CMS Newborn Assessment & Neonatal Care Flashcards

A full-term neonate is grunting, has nasal flaring, and subcostal retractions 2 hours after an uncomplicated vaginal delivery. The most likely diagnosis is:

Answer: Transient tachypnea of the newborn (TTN)

TTN is the most common respiratory problem in term newborns caused by delayed absorption of fetal lung fluid, typically resolving within 24–72 hours.

Which umbilical cord finding at delivery warrants immediate neonatal assessment for renal anomalies?

Answer: Two-vessel cord (single umbilical artery)

A single umbilical artery is associated with renal and cardiac anomalies and warrants renal ultrasound in the newborn period.

A newborn at 36 hours of life has a total serum bilirubin of 14 mg/dL. Which treatment is indicated?

Answer: Phototherapy

Phototherapy is initiated based on the American Academy of Pediatrics nomogram; at 36 hours in a term infant, 14 mg/dL typically meets phototherapy thresholds.

During the newborn hearing screen, a term infant fails the OAE (otoacoustic emissions) test. What is the correct next step?

Answer: Refer for auditory brainstem response (ABR) testing within 3 months

A failed OAE requires follow-up with ABR testing; JCIH guidelines recommend diagnostic ABR by 3 months of age.

Which newborn skin finding is described as a blue-gray discoloration over the lumbosacral area and buttocks, common in darker-skinned neonates?

Answer: Mongolian spot (congenital dermal melanocytosis)

Congenital dermal melanocytosis (formerly Mongolian spots) are benign, flat blue-gray birthmarks that typically fade by age 5.

What is the recommended room-in temperature and environment to support thermoregulation in a healthy term newborn?

Answer: Skin-to-skin contact with the mother or warm blankets in a 68–72°F room

Skin-to-skin contact is the most effective and recommended method for maintaining newborn thermoregulation in healthy term newborns.