 1.

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:
o A. “I will cleanse the neonate’s eyes before instilling ointment.”
o B. “I will flush the eyes after instilling the ointment.”
o C. “I will instill the eye ointment into each of the neonate’s conjunctival sacs
within one hour after birth.”
o 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.”

 2. A baby is born precipitously in the ER. The nurses initial action should be to:
o A. Establish an airway for the baby
o B. Ascertain the condition of the fundus
o C. Quickly tie and cut the umbilical cord
o D. Move mother and baby to the birthing unit

 3. The primary critical observation for Apgar scoring is the:

o A. Heart rate
o B. Respiratory rate
o C. Presence of meconium
o D. Evaluation of the Moro reflex

 4. When performing a newborn assessment. the nurse should measure the vital
signs in the following sequence:
o A. Pulse. respirations. temperature
o B. Temperature. pulse. respirations
o C. Respirations. temperature. pulse
o D. Respirations. pulse. temperature

 5. Within three (3) minutes after birth the normal heart rate of the infant may range
between:
o A. 100 and 180
o B. 130 and 170
o C. 120 and 160
o D. 100 and 130
 6. The expected respiratory rate of a neonate within three (3) minutes of birth may
be as high as:
o A. 50
o B. 60
o C. 80
o D. 100

 7. The nurse is aware that a healthy newborn’s respirations are:

o A. Regular. abdominal. 40-50 per minute. deep
o B. Irregular. abdominal. 30-60 per minute. shallow
o C. Irregular. initiated by chest wall. 30-60 per minute. deep
o D. Regular. initiated by the chest wall. 40-60 per minute. shallow

 8. To help limit the development of hyperbilirubinemia in the neonate. the plan of

care should include:
o A. Monitoring for the passage of meconium each shift
o B. Instituting phototherapy for 30 minutes every 6 hours
o C. Substituting breastfeeding for formula during the 2nd day after birth
o D. Supplementing breastfeeding with glucose water during the first 24 hours

 9. 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:
o A. Milia
o B. Lanugo
o C. Whiteheads
o D. Mongolian spots

 10. When newborns have been on formula for 36-48 hours. they should have a:
o A. Screening for PKU
o B. Vitamin K injection
o C. Test for necrotizing enterocolitis
o D. Heel stick for blood glucose level

 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:
o A. Warming the crib pad
 o B. Turning on the overhead radiant warmer
o C. Closing the doors to the room
o 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?
o A. Document the findings
o B. Contact the physician
o C. Circle the amount of bloody drainage on the dressing and reassess in 30
minutes
o 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?
o A. Hypotension and Bradycardia
o B. Tachypnea and retractions
o C. Acrocyanosis and grunting
o 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:
o A. Wrap the tape measure around the infant’s head and measure just above
the eyebrows.
o 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
o C. Place the tape measure under the infants head. wrap around the
occiput. and measure just above the eyes
o D. Place the tape measure at the back of the infant’s head. wrap around
across the ears. and measure across the infant’s 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?
o A. Switch to bottle feeding the baby for 2 weeks
o B. Stop the breast feedings and switch to bottle-feeding permanently
o C. Feed the newborn infant less frequently
o 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:
o A. Subcutaneous injection
o B. Intravenous injection
o C. Instillation of the preparation into the lungs through an
endotracheal tube
o 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?
o A. Sleepiness
o B. Cuddles when being held
o C. Lethargy
o 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:
o A. “You infant needs vitamin K to develop immunity.”
o B. “The vitamin K will protect your infant from being jaundiced.”
o C. “Newborn infants are deficient in vitamin K. and this injection
prevents your infant from abnormal bleeding.”
o 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-week-gestation newborn with Apgar scores of 1 and 4. In
planning for the admission of this infant. the nurse’s highest priority should be to:
o A. Connect the resuscitation bag to the oxygen outlet
o B. Turn on the apnea and cardiorespiratory monitors
o C. Set up the intravenous line with 5% dextrose in water
o 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?
o A. Deltoid
o B. Triceps
o C. Vastus lateralis
o D. Biceps
 1. The nurse decides on a teaching plan for a new mother and her infant. The plan
should include:
o A. Discussing the matter with her in a non-threatening manner
o B. Showing by example and explanation how to care for the infant
o C. Setting up a schedule for teaching the mother how to care for her baby
o D. Supplying the emotional support to the mother and encouraging her
independence

 2. Which action best explains the main role of surfactant in the neonate?
o A. Assists with ciliary body maturation in the upper airways
o B. Helps maintain a rhythmic breathing pattern
o C. Promotes clearing mucus from the respiratory tract
o D. Helps the lungs remain expanded after the initiation of breathing

 3. 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?
o A. Activate the code blue or emergency system
o B. Do nothing because acrocyanosis is normal in the neonate
o C. Immediately take the newborn’s temperature according to hospital policy
o D. Notify the physician of the need for a cardiac consult

 4. The nurse is aware that a neonate of a mother with diabetes is at risk for what
complication?
o A. Anemia
o B. Hypoglycemia
o C. Nitrogen loss
o D. Thrombosis

 5. 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?
o A. Negative Coombs test
o B. Bleeding from the nose and ear
o C. Jaundice after the first 24 hours of life
o D. Jaundice within the first 24 hours of life
 6. A client has just given birth at 42 weeks’ gestation. When assessing the
neonate. which physical finding is expected?

o A. A sleepy. lethargic baby

o B. Lanugo covering the body
o C. Desquamation of the epidermis
o D. Vernix caseosa covering the body
 7. After reviewing the client’s maternal history of magnesium sulfate during labor.
which condition would the nurse anticipate as a potential problem in the neonate?
o A. Hypoglycemia
o B. Jitteriness
o C. Respiratory depression
o D. Tachycardia

 8. Neonates of mothers with diabetes are at risk for which complication following
birth?
o A. Atelectasis
o B. Microcephaly
o C. Pneumothorax
o D. Macrosomia

 9. By keeping the nursery temperature warm and wrapping the neonate in

blankets. the nurse is preventing which type of heat loss?
o A. Conduction
o B. Convection
o C. Evaporation
o D. Radiation

 10. A neonate has been diagnosed with caput succedaneum. Which statement is
correct about this condition?
o A. It usually resolves in 3-6 weeks
o B. It doesn’t cross the cranial suture line
o C. It’s a collection of blood between the skull and the periosteum
o D. It involves swelling of tissue over the presenting part of the
presenting head

 1. The most common neonatal sepsis and meningitis infections seen within 24
hours after birth are caused by which organism?
o A. Candida albicans
o B. Chlamydia trachomatis
o C. Escherichia coli
o D. Group B beta-hemolytic streptococci
 2. When attempting to interact with a neonate experiencing drug withdrawal. which
behavior would indicate that the neonate is willing to interact?
o A. Gaze aversion
o B. Hiccups
o C. Quiet alert state
o D. Yawning
 3. When teaching umbilical cord care to a new mother. the nurse would include
which information?
o A. Apply peroxide to the cord with each diaper change
o B. Cover the cord with petroleum jelly after bathing
o C. Keep the cord dry and open to air
o D. Wash the cord with soap and water each day during a tub bath

 4. A mother of a term neonate asks what the thick. white. cheesy coating is on his
skin. Which correctly describes this finding?
o A. Lanugo
o B. Milia
o C. Nevus flammeus
o D. Vernix

 5. Which condition or treatment best ensures lung maturity in an infant?

o A. Meconium in the amniotic fluid
o B. Glucocorticoid treatment just before delivery
o C. Lecithin to sphingomyelin ratio more than 2:1
o D. Absence of phosphatidylglycerol in amniotic fluid

 6. When performing nursing care for a neonate after a birth. which intervention
has the highest nursing priority?
o A. Obtain a dextrostix
o B. Give the initial bath
o C. Give the vitamin K injection
o D. Cover the neonates head with a cap

 7. When performing an assessment on a neonate. which assessment finding is

most suggestive of hypothermia?
o A. Bradycardia
o B. Hyperglycemia
o C. Metabolic alkalosis
o D. Shivering
 8. A woman delivers a 3.250 g neonate at 42 weeks’ gestation. Which physical
finding is expected during an examination if this neonate?
o A. Abundant lanugo
o B. Absence of sole creases
o C. Breast bud of 1-2 mm in diameter
o D. Leathery. cracked. and wrinkled skin

 9. 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 ?F. a respiratory rate of 80 breaths/minute. and a heel stick
glucose value of 60 mg/dl. Which action should the nurse take?
o A. Wrap the neonate warmly and place her in an open crib
o B. Administer an oral glucose feeding of 10% dextrose in water
o C. Increase the temperature setting on the radiant warmer
o D. Obtain an order for IV fluid administration

 10. Which neonatal behavior is most commonly associated with fetal alcohol
syndrome (FAS)?
o A. Hypoactivity
o B. High birth weight
o C. Poor wake and sleep patterns
o D. High threshold of stimulation

 1. Which of the following behaviors would indicate that a client was bonding with
her baby?
o A. The client asks her husband to give the baby a bottle of water.
o B. The client talks to the baby and picks him up when he cries.
o C. The client feeds the baby every three hours.
o D. The client asks the nurse to recommend a good child care manual.

 2. A newborn’s mother is alarmed to find small amounts of blood on her infant

girl’s diaper. When the nurse checks the infant’s urine it is straw colored and has
no offensive odor. Which explanation to the newborn’s mother is most
appropriate?
o A. “It appears your baby has a kidney infection”
o B. “Breast-fed babies often experience this type of bleeding problem due to
lack of vitamin C in the breast milk”
o C. “The baby probably passed a small kidney stone”
 o D. “Some infants experience menstruation like bleeding when
hormones from the mother are not available”

 3. An insulin-dependent diabetic delivered a 10-pound male. When the baby is

brought to the nursery. the priority of care is to
o A. Clean the umbilical cord with Betadine to prevent infection
o B. Give the baby a bath
o C. Call the laboratory to collect a PKU screening test
o D. Check the baby’s serum glucose level and administer glucose if <
40 mg/dL

 4. Soon after delivery a neonate is admitted to the central nursery. The nursery
nurse begins the initial assessment by
o A. Auscultate bowel sounds.
o B. Determining chest circumference.
o C. Inspecting the posture. color. and respiratory effort.
o D. Checking for identifying birthmarks.

 5. 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
o A. Cover the umbilicus with a band-aid.
o B. Continue to clean the stump with alcohol for one week.
o C. Apply an antibiotic ointment to the stump.
o D. Give him a bath in an infant tub now.

 6. A neonate is admitted to a hospital’s central nursery. The neonate’s 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
o A. Ineffective thermoregulation related to fluctuating environmental
temperatures.
o B. Potential for infection related to lack of immunity.
o C. Altered nutrition. less than body requirements related to diminished
sucking reflex.
o D. Altered elimination pattern related to lack of nourishment.

 7. The nurse hears the mother of a 5-pound neonate telling a friend on the
telephone. “As soon as I get home. I’ll give him some cereal to get him to gain
weight?” The nurse recognizes the need for further instruction about infant
feeding and tells her
o A. “If you give the baby cereal. be sure to use Rice to prevent allergy.”
 o B. “The baby is not able to swallow cereal. because he is too small.”
o C. “The infant’s digestive tract cannot handle complex carbohydrates
like cereal.”
o D. “If you want him to gain weight. just double his daily intake of formula.”

 8. 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
o A. “All neonates should be in an approved car seat when in an automobile.”
o B. “It’s acceptable to prop the infant’s bottle once in awhile.”
o C. “Pillows should not be used in the infant’s crib.”
o D. “Infants should never be left unattended on an unguarded surface.”
 9. 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
o A. As soon as possible after the infant’s birth.
o B. After the mother has rested for 4-6 hours.
o C. During the infant’s second period of reactivity.
o D. After the infant has taken sterile water without complications.

 10. 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
o A. Wear a tight fitting bra or breast binder.
o B. Apply warm. moist heat to the breasts.
o C. Contact the nurse midwife for a lactation suppressant.
o D. Restrict fluid intake to 1000 ml. daily .