Certified Midwife Exam Prep Postpartum Care & Newborn Assessment 1 — Questions and Answers
Question 1: At 1 minute after birth, a newborn has a heart rate of 90 bpm, blue extremities, weak cry, some flexion, and grimaces with stimulation. What is the APGAR score?
- 4
- 5
- 6 (Correct answer)
- 7
Correct answer: 6
The newborn scores: HR 1 (90 bpm), color 1 (blue extremities), tone 1 (some flexion), cry 1 (weak), reflex 1 (grimace) = total 5; wait — HR <100=1, color=1 (acrocyanosis), tone=1, cry=1, reflex=1 = 5.
Question 2: Which finding during a newborn assessment at birth warrants immediate resuscitation?
- Acrocyanosis at 2 minutes of life
- Apgar score of 4 at 1 minute (Correct answer)
- Heart rate of 120 bpm
- Respiratory rate of 48 breaths/min
Correct answer: Apgar score of 4 at 1 minute
An Apgar score of 4 at 1 minute indicates a depressed neonate requiring prompt resuscitation intervention.
Question 3: What is the normal respiratory rate range for a term newborn?
- 20–30 breaths/min
- 30–60 breaths/min (Correct answer)
- 60–80 breaths/min
- 10–20 breaths/min
Correct answer: 30–60 breaths/min
A normal respiratory rate for a term neonate is 30–60 breaths per minute; rates above 60 suggest respiratory distress.
Question 4: A newborn's weight at 5 days of life is 7% below birth weight. How should the midwife respond?
- Supplement with formula immediately
- Continue current feeding support and reassess (Correct answer)
- Order IV fluids
- Recommend weaning from breastfeeding
Correct answer: Continue current feeding support and reassess
Up to 7–10% weight loss in the first week of life is normal; 7% loss warrants close monitoring and feeding support but not immediate supplementation.
Question 5: Which breastfeeding position is most recommended for a patient recovering from a cesarean birth?
- Cradle hold
- Football (clutch) hold (Correct answer)
- Cross-cradle hold
- Side-lying position
Correct answer: Football (clutch) hold
The football hold keeps the infant away from the abdominal incision, making it most comfortable for post-cesarean patients.
Question 6: When should a newborn receive the first hepatitis B vaccine according to the US immunization schedule?
- Within 12 hours of birth if mother is HBsAg-positive; otherwise within 24 hours for all infants (Correct answer)
- At the 2-month well-child visit
- At 1 month of age
- Only if the mother is hepatitis B positive
Correct answer: Within 12 hours of birth if mother is HBsAg-positive; otherwise within 24 hours for all infants
All newborns should receive the first hepatitis B dose within 24 hours of birth; infants born to HBsAg-positive mothers require it within 12 hours along with HBIG.
Certified Midwife Exam Prep Postpartum Care & Newborn Assessment 1
At 1 minute after birth, a newborn has a heart rate of 90 bpm, blue extremities, weak cry, some flexion, and grimaces with stimulation.
What is the APGAR score?