Obstetric Nurse Test Obstetric Nurse Newborn Assessment and Care 3 — Questions and Answers
Question 1: Which reflex, elicited by stroking the lateral sole of the foot, results in hyperextension and fanning of the toes in newborns and is considered normal?
- Babinski reflex (Correct answer)
- Plantar grasp reflex
- Galant reflex
- Stepping reflex
Correct answer: Babinski reflex
The Babinski reflex (upgoing plantar reflex) is normal in newborns and infants up to approximately 12 months due to immature corticospinal tracts.
Question 2: A newborn is noted to have a cephalohematoma. Which of the following accurately describes this finding?
- Blood accumulation below the periosteum, confined to one cranial bone, does not cross suture lines (Correct answer)
- Diffuse edematous swelling of the scalp that crosses suture lines and resolves within days
- Hemorrhage within the subdural space requiring neurosurgical consultation
- A benign fluid-filled cyst at the base of the skull requiring drainage
Correct answer: Blood accumulation below the periosteum, confined to one cranial bone, does not cross suture lines
A cephalohematoma is subperiosteal bleeding confined by periosteal attachments at suture lines, causing a unilateral, well-demarcated swelling that resolves over weeks.
Question 3: The nurse is evaluating a newborn for hypoglycemia. Which clinical manifestation warrants immediate glucose screening?
- Jitteriness and high-pitched cry (Correct answer)
- Acrocyanosis of hands and feet
- Milia on the nose and cheeks
- Mongolian spots on the sacral area
Correct answer: Jitteriness and high-pitched cry
Jitteriness, high-pitched cry, lethargy, and poor feeding are classic signs of neonatal hypoglycemia and require immediate point-of-care glucose testing.
Question 4: When auscultating a newborn's heart, the nurse detects a harsh systolic murmur at the left sternal border at 2 hours of age. The most appropriate initial action is to:
- Document findings and reassess at 24 hours, as murmurs may reflect transitional circulation (Correct answer)
- Immediately prepare for emergency cardiac catheterization
- Administer oxygen via facemask and call a rapid response
- Restrict oral feeds and obtain a chest X-ray emergently
Correct answer: Document findings and reassess at 24 hours, as murmurs may reflect transitional circulation
Transient murmurs are common in the first hours of life as transitional circulation closes (ductus arteriosus, foramen ovale); reassessment and provider notification are appropriate first steps.
Question 5: A newborn's glucose level is 38 mg/dL at 1 hour of life. The infant is alert and breastfeeding vigorously. The nurse should:
- Encourage continued frequent breastfeeding and recheck glucose in 1 hour (Correct answer)
- Initiate a 10% dextrose IV infusion immediately
- Administer glucagon IM per standing protocol
- Transfer to the NICU for continuous glucose monitoring
Correct answer: Encourage continued frequent breastfeeding and recheck glucose in 1 hour
An asymptomatic newborn with a glucose of 36–45 mg/dL should receive oral feeding as the first intervention, followed by repeat glucose check within 30–60 minutes.
Question 6: Which newborn measurement correctly describes macrosomia?
- Birth weight greater than 4,000–4,500 g (8 lb 13 oz–9 lb 14 oz) (Correct answer)
- Birth weight at the 90th percentile for gestational age
- Birth weight greater than 2,500 g
- Length greater than the 90th percentile regardless of weight
Correct answer: Birth weight greater than 4,000–4,500 g (8 lb 13 oz–9 lb 14 oz)
Macrosomia is defined as birth weight exceeding 4,000–4,500 g (8 lb 13 oz to 9 lb 14 oz), with 4,500 g commonly used as the threshold for clinical significance.
Question 7: The nurse is performing a CRIES pain assessment on a postoperative neonate. Which parameter is NOT included in this tool?
- Gestational age (Correct answer)
- Crying
- Oxygen requirement
- Expression (facial grimace)
Correct answer: Gestational age
The CRIES scale assesses Crying, Requires O2, Increased vital signs, Expression, and Sleeplessness—gestational age is not one of its parameters.
Obstetric Nurse Test Obstetric Nurse Newborn Assessment and Care 3
Which reflex, elicited by stroking the lateral sole of the foot, results in hyperextension and fanning of the toes in newborns and is considered normal?