Q.1 Which of the following is the most appropriate method to assess a neonate's respiratory rate?
Observe chest movements for one minute while the baby is calm
Check pulse for 15 seconds and multiply by 4
Ask the baby to breathe deeply
Use a stethoscope on the abdomen only
Explanation - Neonates have irregular breathing patterns, so counting respirations for a full minute while the baby is calm gives the most accurate rate.
Correct answer is: Observe chest movements for one minute while the baby is calm
Q.2 A neonate has a temperature of 36°C. How should a nurse interpret this finding?
Hyperthermia
Normal
Hypothermia
Fever
Explanation - Normal neonatal temperature ranges from 36.5°C to 37.5°C. A temperature of 36°C indicates mild hypothermia, which requires intervention.
Correct answer is: Hypothermia
Q.3 Which reflex is tested by stroking the sole of the neonate’s foot?
Moro reflex
Rooting reflex
Babinski reflex
Palmar grasp reflex
Explanation - The Babinski reflex is elicited by stroking the sole of the foot, causing the toes to fan out and dorsiflex.
Correct answer is: Babinski reflex
Q.4 What is the primary purpose of Apgar scoring immediately after birth?
To predict long-term neurodevelopmental outcomes
To assess the newborn's immediate adaptation to extrauterine life
To diagnose congenital anomalies
To determine birth weight
Explanation - The Apgar score evaluates heart rate, respiratory effort, muscle tone, reflex irritability, and color to determine the newborn's immediate health status.
Correct answer is: To assess the newborn's immediate adaptation to extrauterine life
Q.5 Which site is preferred for intramuscular injection in a neonate?
Deltoid muscle
Vastus lateralis muscle
Gluteus maximus
Biceps brachii
Explanation - The vastus lateralis is preferred due to its well-developed mass and reduced risk of nerve injury compared to gluteal or upper arm sites.
Correct answer is: Vastus lateralis muscle
Q.6 Which sign indicates neonatal jaundice requiring immediate evaluation?
Yellowing of palms and soles in a 24-hour-old
Yellowing of sclera after 72 hours of birth
Yellowing of skin limited to the face in a 48-hour-old
No yellowing at 5 days
Explanation - Early jaundice (within 24 hours) can indicate hemolytic disease or other serious conditions and requires urgent evaluation.
Correct answer is: Yellowing of palms and soles in a 24-hour-old
Q.7 Which of the following is the correct normal heart rate range for a term neonate?
80–120 beats/min
100–160 beats/min
60–100 beats/min
120–180 beats/min
Explanation - A term neonate’s normal heart rate ranges from 100 to 160 beats per minute, varying with activity and sleep states.
Correct answer is: 100–160 beats/min
Q.8 Which is the most reliable method to assess a neonate's hydration status?
Urine output and skin turgor
Capillary refill alone
Pulse rate only
Weight only
Explanation - Monitoring urine output and skin turgor provides a practical and reliable assessment of neonatal hydration.
Correct answer is: Urine output and skin turgor
Q.9 When performing a neonatal assessment, the nurse observes a bulging fontanel. This may indicate:
Dehydration
Increased intracranial pressure
Normal finding
Hypothermia
Explanation - A bulging fontanel can be a sign of increased intracranial pressure due to conditions like hydrocephalus or infection.
Correct answer is: Increased intracranial pressure
Q.10 Which of the following is considered an abnormal respiratory pattern in neonates?
Periodic breathing
Nasal flaring and grunting
Irregular breathing while asleep
Brief pauses of 5 seconds
Explanation - Nasal flaring and grunting are signs of respiratory distress in neonates and need immediate evaluation.
Correct answer is: Nasal flaring and grunting
Q.11 Which intervention is appropriate for preventing hypothermia in a neonate immediately after birth?
Placing the neonate under an overhead warmer
Leaving the neonate undressed for examination
Administering a cold bath
Placing the neonate near a window
Explanation - Immediate warming with an overhead warmer helps maintain body temperature and prevent hypothermia in neonates.
Correct answer is: Placing the neonate under an overhead warmer
Q.12 Which sign would indicate respiratory distress in a neonate?
Mild hiccups
Grunting with each breath
Regular breathing
Pink mucous membranes
Explanation - Grunting indicates the neonate is attempting to maintain functional residual capacity and is a sign of respiratory distress.
Correct answer is: Grunting with each breath
Q.13 Which neonatal reflex helps the baby locate the breast or bottle for feeding?
Moro reflex
Rooting reflex
Sucking reflex
Stepping reflex
Explanation - The rooting reflex occurs when the cheek is stroked, prompting the neonate to turn the head toward the stimulus to feed.
Correct answer is: Rooting reflex
Q.14 What is the main reason for monitoring blood glucose levels in neonates?
To detect hyperglycemia
To assess for hypoglycemia risk
To monitor liver function
To evaluate hydration
Explanation - Neonates, especially preterm or small-for-gestational-age babies, are at risk for hypoglycemia, which can affect neurological outcomes.
Correct answer is: To assess for hypoglycemia risk
Q.15 Which nursing action is most appropriate when a neonate exhibits jaundice at 72 hours of life?
Immediate exchange transfusion
Monitor bilirubin levels and phototherapy if needed
No action required
Administer antibiotics immediately
Explanation - Physiological jaundice often appears after 48 hours and can be managed with phototherapy if bilirubin exceeds safe limits.
Correct answer is: Monitor bilirubin levels and phototherapy if needed
Q.16 Which is the correct method for measuring neonatal head circumference?
Above the eyebrows and ears, around the occiput
Around the neck
Around the chest and abdomen
Across the forehead only
Explanation - Head circumference is measured from the most prominent part of the occiput to just above the eyebrows to track brain growth.
Correct answer is: Above the eyebrows and ears, around the occiput
Q.17 During a neonatal assessment, a nurse notes a heart murmur. What is the next best step?
Ignore it; it is always normal
Refer for echocardiography and pediatric cardiology evaluation
Start antibiotics immediately
Document and discharge
Explanation - Heart murmurs can indicate congenital heart disease; further assessment with echocardiography is necessary.
Correct answer is: Refer for echocardiography and pediatric cardiology evaluation
Q.18 Which nursing intervention helps promote bonding between a mother and her neonate?
Skin-to-skin contact
Bathing the baby immediately
Separating baby for observation
Delaying feeding
Explanation - Skin-to-skin contact stabilizes temperature, promotes breastfeeding, and strengthens maternal-infant bonding.
Correct answer is: Skin-to-skin contact
Q.19 Which position is recommended for a neonate during feeding to prevent aspiration?
Supine with head flat
Side-lying or semi-upright
Prone on the abdomen
Head hanging back
Explanation - Positioning the neonate semi-upright or side-lying during feeding helps prevent aspiration and promotes safe swallowing.
Correct answer is: Side-lying or semi-upright
Q.20 Which sign is normal in a newborn but abnormal if persists beyond 2 weeks?
Moro reflex
Tremors due to hypoglycemia
Milia on the face
Physiological jaundice resolving within 2 weeks
Explanation - Jaundice that persists beyond 2 weeks may indicate pathological conditions requiring evaluation.
Correct answer is: Physiological jaundice resolving within 2 weeks
Q.21 Which parameter is most important to assess before initiating phototherapy in neonates?
Heart rate
Total serum bilirubin
Weight
Length
Explanation - Phototherapy is indicated based on bilirubin levels to prevent kernicterus and neurological damage.
Correct answer is: Total serum bilirubin
Q.22 Which finding requires urgent intervention in a neonate?
Capillary refill of 2 seconds
Heart rate of 140 bpm
Respiratory rate of 70/min with chest retractions
Pink mucous membranes
Explanation - Tachypnea with chest retractions indicates respiratory distress and needs immediate attention.
Correct answer is: Respiratory rate of 70/min with chest retractions
Q.23 What is the main purpose of monitoring weight daily in neonates?
To track growth and hydration status
To determine clothing size
To monitor heart function
To calculate Apgar score
Explanation - Daily weight measurement helps assess adequate nutrition, hydration, and early signs of illness.
Correct answer is: To track growth and hydration status
Q.24 Which of the following is an appropriate nursing action to prevent infection in neonates?
Frequent hand washing before handling
Allowing visitors to touch the baby freely
Delaying vaccinations
Avoiding bathing
Explanation - Hand hygiene is the most effective way to prevent neonatal infections.
Correct answer is: Frequent hand washing before handling