Low Risk Neonatal Nurse Exam Low Risk Neonatal Nurse Exam Thermoregulation & Neonatal Environment 1 — Questions and Answers
Question 1: What is the normal axillary temperature range for a healthy term newborn?
- 96.0–97.0°F (35.6–36.1°C)
- 97.7–99.5°F (36.5–37.5°C) (Correct answer)
- 99.6–100.4°F (37.6–38.0°C)
- 95.0–96.5°F (35.0–35.8°C)
Correct answer: 97.7–99.5°F (36.5–37.5°C)
Normal axillary temperature for a term newborn is 97.7–99.5°F (36.5–37.5°C); values outside this range require further assessment.
Question 2: Which mechanism of heat loss is responsible for a newborn losing heat to a cold incubator wall without direct contact?
- Conduction
- Convection
- Radiation (Correct answer)
- Evaporation
Correct answer: Radiation
Radiation is the transfer of heat from the newborn's body to cooler surrounding surfaces without direct contact.
Question 3: What is the primary reason newborns are at high risk for heat loss immediately after birth?
- Overdeveloped sweat glands cause excess moisture
- Large body surface area relative to body mass and limited subcutaneous fat (Correct answer)
- High metabolic rate that produces too much internal heat
- Inability to generate brown adipose tissue thermogenesis
Correct answer: Large body surface area relative to body mass and limited subcutaneous fat
Newborns have a large surface area-to-mass ratio and minimal subcutaneous fat, making them highly susceptible to heat loss.
Question 4: Which immediate nursing action best prevents heat loss by evaporation in the delivery room?
- Placing the infant under a radiant warmer
- Thoroughly drying the newborn and removing wet linens (Correct answer)
- Administering warmed IV fluids
- Covering only the head with a cap
Correct answer: Thoroughly drying the newborn and removing wet linens
Drying the newborn immediately and replacing wet linens removes the primary source of evaporative heat loss after birth.
Question 5: What is the neutral thermal environment (NTE) for a newborn?
- The temperature at which the newborn sweats to maintain temperature
- The environmental temperature at which the newborn maintains normal body temperature with minimal metabolic effort (Correct answer)
- The room temperature recommended for visitor comfort in the nursery
- The temperature inside a warmed formula bottle
Correct answer: The environmental temperature at which the newborn maintains normal body temperature with minimal metabolic effort
The neutral thermal environment is the environmental temperature range at which a newborn maintains normal body temperature with minimal oxygen and caloric expenditure.
Question 6: A nurse notes a newborn's skin temperature is 35.8°C (96.4°F) and the infant is lethargic and not feeding well. What is the priority intervention?
- Administer antipyretics
- Initiate rewarming gradually using skin-to-skin contact or a warmed incubator (Correct answer)
- Obtain blood cultures only
- Place the infant in a cool environment to prevent fever
Correct answer: Initiate rewarming gradually using skin-to-skin contact or a warmed incubator
Cold stress with lethargy requires gradual rewarming to prevent further metabolic stress, hypoglycemia, and respiratory complications.
Low Risk Neonatal Nurse Exam Low Risk Neonatal Nurse Exam Thermoregulation & Neonatal Environment 1
What is the normal axillary temperature range for a healthy term newborn?