NRP 531 ACTUAL EXAM PAPER 2026
QUESTIONS WITH ANSWERS GRADED A+
◍ What are potential complications of occular chlamydia?.
Answer: Pneumona (cough, fever, tachypnea)
◍ What are the three types of neonatal jaundice?.
Answer: -Physiologic jaundice/breastfeeding jaundice-Breast milk
jaundice-Pathologic jaundice
◍ What lab tests should be ordered for workup of neonatal sepsis?.
Answer: -Blood, urine and CSF-CRP and PCT-Cultures from tracheal
aspirates if intubated
◍ How should the red reflex appear?.
Answer: Bilateral red reflecting on both eyes without opacities, lgith or dark
spots
◍ Can breast milk be stored if there is a lesion on the breast?.
Answer: No - pump and dump
◍ What is the role of the FNP for patients with red flags associated with
colic?.
Answer: Identify and refer to specialist
◍ Should infants less than six months of age ever be given plain water?.
Answer: No, they should only ever be given breastmilk or formula.
◍ What are symptoms of hypertrophic pyloric stenosis in the neonate?.
Answer: Frequent projectile vomiting (forceful vomiting), usually within a
half hour to one hour after eating. Abdominal (belly) pain.
◍ Beyond the provision of antibodies, what is a benefit IgA on the newborn GI
system?.
, Answer: A laxative effect, stimulates meconium and promotes excretion of
bilirubin through the GI tract.
◍ The infants height has typically increased by how much by the end of the
first year?.
Answer: 50%
◍ What type of formula can be used to reduce symptoms of colic?.
Answer: Hydrolyzed
◍ What should be reviewed for completion prior to discharging the newborn?.
Answer: 24 hour tests:-Newborn metabolic disorder screening (metabolic,
endocrine, hematologic, infectious)-Glucose screening if at risk-Hearing
screen-Congenital heart disease screening (anytime after 24 hours)After 72
hours:-Jaundice (follow up with pediatrician if discharged)Ensure the
newborn has:-Passed 1 stool-Voiding-EatingAdminister HepB vaccine
(within first 24 hours)Vitamin K (preferrably within 1 hour but up to 6
hours)Eye prophylaxis (within 1 hour)Discharge education
◍ By what age should the baby have tripled birth weight?.
Answer: 12 months
◍ How long after exposure will symptoms of ocular gonorrhea present?.
Answer: 0-5 days
◍ How does CNS HSV infection present in the newborn?.
Answer: Encephalitis and seizures, more common in 2nd-4th week of life
◍ What is the most common chromosomal abnormality?.
Answer: Trisomy 21 (Down Syndrome)
◍ How long do the benefits of the Vitamin K injection last?.
Answer: Up to 6 months, at which enough is provided through solid food
intake.
◍ What are risk factors for group B strep.
Answer: -Born prior to 37 weeks with OB complications (testing didnt
occur)-Ruptured membranes >18 hours before delivery-Group B strep
, bacteremia during pregnancy-T >100.4 during labor
◍ Are early or late onset causative agents of neonatal sepsis associated with
higher mortality?.
Answer: Early
◍ At what rate do babies grow from months 6 to 12?.
Answer: ~3/4 in / mo
◍ How should acute hyperbiliruben encephalopathy be managed?.
Answer: immediate treatment to prevent further damage
◍ What is breastmilk jaundice?.
Answer: Neonatal condition potentially due to immature liver and intestines,
presenting after 7 days of life, peaking within 2-3 weeks.
◍ What is the fatality rate of disseminated herpes in the neonate if untreated?.
Answer: 85%
◍ What are the benefits of breast-feeding for baby?.
Answer: -provides antibodies, probiotics and probiotics-reduces the risk of
developing respiratory and bowel disease, allergies, diabetes, ear
infections-Promotes healthy, weight, prevents obesity leptin regulates,
appetite, and fat storage-reduces the risk of sudden infant death syndrome
SIDS-positive effect on brain development
◍ What are some potential causes of a 3rd fontanelle?.
Answer: -Normal variation-Infection-Trisomy 21
◍ Who should be notified if NAS symptoms are present?.
Answer: Child protective services
◍ What are some risk factors for 2 vessel cords?.
Answer: CaucasianFemaleTwinsMaternal age 40<
◍ What other conditions should be ruled out when considering NAS?.
Answer: Sepsis, hypoglycemia, infections
◍ When is it normal for a newborn to sleep for 5 hours?.
, Answer: Once nightly between feeds
◍ How much weight is a newborn expected to lose immediately after birth?.
Answer: 5-10% of birth weight
◍ What is Colic?.
Answer: Period of extended loud crying and difficult to sooth for-3 or more
hours/day-3 or more days per week-3 week period (at least)
◍ What should be included in the oral assessment of the newborn?.
Answer: -Jaw size-Natal teeth, epstein pearls-Ankyloglossia - tongue
tie-Palate (cleft, high arched, midline-Uvula-suck reflex
◍ What is the duration and onset of colic?.
Answer: Typically occurs after 1 month and resolved before 3 months.
◍ By what age should the newborn return to birth weight?.
Answer: 2 weeks of age
◍ Why is it common to hear crackles in the newborns lungs?.
Answer: Retained amniotic fluid
◍ What are the two outcomes of an intraoperative consult?.
Answer: - Determine preliminary diagnosis (must get final) - Determine if
margins are clear or further resection needed
◍ What are possible causes of conjunctivitis in the newborn?.
Answer: -Irritation from prophylactic medications-nasal lacrimal duct
obstruction-viruses-bacteria
◍ What is biliruben?.
Answer: Yellow pigment naturally cleared by the liver and excreted in the
stool and urine
◍ How many grades of jaundice are there for the newborn?.
Answer: 5
◍ Bowel sounds should be active in all quadrants by when?.
Answer: 2 hours of age
QUESTIONS WITH ANSWERS GRADED A+
◍ What are potential complications of occular chlamydia?.
Answer: Pneumona (cough, fever, tachypnea)
◍ What are the three types of neonatal jaundice?.
Answer: -Physiologic jaundice/breastfeeding jaundice-Breast milk
jaundice-Pathologic jaundice
◍ What lab tests should be ordered for workup of neonatal sepsis?.
Answer: -Blood, urine and CSF-CRP and PCT-Cultures from tracheal
aspirates if intubated
◍ How should the red reflex appear?.
Answer: Bilateral red reflecting on both eyes without opacities, lgith or dark
spots
◍ Can breast milk be stored if there is a lesion on the breast?.
Answer: No - pump and dump
◍ What is the role of the FNP for patients with red flags associated with
colic?.
Answer: Identify and refer to specialist
◍ Should infants less than six months of age ever be given plain water?.
Answer: No, they should only ever be given breastmilk or formula.
◍ What are symptoms of hypertrophic pyloric stenosis in the neonate?.
Answer: Frequent projectile vomiting (forceful vomiting), usually within a
half hour to one hour after eating. Abdominal (belly) pain.
◍ Beyond the provision of antibodies, what is a benefit IgA on the newborn GI
system?.
, Answer: A laxative effect, stimulates meconium and promotes excretion of
bilirubin through the GI tract.
◍ The infants height has typically increased by how much by the end of the
first year?.
Answer: 50%
◍ What type of formula can be used to reduce symptoms of colic?.
Answer: Hydrolyzed
◍ What should be reviewed for completion prior to discharging the newborn?.
Answer: 24 hour tests:-Newborn metabolic disorder screening (metabolic,
endocrine, hematologic, infectious)-Glucose screening if at risk-Hearing
screen-Congenital heart disease screening (anytime after 24 hours)After 72
hours:-Jaundice (follow up with pediatrician if discharged)Ensure the
newborn has:-Passed 1 stool-Voiding-EatingAdminister HepB vaccine
(within first 24 hours)Vitamin K (preferrably within 1 hour but up to 6
hours)Eye prophylaxis (within 1 hour)Discharge education
◍ By what age should the baby have tripled birth weight?.
Answer: 12 months
◍ How long after exposure will symptoms of ocular gonorrhea present?.
Answer: 0-5 days
◍ How does CNS HSV infection present in the newborn?.
Answer: Encephalitis and seizures, more common in 2nd-4th week of life
◍ What is the most common chromosomal abnormality?.
Answer: Trisomy 21 (Down Syndrome)
◍ How long do the benefits of the Vitamin K injection last?.
Answer: Up to 6 months, at which enough is provided through solid food
intake.
◍ What are risk factors for group B strep.
Answer: -Born prior to 37 weeks with OB complications (testing didnt
occur)-Ruptured membranes >18 hours before delivery-Group B strep
, bacteremia during pregnancy-T >100.4 during labor
◍ Are early or late onset causative agents of neonatal sepsis associated with
higher mortality?.
Answer: Early
◍ At what rate do babies grow from months 6 to 12?.
Answer: ~3/4 in / mo
◍ How should acute hyperbiliruben encephalopathy be managed?.
Answer: immediate treatment to prevent further damage
◍ What is breastmilk jaundice?.
Answer: Neonatal condition potentially due to immature liver and intestines,
presenting after 7 days of life, peaking within 2-3 weeks.
◍ What is the fatality rate of disseminated herpes in the neonate if untreated?.
Answer: 85%
◍ What are the benefits of breast-feeding for baby?.
Answer: -provides antibodies, probiotics and probiotics-reduces the risk of
developing respiratory and bowel disease, allergies, diabetes, ear
infections-Promotes healthy, weight, prevents obesity leptin regulates,
appetite, and fat storage-reduces the risk of sudden infant death syndrome
SIDS-positive effect on brain development
◍ What are some potential causes of a 3rd fontanelle?.
Answer: -Normal variation-Infection-Trisomy 21
◍ Who should be notified if NAS symptoms are present?.
Answer: Child protective services
◍ What are some risk factors for 2 vessel cords?.
Answer: CaucasianFemaleTwinsMaternal age 40<
◍ What other conditions should be ruled out when considering NAS?.
Answer: Sepsis, hypoglycemia, infections
◍ When is it normal for a newborn to sleep for 5 hours?.
, Answer: Once nightly between feeds
◍ How much weight is a newborn expected to lose immediately after birth?.
Answer: 5-10% of birth weight
◍ What is Colic?.
Answer: Period of extended loud crying and difficult to sooth for-3 or more
hours/day-3 or more days per week-3 week period (at least)
◍ What should be included in the oral assessment of the newborn?.
Answer: -Jaw size-Natal teeth, epstein pearls-Ankyloglossia - tongue
tie-Palate (cleft, high arched, midline-Uvula-suck reflex
◍ What is the duration and onset of colic?.
Answer: Typically occurs after 1 month and resolved before 3 months.
◍ By what age should the newborn return to birth weight?.
Answer: 2 weeks of age
◍ Why is it common to hear crackles in the newborns lungs?.
Answer: Retained amniotic fluid
◍ What are the two outcomes of an intraoperative consult?.
Answer: - Determine preliminary diagnosis (must get final) - Determine if
margins are clear or further resection needed
◍ What are possible causes of conjunctivitis in the newborn?.
Answer: -Irritation from prophylactic medications-nasal lacrimal duct
obstruction-viruses-bacteria
◍ What is biliruben?.
Answer: Yellow pigment naturally cleared by the liver and excreted in the
stool and urine
◍ How many grades of jaundice are there for the newborn?.
Answer: 5
◍ Bowel sounds should be active in all quadrants by when?.
Answer: 2 hours of age
