimeters in diameter.
✔✔Ear/Eye exam Ballard Score Exam - ✔✔The eye/ear assessment is an analysis of
the ear cartilage and shape of the pinna. The pinna is less curved in preterm newborns,
while term newborns have a well-curved pinna with firm cartilage. Determine ear recoil
by folding the pinna down and assessing how quickly it returns to its previous position.
Also, very preterm newborns may have fused eyelids. You'll score the degree of fusion
for these newborns.
✔✔Genitals exam Ballard Score Exam - ✔✔Observe the genitals for physical maturity.
With males, the testes usually descend near term and rugae (ridges or folds) are visible
on the scrotum. Palpate the testes to determine if they have descended and note the
rugae. With extreme prematurity, the scrotum is flat and smooth. With female newborns
at term, the labia majora are larger than the clitoris and the labia minora. Preterm
newborns (image on the right) have a prominent clitoris and small labia minora. Base
your scores on the degree of development of the labia.
✔✔Leopold Maneuvers determine what 7 things.. - ✔✔the number of fetuses, the
presenting part, the fetal lie, the fetal attitude, the fetal position, the degree of the
descent into the pelvis, and the best location for auscultating fetal heart tones.
✔✔How do you position a patient for Leopold Maneuver? - ✔✔Empty bladder, a rolled
towel under one hip to shift her uterus off major arteries, to decrease supine
hypotension. Stand on pts right side
