1.    Nurse Lucy is aware that a healthy term white newborn male should weigh approximately:a.    7 lb (3.2 kg).b.    8 lb (3.6 kg).c.    7½ lb (3.4 kg).d.    an amount that varies with length of pregnancy.

2.    Nurse Amy is teaching the mother of an infant about the importance of immunizations. The nurse should teach her that active immunity:a.    develops rapidly and is temporaryb.    occurs by antibody transmissionc.    results from exposure of an antigen through immunization or disease contactd.    may be transferred by mother to neonate

3.    A client gives birth to a neonate prematurely, at 28 weeks’ gestation. To obtain the neonate’s Apgar score, nurse Tanya assesses the neonate’s:a.    Temperatureb.    Respirationc.    blood pressured.    weight

4.    During neonatal resuscitation immediately after delivery, chest compressions should be initiated when the heart rate falls below which of the following?a.    60 beats/minuteb.    80 beats/minutec.    100 beats/minuted.    110 beats/minute

5.    The newborn of a client with type 1 diabetes mellitus is at high risk for hypoglycemia. An initial sign that nurse should recognize as indicating hypoglycemia in a newborn is:a.    peripheral acrocyanosisb.    bradycardiac.    lethargyd.    jaundice

6.    During the admission assessment of a newborn female, nurse Pen notes a large lump on the baby’s head. Concerned about making the correct assessment, the nurse differentiates between caput succedaneum and a cephalohematoma based on the knowledge that:a.    a cephalohematoma doesn’t cross the suture linesb.    caput succedaneum occurs primarily with primigravidasc.    a cephalohematoma occurs with a birth that required instrumentationd.    caput succedaneum occurs primarily with a prolonged second stage of labor

7.    Nurse Agnes is assessing a neonate born 1 day ago to a client who smoked one pack of cigarettes daily during pregnancy. Which finding is most common in neonates whose mothers smoked during pregnancy?a.    Postterm birth

b.    Large size for gestational agec.    Small size for gestational aged.    Appropriate size for gestational age

8.    While caring for a healthy newborn female, nurse Noemi notices red stains on the diaper after the baby voids. Which of the following should the nurse do next?a.    Call the physician to report the problem.b.    Encourage the mother to feed the baby to decrease dehydration.c.    Do nothing because this is normal.d.    Check the baby’s urine for hematuria.

9.    Baby Joy, a full-term neonate is diagnosed with hydrocephalus. Nursing assessment is most likely to reveal:a.    wide or bulging fontanelsb.    a decreased occipitofrontal circumferencec.    upward-slanting eyesd.    heightened alertness

10.    Six hours after birth, a neonate is transferred to the nursery, where nurse Apple intervenes to prevent hypothermia. What is a common source of radiant heat loss?a.    Low room humidityb.    Cold weight scalec.    Cool incubator wallsd.    Cool room temperature

1.    Answer: C

Rationale:  The normal weight for a term newborn white male should be about 7½ lb. White females should weigh about 7 lb. Newborns of Asian or black mothers often weigh less.

2.    Answer: C

Rationale:  Active immunity results from direct exposure of an antigen by immunization or disease exposure. Passive immunity occurs from antibody transmission and occurs rapidly but it’s temporary. Passive immunity may be transferred by mother to neonate

3.    Answer: B

Rationale:  The Apgar score is determined by the neonate’s heart rate, respiration, muscle tone, reflex irritability, and color. Temperature, blood pressure, and weight don’t count toward the Apgar score

4.    Answer: A

Rationale:  The normal neonatal heart rate is 120 to 160 beats/minute. Heart rates lower than 60 beats/minute necessitate chest compressions and ventilatory support.

5.    Answer: C

Rationale:  Lethargy in the newborn may be seen with hypoglycemia because of a lack of glucose in the nerve cells. Peripheral acrocyanosis is normal in the newborn because of immature capillary function. Tachycardia — not bradycardia — is seen with hypoglycemia. Jaundice isn’t a sign of hypoglycemia.

6.    Answer: A

Rationale:  Cephalohematomas don’t cross the suture lines and are the result of blood vessels rupturing in the baby’s scalp during labor. Blood outside the vasculature in a newborn increases the possibility of jaundice as the newborn’s body tries to reabsorb the blood. Caput succedaneum, which is simply soft tissue edema of the scalp, can occur in any labor and isn’t limited to a prolonged second stage of labor.

7.    Answer: C

Rationale:  Neonates of women who smoked during pregnancy are small for gestational age for two reasons: Nicotine causes vasoconstriction, which reduces blood flow and thus nutrient transfer to the fetus, and smokers are at greater risk for poor nutrition. These neonates are more likely to be preterm than postterm because smoking causes maternal vasoconstriction, decreases placental perfusion, and induces uterine contractions. Large size for gestational age results from increased nutrient transfer to the fetus such as in a neonate who receives excessive glucose from a diabetic mother.

8.    Answer: C

Rationale:  Female newborns may have some vaginal bleeding in the 1st or 2nd day after birth because they no longer have the high levels of female hormones that they were exposed to while in the uterus. The physician needn’t be called. This bleeding is normal and doesn’t indicate dehydration or hematuria.

9.    Answer: A

Rationale:  Hydrocephalus typically causes an enlarged head with wide or bulging fontanels, an excessive diameter (increased occipitofrontal diameter), a shiny scalp with prominent veins, separation of the suture lines, and downward-slanting eyes. Other findings in hydrocephalus include bradycardia, apneic episodes, vomiting, irritability, excessive crying, and reduced alertness.

10.    Answer: C

Rationale:  Common sources of radiant heat loss include cool incubator walls and windows. Low room humidity promotes evaporative heat loss. When the skin directly contacts a cooler object, such as a cold weight scale, conductive heat loss may occur. A cool room temperature may lead to convective heat loss.