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1. A nurse in a delivery room is assisting with the delivery of a newborn infant. After the delivery, the
nurse prepares to prevent heat loss in the newborn resulting from evaporation by:
A. Warming the crib pad
B. Turning on the overhead radiant warmer
C. Closing the doors to the room
D. Drying the infant in a warm blanket
2. A nurse is assessing a newborn infant following circumcision and notes that the circumcised area is
red with a small amount of bloody drainage. Which of the following nursing actions would be most
appropriate?
A. Document the findings
B. Contact the physician
C. Circle the amount of bloody drainage on the dressing and reassess in 30 minutes
D. Reinforce the dressing
3. A nurse in the newborn nursery is monitoring a preterm newborn infant for respiratory distress
syndrome. Which assessment signs if noted in the newborn infant would alert the nurse to the
possibility of this syndrome?
A. Hypotension and Bradycardia
B. Tachypnea and retractions
C. Acrocyanosis and grunting
D. The presence of a barrel chest with grunting
4. A nurse in a newborn nursery is performing an assessment of a newborn infant. The nurse is
preparing to measure the head circumference of the infant. The nurse would most appropriately:
A. Wrap the tape measure around the infants head and measure just above the eyebrows.
B. Place the tape measure under the infants head at the base of the skull and wrap around to the front just
above the eyes
C. Place the tape measure under the infants head, wrap around the occiput, and measure just above the eyes
D. Place the tape measure at the back of the infants head, wrap around across the ears, and measure across
the infants mouth.
5. A postpartum nurse is providing instructions to the mother of a newborn infant with
hyperbilirubinemia who is being breastfed. The nurse provides which most appropriate instructions to
the mother?
A. Switch to bottle feeding the baby for 2 weeks
B. Stop the breast feedings and switch to bottle-feeding permanently
C. Feed the newborn infant less frequently
D. Continue to breast-feed every 2-4 hours

6. A nurse on the newborn nursery floor is caring for a neonate. On assessment the infant is exhibiting
signs of cyanosis, tachypnea, nasal flaring, and grunting. Respiratory distress syndrome is diagnosed,
and the physician prescribes surfactant replacement therapy. The nurse would prepare to administer
this therapy by:
A. Subcutaneous injection
B. Intravenous injection
C. Instillation of the preparation into the lungs through an endotracheal tube
D. Intramuscular injection
7. A nurse is assessing a newborn infant who was born to a mother who is addicted to drugs. Which of
the following assessment findings would the nurse expect to note during the assessment of this
newborn?
A. Sleepiness
B. Cuddles when being held
C. Lethargy
D. Incessant crying
8. A nurse prepares to administer a vitamin K injection to a newborn infant. The mother asks the nurse
why her newborn infant needs the injection. The best response by the nurse would be:
A. You infant needs vitamin K to develop immunity.
B. The vitamin K will protect your infant from being jaundiced.
C. Newborn infants are deficient in vitamin K, and this injection prevents your infant from abnormal bleeding.
D. Newborn infants have sterile bowels, and vitamin K promotes the growth of bacteria in the bowel.
9. A nurse in a newborn nursery receives a phone call to prepare for the admission of a 43-weekgestation newborn with Apgar scores of 1 and 4. In planning for the admission of this infant, the
nurses highest priority should be to:
A. Connect the resuscitation bag to the oxygen outlet
B. Turn on the apnea and cardiorespiratory monitors
C. Set up the intravenous line with 5% dextrose in water
D. Set the radiant warmer control temperature at 36.5* C (97.6*F)
10. Vitamin K is prescribed for a neonate. A nurse prepares to administer the medication in which
muscle site?
A. Deltoid
B. Triceps
C. Vastus lateralis
D. Biceps
11. A nursing instructor asks a nursing student to describe the procedure for administering
erythromycin ointment into the eyes if a neonate. The instructor determines that the student needs to
research this procedure further if the student states:

A. I will cleanse the neonates eyes before instilling ointment.

B. I will flush the eyes after instilling the ointment.
C. I will instill the eye ointment into each of the neonates conjunctival sacs within one hour after birth.
D. Administration of the eye ointment may be delayed until an hour or so after birth so that eye contact and
parent-infant attachment and bonding can occur.
12. A baby is born precipitously in the ER. The nurses initial action should be to:
A. Establish an airway for the baby
B. Ascertain the condition of the fundus
C. Quickly tie and cut the umbilical cord
D. Move mother and baby to the birthing unit
13. The primary critical observation for Apgar scoring is the:
A. Heart rate
B. Respiratory rate
C. Presence of meconium
D. Evaluation of the Moro reflex
14. When performing a newborn assessment, the nurse should measure the vital signs in the following
sequence:
A. Pulse, respirations, temperature
B. Temperature, pulse, respirations
C. Respirations, temperature, pulse
D. Respirations, pulse, temperature
15. Within 3 minutes after birth the normal heart rate of the infant may range between:
A. 100 and 180
B. 130 and 170
C. 120 and 160
D. 100 and 130
16. The expected respiratory rate of a neonate within 3 minutes of birth may be as high as:
A. 50
B. 60
C. 80
D. 100
17. The nurse is aware that a healthy newborns respirations are:
A. Regular, abdominal, 40-50 per minute, deep
B. Irregular, abdominal, 30-60 per minute, shallow
C. Irregular, initiated by chest wall, 30-60 per minute, deep
D. Regular, initiated by the chest wall, 40-60 per minute, shallow

18. To help limit the development of hyperbilirubinemia in the neonate, the plan of care should include:
A. Monitoring for the passage of meconium each shift
B. Instituting phototherapy for 30 minutes every 6 hours
C. Substituting breastfeeding for formula during the 2nd day after birth
D. Supplementing breastfeeding with glucose water during the first 24 hours
19. A newborn has small, whitish, pinpoint spots over the nose, which the nurse knows are caused by
retained sebaceous secretions. When charting this observation, the nurse identifies it as:
A. Milia
B. Lanugo
C. Whiteheads
D. Mongolian spots
20. When newborns have been on formula for 36-48 hours, they should have a:
A. Screening for PKU
B. Vitamin K injection
C. Test for necrotizing enterocolitis
D. Heel stick for blood glucose level
21. The nurse decides on a teaching plan for a new mother and her infant. The plan should include:
A. Discussing the matter with her in a non-threatening manner
B. Showing by example and explanation how to care for the infant
C. Setting up a schedule for teaching the mother how to care for her baby
D. Supplying the emotional support to the mother and encouraging her independence
22. Which action best explains the main role of surfactant in the neonate?
A. Assists with ciliary body maturation in the upper airways
B. Helps maintain a rhythmic breathing pattern
C. Promotes clearing mucus from the respiratory tract
D. Helps the lungs remain expanded after the initiation of breathing
23. While assessing a 2-hour old neonate, the nurse observes the neonate to have acrocyanosis. Which
of the following nursing actions should be performed initially?
A. Activate the code blue or emergency system
B. Do nothing because acrocyanosis is normal in the neonate
C. Immediately take the newborns temperature according to hospital policy
D. Notify the physician of the need for a cardiac consult
24. The nurse is aware that a neonate of a mother with diabetes is at risk for what complication?
A. Anemia
B. Hypoglycemia

C. Nitrogen loss
D. Thrombosis
25. A client with group AB blood whose husband has group O has just given birth. The major sign of
ABO blood incompatibility in the neonate is which complication or test result?
A. Negative Coombs test
B. Bleeding from the nose and ear
C. Jaundice after the first 24 hours of life
D. Jaundice within the first 24 hours of life
26. A client has just given birth at 42 weeks gestation. When assessing the neonate, which physical
finding is expected?
A. A sleepy, lethargic baby
B. Lanugo covering the body
C. Desquamation of the epidermis
D. Vernix caseosa covering the body
27. After reviewing the clients maternal history of magnesium sulfate during labor, which condition
would the nurse anticipate as a potential problem in the neonate?
A. Hypoglycemia
B. Jitteriness
C. Respiratory depression
D. Tachycardia
28. Neonates of mothers with diabetes are at risk for which complication following birth?
A. Atelectasis
B. Microcephaly
C. Pneumothorax
D. Macrosomia
29. By keeping the nursery temperature warm and wrapping the neonate in blankets, the nurse is
preventing which type of heat loss?
A. Conduction
B. Convection
C. Evaporation
D. Radiation
30. A neonate has been diagnosed with caput succedaneum. Which statement is correct about this
condition?
A. It usually resolves in 3-6 weeks
B. It doesnt cross the cranial suture line
C. Its a collection of blood between the skull and the periosteum
D. It involves swelling of tissue over the presenting part of the presenting head

31. The most common neonatal sepsis and meningitis infections seen within 24 hours after birth are
caused by which organism?
A. Candida albicans
B. Chlamydia trachomatis
C. Escherichia coli
D. Group B beta-hemolytic streptococci
32. When attempting to interact with a neonate experiencing drug withdrawal, which behavior would
indicate that the neonate is willing to interact?
A. Gaze aversion
B. Hiccups
C. Quiet alert state
D. Yawning
33. When teaching umbilical cord care to a new mother, the nurse would include which information?
A. Apply peroxide to the cord with each diaper change
B. Cover the cord with petroleum jelly after bathing
C. Keep the cord dry and open to air
D. Wash the cord with soap and water each day during a tub bath
34. A mother of a term neonate asks what the thick, white, cheesy coating is on his skin. Which
correctly describes this finding?
A. Lanugo
B. Milia
C. Nevus flammeus
D. Vernix
35. Which condition or treatment best ensures lung maturity in an infant?
A. Meconium in the amniotic fluid
B. Glucocorticoid treatment just before delivery
C. Lecithin to sphingomyelin ratio more than 2:1
D. Absence of phosphatidylglycerol in amniotic fluid
36. When performing nursing care for a neonate after a birth, which intervention has the highest
nursing priority?
A. Obtain a dextrostix
B. Give the initial bath
C. Give the vitamin K injection
D. Cover the neonates head with a cap
37. When performing an assessment on a neonate, which assessment finding is most suggestive of
hypothermia?

A. Bradycardia
B. Hyperglycemia
C. Metabolic alkalosis
D. Shivering
38. A woman delivers a 3.250 g neonate at 42 weeks gestation. Which physical finding is expected
during an examination if this neonate?
A. Abundant lanugo
B. Absence of sole creases
C. Breast bud of 1-2 mm in diameter
D. Leathery, cracked, and wrinkled skin
39. A healthy term neonate born by C-section was admitted to the transitional nursery 30 minutes ago
and placed under a radiant warmer. The neonate has an axillary temperature of 99.5oF, a respiratory
rate of 80 breaths/minute, and a heel stick glucose value of 60 mg/dl. Which action should the nurse
take?
A. Wrap the neonate warmly and place her in an open crib
B. Administer an oral glucose feeding of 10% dextrose in water
C. Increase the temperature setting on the radiant warmer
D. Obtain an order for IV fluid administration
40. Which neonatal behavior is most commonly associated with fetal alcohol syndrome (FAS)?
A. Hypoactivity
B. High birth weight
C. Poor wake and sleep patterns
D. High threshold of stimulation
41. Which of the following behaviors would indicate that a client was bonding with her baby?
A. The client asks her husband to give the baby a bottle of water.
B. The client talks to the baby and picks him up when he cries.
C. The client feeds the baby every three hours.
D. The client asks the nurse to recommend a good child care manual.
42. A newborns mother is alarmed to find small amounts of blood on her infant girls diaper. When the
nurse checks the infants urine it is straw colored and has no offensive odor. Which explanation to the
newborns mother is most appropriate?
1. It appears your baby has a kidney infection
2. Breast-fed babies often experience this type of bleeding problem due to lack of vitamin C in the breast milk
3. The baby probably passed a small kidney stone
4. Some infants experience menstruation like bleeding when hormones from the mother are not available
43. An insulin-dependent diabetic delivered a 10-pound male. When the baby is brought to the nursery,
the priority of care is to

A. clean the umbilical cord with Betadine to prevent infection

B. give the baby a bath
C. call the laboratory to collect a PKU screening test
D. check the babys serum glucose level and administer glucose if < 40 mg/dL
44. Soon after delivery a neonate is admitted to the central nursery. The nursery nurse begins the initial
assessment by
A. auscultate bowel sounds.
B. determining chest circumference.
C. inspecting the posture, color, and respiratory effort.
D. checking for identifying birthmarks.
45. The home health nurse visits the Cox family 2 weeks after hospital discharge. She observes that the
umbilical cord has dried and fallen off. The area appears healed with no drainage or erythema present.
The mother can be instructed to
A. cover the umbilicus with a band-aid.
B. continue to clean the stump with alcohol for one week.
C. apply an antibiotic ointment to the stump.
D. give him a bath in an infant tub now.
46. A neonate is admitted to a hospitals central nursery. The neonates vital signs are: temperature =
96.5 degrees F., heart rate = 120 bpm, and respirations = 40/minute. The infant is pink with slight
acrocyanosis. The priority nursing diagnosis for the neonate is
A. Ineffective thermoregulation related to fluctuating environmental temperatures.
B. Potential for infection related to lack of immunity.
C. Altered nutrition, less than body requirements related to diminished sucking reflex.
D. Altered elimination pattern related to lack of nourishment.
47. The nurse hears the mother of a 5-pound neonate telling a friend on the telephone, As soon as I
get home, Ill give him some cereal to get him to gain weight? The nurse recognizes the need for
further instruction about infant feeding and tells her
A. If you give the baby cereal, be sure to use Rice to prevent allergy.
B. The baby is not able to swallow cereal, because he is too small.
C. The infants digestive tract cannot handle complex carbohydrates like cereal.
D. If you want him to gain weight, just double his daily intake of formula.
48. The nurse instructs a primipara about safety considerations for the neonate. The nurse determines
that the client does not understand the instructions when she says
A. All neonates should be in an approved car seat when in an automobile.
B. Its acceptable to prop the infants bottle once in awhile.
C. Pillows should not be used in the infants crib.
D. Infants should never be left unattended on an unguarded surface.

49. The nurse manager is presenting education to her staff to promote consistency in the interventions
used with lactating mothers. She emphasizes that the optimum time to initiate lactation is
A. as soon as possible after the infants birth.
B. after the mother has rested for 4-6 hours.
C. during the infants second period of reactivity.
D. after the infant has taken sterile water without complications.
50. The nurse is preparing to discharge a multipara 24 hours after a vaginal delivery. The client
is breastfeeding her newborn. The nurse instructs the client that if engorgement occurs the client
should
A. wear a tight fitting bra or breast binder.
B. apply warm, moist heat to the breasts.
C. contact the nurse midwife for a lactation suppressant.
D. restrict fluid intake to 1000 ml. daily .