CMS CMS Newborn Assessment & Neonatal Care 2 — Questions and Answers
Question 1: Which head circumference measurement is considered within normal range for a full-term newborn?
- 32–38 cm (Correct answer)
- 25–30 cm
- 40–45 cm
- 28–31 cm
Correct answer: 32–38 cm
Normal term newborn head circumference is 32–38 cm, with 34–35 cm being the average.
Question 2: A newborn develops jaundice within the first 24 hours of life. Which condition must be ruled out first?
- Hemolytic disease of the newborn (HDN) (Correct answer)
- Physiologic jaundice
- Breastfeeding jaundice
- Biliary atresia
Correct answer: Hemolytic disease of the newborn (HDN)
Jaundice appearing within the first 24 hours is always pathological and most commonly due to hemolytic disease caused by ABO or Rh incompatibility.
Question 3: Which vitamin is routinely administered to all newborns at birth to prevent hemorrhagic disease?
- Vitamin K (Correct answer)
- Vitamin D
- Vitamin C
- Vitamin E
Correct answer: Vitamin K
Vitamin K is given intramuscularly at birth because newborns have low gut flora and cannot produce adequate vitamin K, risking hemorrhagic disease of the newborn.
Question 4: What is the normal respiratory rate for a term newborn at rest?
- 30–60 breaths/min (Correct answer)
- 12–20 breaths/min
- 60–80 breaths/min
- 20–30 breaths/min
Correct answer: 30–60 breaths/min
Normal neonatal respiratory rate is 30–60 breaths per minute; rates above 60 are considered tachypnea.
Question 5: A newborn is noted to have a single transverse palmar crease bilaterally. This finding is most commonly associated with:
- Trisomy 21 (Down syndrome) (Correct answer)
- Turner syndrome
- Fetal alcohol syndrome
- Fragile X syndrome
Correct answer: Trisomy 21 (Down syndrome)
A single transverse palmar crease (simian crease) is classically associated with Trisomy 21, though it can be a normal variant.
Question 6: Which screening test is mandated for all US newborns to detect hypothyroidism and metabolic disorders?
- Newborn metabolic screening (heel-stick panel) (Correct answer)
- Cord blood gas analysis
- Complete blood count at 24 hours
- Lumbar puncture for metabolic workup
Correct answer: Newborn metabolic screening (heel-stick panel)
The heel-stick newborn metabolic screening panel detects conditions such as congenital hypothyroidism, PKU, and galactosemia before symptoms appear.
CMS CMS Newborn Assessment & Neonatal Care 2
Which head circumference measurement is considered within normal range for a full-term newborn?