EXAM 2 NM705 ACTUAL QUESTIONS AND ANSWERS WITH
COMPLETE SOLUTIONS VERIFIED LATEST UPDATE
What is the transition period after birth?
4-6 hours
What aspects of the maternal history and lab values would you want to know in
order to anticipate problems with the NB? (5 main areas)
Maternal
Labs: blood type, Rh, OTT, GBS, H/H, HB
Infections: STI, covid-19, Zika
Medical conditions: severe anemia, DM, HTN
Vaccination status: covid-19, flu, Tdap, Rubella
Labor complications: C/S, forceps or vacuum, fetal distress, PPH, fever
What are the 5 Apgar criteria?
1. Color
2. Heart Rate
3. Reflex Irritability
4. Muscle tone
5. Respirations
Apgar Table (Criteria and how they are scored)
see paper
When should the Apgar score be taken?
,1. At 1 minute
2. At 5 minutes
3. If the score is less than 7 at 5-minutes, then continue scoring at 5-min intervals up to
20 mins.
What is the purpose of the Apgar score?
To assess the newborn's transition to extrauterine life by using 5 components to assess
CV and circulatory status, lung function, and neuromuscular integrity.
What is a common misconception about the purpose of the Apgar score?
1. Does not predict individual neonatal mortality or neurologic outcome, and should
not be used for that purpose.
2. May be misinterpreted as an assessment used to detect the presence of perinatal
asphyxia. BUT it is not a reliable measure of perinatal asphyxia, though it can be used
to determine if umbilical cord gases should be collected.
What does an Apgar score of 7-10 denote?
A vigorous neonate
What is an Apgar score of 4-6 associated with?
Focused resuscitation efforts
What is a newborn score of 3 or less require?
Requires intensive resuscitation procedures.
What are the normal ranges for a newborn who is less than 12 hours old: HR, RR,
BP, and T?
HR: 100-160 bpm
RR: 40-60 bpm
,Temp: Axillary 36.5-37.5 (97.7-99.0F) or Abd Skin 36-36.5 (96.8-97.7f)
BP: SBP 63 mm Hg (Full term) and equal on all 4 extremities
What are the normal variations of heart rate in a newborn? (3 points)
1. Initial murmur left sternal border until ductus arteriosus closes
2. May increase to >/= 170 bpm with crying or activity
3. May decrease to 7—90 bpm in deep sleep or with vagal stimulation that can occur
with yawning, stooling, or suctioning
What are the normal variations of respirations in a newborn? (2 points)
1. Diaphragmatic and abdominal breathing
2. Obligate nasal breather
What may be considered normal variations of respirations in a newborn if other
assessment findings are normal and if these findings are NOT persistent: (5
points)
1. Occasional rales in the first few hours
2. Apnea <15 seconds
3. Irregular rate
4. "Brief" tachypnea up to 6 hours post birth
5. Occasional rales in the 1st 24 hours
List the unacceptable abnormal characteristics in respiration. (4)
1. <30 or >60 bpm
2. Grunting with every expiration
3. Nasal flaring with every breath
4. Visible retractions: suprasternal or subcostal
, List normal temperature variations in a newborn (2 points)
1. When using an abdominal skin sensor, be sure it is in good contact with skin and
covered with reflective shield
2. Skin temperatures are slightly lower than core temperatures. Skin<core temps
List abnormal temperature variations in a newborn (1 point)
Axillary temp <36.5 or >37.5
Does the AAP recommend universal BP screenings on healthy neonates? Why or
why not?
No, because values in NB vary depending on weight, postnatal age, type of delivery,
birth asphyxia, and placental transfusion.
What are some newborn vital signs criteria that would help you know you need to
consult on this baby? (I.e., "Yellow Flags") (6)
1. Elevated HR that does not stabilize despite STS
2. Elevated RR that does not decrease and stabilize once crying subsided, but possibly
increased over time
3. Grunting with respiration
4. Nasal flaring with breathing
5. Retractions with respirations
6. A temp that began to rise or fall over time
What connection should come to mind when our baby does not feed well, no
matter whether human milk or formula, and begins to drop their temp?
Hypoglycemia and hypothermia
COMPLETE SOLUTIONS VERIFIED LATEST UPDATE
What is the transition period after birth?
4-6 hours
What aspects of the maternal history and lab values would you want to know in
order to anticipate problems with the NB? (5 main areas)
Maternal
Labs: blood type, Rh, OTT, GBS, H/H, HB
Infections: STI, covid-19, Zika
Medical conditions: severe anemia, DM, HTN
Vaccination status: covid-19, flu, Tdap, Rubella
Labor complications: C/S, forceps or vacuum, fetal distress, PPH, fever
What are the 5 Apgar criteria?
1. Color
2. Heart Rate
3. Reflex Irritability
4. Muscle tone
5. Respirations
Apgar Table (Criteria and how they are scored)
see paper
When should the Apgar score be taken?
,1. At 1 minute
2. At 5 minutes
3. If the score is less than 7 at 5-minutes, then continue scoring at 5-min intervals up to
20 mins.
What is the purpose of the Apgar score?
To assess the newborn's transition to extrauterine life by using 5 components to assess
CV and circulatory status, lung function, and neuromuscular integrity.
What is a common misconception about the purpose of the Apgar score?
1. Does not predict individual neonatal mortality or neurologic outcome, and should
not be used for that purpose.
2. May be misinterpreted as an assessment used to detect the presence of perinatal
asphyxia. BUT it is not a reliable measure of perinatal asphyxia, though it can be used
to determine if umbilical cord gases should be collected.
What does an Apgar score of 7-10 denote?
A vigorous neonate
What is an Apgar score of 4-6 associated with?
Focused resuscitation efforts
What is a newborn score of 3 or less require?
Requires intensive resuscitation procedures.
What are the normal ranges for a newborn who is less than 12 hours old: HR, RR,
BP, and T?
HR: 100-160 bpm
RR: 40-60 bpm
,Temp: Axillary 36.5-37.5 (97.7-99.0F) or Abd Skin 36-36.5 (96.8-97.7f)
BP: SBP 63 mm Hg (Full term) and equal on all 4 extremities
What are the normal variations of heart rate in a newborn? (3 points)
1. Initial murmur left sternal border until ductus arteriosus closes
2. May increase to >/= 170 bpm with crying or activity
3. May decrease to 7—90 bpm in deep sleep or with vagal stimulation that can occur
with yawning, stooling, or suctioning
What are the normal variations of respirations in a newborn? (2 points)
1. Diaphragmatic and abdominal breathing
2. Obligate nasal breather
What may be considered normal variations of respirations in a newborn if other
assessment findings are normal and if these findings are NOT persistent: (5
points)
1. Occasional rales in the first few hours
2. Apnea <15 seconds
3. Irregular rate
4. "Brief" tachypnea up to 6 hours post birth
5. Occasional rales in the 1st 24 hours
List the unacceptable abnormal characteristics in respiration. (4)
1. <30 or >60 bpm
2. Grunting with every expiration
3. Nasal flaring with every breath
4. Visible retractions: suprasternal or subcostal
, List normal temperature variations in a newborn (2 points)
1. When using an abdominal skin sensor, be sure it is in good contact with skin and
covered with reflective shield
2. Skin temperatures are slightly lower than core temperatures. Skin<core temps
List abnormal temperature variations in a newborn (1 point)
Axillary temp <36.5 or >37.5
Does the AAP recommend universal BP screenings on healthy neonates? Why or
why not?
No, because values in NB vary depending on weight, postnatal age, type of delivery,
birth asphyxia, and placental transfusion.
What are some newborn vital signs criteria that would help you know you need to
consult on this baby? (I.e., "Yellow Flags") (6)
1. Elevated HR that does not stabilize despite STS
2. Elevated RR that does not decrease and stabilize once crying subsided, but possibly
increased over time
3. Grunting with respiration
4. Nasal flaring with breathing
5. Retractions with respirations
6. A temp that began to rise or fall over time
What connection should come to mind when our baby does not feed well, no
matter whether human milk or formula, and begins to drop their temp?
Hypoglycemia and hypothermia
