CMS CMS Newborn Assessment & Neonatal Care

Question 1

The Apgar score is assessed at 1 minute and 5 minutes after birth. Which five criteria are evaluated?

Accepted Answer

Heart rate, respiratory effort, muscle tone, reflex irritability, color

Answer

Apgar score assesses heart rate, respiratory effort, muscle tone, reflex irritability, and skin color, each scored 0–2 for a maximum of 10.

Question 2

A newborn has an Apgar score of 4 at 1 minute. Which immediate action is most appropriate?

Accepted Answer

Begin positive-pressure ventilation

Answer

An Apgar score of 4–6 indicates moderate depression; positive-pressure ventilation is initiated if the newborn is not breathing adequately.

Question 3

Which finding on newborn physical exam is considered a normal variant requiring no intervention?

Accepted Answer

Epstein pearls on the hard palate

Answer

Epstein pearls are benign inclusion cysts on the hard palate that resolve spontaneously within weeks.

Question 4

A term newborn's blood glucose is 38 mg/dL at 2 hours of life. What is the first-line management?

Accepted Answer

Early breastfeeding or formula supplementation

Answer

For symptomatic-free newborns with glucose 36–45 mg/dL, the first step is early oral feeding before considering IV glucose.

Question 5

Which newborn reflex disappears by 4–6 months of age and its persistence may indicate neurological pathology?

Accepted Answer

Moro reflex

Answer

The Moro (startle) reflex normally disappears by 4–6 months; its persistence beyond this suggests possible neurological abnormality.

CMS - Clinical Midwife Specialist Practice Test