Obstetric Nurse Test Obstetric Nurse Newborn Assessment and Care 2 ā Questions and Answers
Question 1: A term newborn's axillary temperature is 36.0Ā°C (96.8Ā°F) at 2 hours of life. What is the nurse's priority intervention?
- Place the newborn skin-to-skin with the mother and recheck in 30 minutes (Correct answer)
- Administer warmed IV fluids
- Obtain a blood culture before warming
- Document as normal and continue routine care
Correct answer: Place the newborn skin-to-skin with the mother and recheck in 30 minutes
Skin-to-skin contact (kangaroo care) is the safest, most effective first-line intervention for mild neonatal hypothermia in a stable newborn.
Question 2: Which finding on newborn skin assessment is considered a normal variant requiring no intervention?
- Erythema toxicum neonatorum (Correct answer)
- Port-wine stain over the trigeminal nerve distribution
- Petechiae over the trunk and extremities
- Pustular melanosis with surrounding erythema
Correct answer: Erythema toxicum neonatorum
Erythema toxicum is a benign, self-limiting newborn rash appearing in the first 1ā3 days that requires no treatment.
Question 3: The nurse is teaching a new mother about newborn stool patterns. Which stool description is normal for a 3-day-old breastfed infant?
- Transitional yellowish-green, loose, seedy (Correct answer)
- Bright green, watery, 8ā10 times per day
- Dark tarry meconium
- Pale clay-colored, firm
Correct answer: Transitional yellowish-green, loose, seedy
By day 3, breastfed infants transition from meconium to transitional stools that are yellowish-green, loose, and often seedy.
Question 4: When performing a newborn Ballard score assessment, which finding suggests a gestational age of approximately 40 weeks?
- Full flexion of all four extremities at rest (Correct answer)
- Ear pinna flat and stays folded
- Skin translucent with visible veins
- Testes undescended, scrotum smooth
Correct answer: Full flexion of all four extremities at rest
Full flexion posture (score of 4 in posture) is characteristic of a term, 40-week newborn on the neuromuscular maturity scale.
Question 5: A newborn's bilirubin level at 24 hours of life is 8 mg/dL. The nurse's most appropriate action is to:
- Notify the provider immediately as this is pathologic hyperbilirubinemia (Correct answer)
- Document and reassess in 12 hours as this is within normal limits
- Begin phototherapy per standing orders
- Obtain a Coombs test and blood type
Correct answer: Notify the provider immediately as this is pathologic hyperbilirubinemia
Any bilirubin elevation visible in the first 24 hours of life is considered pathologic and requires immediate provider notification and evaluation.
Question 6: The nurse notes that a newborn has not passed meconium within 48 hours of birth. This finding should prompt evaluation for:
- Hirschsprung disease or cystic fibrosis (Correct answer)
- Normal variation; meconium can be delayed up to 72 hours
- Overfeeding causing intestinal slowdown
- Hypothyroidism exclusively
Correct answer: Hirschsprung disease or cystic fibrosis
Failure to pass meconium within 24ā48 hours warrants evaluation for conditions such as Hirschsprung disease, meconium ileus (cystic fibrosis), or imperforate anus.
Question 7: During newborn assessment, the nurse observes intermittent episodes of apnea lasting 5ā10 seconds alternating with regular breathing. How should this be documented?
- Periodic breathing, a normal newborn respiratory pattern (Correct answer)
- Pathologic apnea requiring immediate CPAP
- Cheyne-Stokes respirations, report to provider
- Episodic bradypnea, initiate pulse oximetry monitoring
Correct answer: Periodic breathing, a normal newborn respiratory pattern
Periodic breathingābrief pauses of less than 20 seconds alternating with normal respirationsāis a normal pattern in newborns and requires no intervention.
Obstetric Nurse Test Obstetric Nurse Newborn Assessment and Care 2
A term newborn's axillary temperature is 36.0Ā°C (96.8Ā°F) at 2 hours of life.
What is the nurse's priority intervention?