Neonatal care is a specialized area in Pediatric Nursing that demands precision. Whether you are preparing for AIIMS NORCET, RRB Staff Nurse, or NCLEX-RN, understanding newborn disorders is critical.
This daily mock test covers high-yield topics like Neonatal Jaundice (Hyperbilirubinemia) and nursing care during Phototherapy. We also focus on Respiratory Distress Syndrome (RDS) in preterm infants, management of Neonatal Hypoglycemia, and prevention of Hypothermia (Silent Killer). Master these concepts with our solved MCQs.
Newborn Health Challenges & Care
💡 Golden Points to Remember:
- Physiological Jaundice: Appears after 24 hours of birth.
- Pathological Jaundice: Appears within 24 hours (Always abnormal).
- Kramer's Rule: Used to visually estimate bilirubin levels (Zone 1 to 5).
- RDS Cause: Deficiency of Surfactant (Lecithin/Sphingomyelin ratio < 2:1).
- Hypoglycemia Threshold: Blood glucose < 40-45 mg/dL in a newborn.
Pediatric Nursing: Neonatal Disorders Quiz
Q1."Physiological Jaundice" in a term newborn typically appears:
A. Within the first 24 hours of life
B. At birth
C. Between 24 to 72 hours of life
D. After 1 week of life
View Answer & Rationale
Answer: C
Rationale: Answer C is correct. Physiological jaundice is due to immature liver function and RBC breakdown. It appears after 24 hours, peaks at day 3-4, and resolves by day 7-10. Jaundice appearing within the first 24 hours is always pathological.
Source: www.logyanlo.in
Q2.Which of the following blood glucose levels indicates "Neonatal Hypoglycemia" requiring intervention?
A. < 60 mg/dL
B. < 40 mg/dL
C. < 80 mg/dL
D. < 100 mg/dL
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. A plasma glucose level less than 40-45 mg/dL in a newborn typically warrants treatment (feeding or IV dextrose) to prevent neurological damage.
Source: www.logyanlo.in
Q3.Respiratory Distress Syndrome (RDS) in premature infants is primarily caused by a deficiency of:
A. Oxygen
B. Surfactant
C. Glucose
D. Hemoglobin
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. Surfactant (lipoprotein) reduces surface tension in alveoli preventing collapse. Premature lungs lack sufficient surfactant, leading to hyaline membrane disease (RDS).
Source: www.logyanlo.in
Q4."Kernicterus" is a potential complication of severe hyperbilirubinemia characterized by:
A. Liver failure
B. Deposition of bilirubin in the brain cells
C. Renal failure
D. Hemolysis
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. Unconjugated bilirubin is fat-soluble and can cross the blood-brain barrier, depositing in the basal ganglia and causing permanent brain damage (Kernicterus).
Source: www.logyanlo.in
Q5.Which nursing intervention is crucial for a neonate undergoing Phototherapy?
A. Applying lotion to the skin
B. Covering the infant's eyes and genitals
C. Keeping the infant fully clothed
D. Keeping the infant in a prone position only
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. High-intensity light can damage the retina and gonads. Protective eye patches and a diaper/shield for genitals are mandatory safety measures during phototherapy.
Source: www.logyanlo.in
Q6.Infants of Diabetic Mothers (IDM) are at increased risk for which electrolyte imbalance?
A. Hypercalcemia
B. Hypocalcemia
C. Hypernatremia
D. Hypermagnesemia
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. IDMs often develop Hypocalcemia (and Hypomagnesemia) shortly after birth due to a delay in parathyroid hormone response.
Source: www.logyanlo.in
Q7."Kramer's Rule" is used for the clinical assessment of:
A. Respiratory Distress
B. Apgar Score
C. Severity of Jaundice (Dermal Zones)
D. Gestational Age
View Answer & Rationale
Answer: C
Rationale: Answer C is correct. Kramer's rule estimates serum bilirubin levels based on the cephalo-caudal progression of dermal icterus (yellowing) across five dermal zones.
Source: www.logyanlo.in
Q8.A neonate with RDS is receiving oxygen therapy. The nurse knows that excessive oxygen administration can lead to:
A. Retinopathy of Prematurity (ROP)
B. Hypoglycemia
C. Jaundice
D. Pneumothorax
View Answer & Rationale
Answer: A
Rationale: Answer A is correct. High concentrations of oxygen cause vasoconstriction of retinal vessels in preemies, leading to abnormal vessel growth and potentially blindness (ROP).
Source: www.logyanlo.in
Q9.Which drug is administered to a pregnant woman at risk of preterm delivery to accelerate fetal lung maturity?
A. Oxytocin
B. Magnesium Sulfate
C. Betamethasone (Corticosteroid)
D. Progesterone
View Answer & Rationale
Answer: C
Rationale: Answer C is correct. Antenatal corticosteroids like Betamethasone or Dexamethasone stimulate Type II pneumocytes in the fetal lung to produce surfactant, reducing the risk of RDS.
Source: www.logyanlo.in
Q10.Pathological Jaundice is suspected if the serum bilirubin rises by more than:
A. 2 mg/dL per day
B. 5 mg/dL per day
C. 0.5 mg/dL per day
D. 1 mg/dL per day
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. A rapid rise in bilirubin (>5 mg/dL in 24 hours) indicates a pathological process like hemolysis or sepsis, rather than physiological clearing.
Source: www.logyanlo.in
Q11.The classic triad of symptoms for Neonatal Hypoglycemia includes Jitteriness, Lethargy, and:
A. Hyperthermia
B. Seizures/Apnea
C. Bradycardia
D. Diarrhea
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. The brain is glucose-dependent. Severe hypoglycemia causes neurological signs like tremors (jitteriness), seizures, weak cry, and apnea.
Source: www.logyanlo.in
Q12."Bronze Baby Syndrome" is a rare complication associated with:
A. Severe Hypoglycemia
B. Phototherapy
C. Exchange Transfusion
D. Hepatitis B
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. Bronze Baby Syndrome occurs in infants with direct (conjugated) hyperbilirubinemia undergoing phototherapy, causing a grey-brown discoloration of skin, serum, and urine.
Source: www.logyanlo.in
Q13.The Silverman-Anderson Score is used to assess:
A. Gestational Age
B. Degree of Respiratory Distress
C. Level of Jaundice
D. Neurological Status
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. It assesses respiratory distress based on 5 parameters (chest retractions, xiphoid retractions, nasal flaring, expiratory grunting, and chin movement). A higher score indicates severe distress (unlike Apgar where high is good).
Source: www.logyanlo.in
Q14.In "Breast Milk Jaundice", the bilirubin level typically peaks around:
A. Day 2-3
B. Day 5-7
C. Day 10-14
D. 1 Month
View Answer & Rationale
Answer: C
Rationale: Answer C is correct. This late-onset jaundice typically peaks in the second week (Day 10-14) due to substances in breast milk inhibiting bilirubin conjugation.
Source: www.logyanlo.in
Q15.Which of the following is the most common cause of Pathological Jaundice appearing within 24 hours?
A. Breastfeeding
B. Rh or ABO Incompatibility (Hemolysis)
C. Hypothyroidism
D. Biliary Atresia
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. Hemolytic disease of the newborn due to blood group incompatibility destroys RBCs rapidly, causing jaundice immediately after birth within the first 24 hours.
Source: www.logyanlo.in
Q16.An infant with RDS exhibits "Grunting". This physiological mechanism serves to:
A. Clear the airway
B. Signal hunger
C. Maintain Positive End-Expiratory Pressure (PEEP)
D. Increase heart rate
View Answer & Rationale
Answer: C
Rationale: Answer C is correct. Expiratory grunting is the partial closure of the glottis to trap air in the alveoli, preventing alveolar collapse and improving oxygenation (Auto-PEEP mechanism).
Source: www.logyanlo.in
Q17.What is the standard treatment for severe hyperbilirubinemia unresponsive to phototherapy?
A. IV Albumin
B. Exchange Transfusion
C. Phenobarbital
D. IV Glucose
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. Exchange Transfusion removes antibody-coated RBCs and excess bilirubin from the blood, replacing them with donor blood to prevent Kernicterus.
Source: www.logyanlo.in
Q18.Persistent hypoglycemia in a newborn may be a sign of:
A. Hypothyroidism
B. Hyperinsulinism (Nesidioblastosis)
C. Pyloric Stenosis
D. Cleft Palate
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. Conditions like Nesidioblastosis or Islet Cell Adenoma cause excessive insulin secretion, leading to refractory hypoglycemia requiring high glucose infusion rates.
Source: www.logyanlo.in
Q19.Surfactant is produced by which cells in the lungs?
A. Type I Pneumocytes
B. Type II Pneumocytes
C. Alveolar Macrophages
D. Bronchial Cilia
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. Type II alveolar cells (pneumocytes) synthesize and secrete pulmonary surfactant starting around 24 weeks of gestation, with adequate levels typically reached by 34-36 weeks.
Source: www.logyanlo.in
Q20.The color of light most effective for Phototherapy is:
A. Red light (600-700 nm)
B. Blue-Green light (460-490 nm)
C. Ultraviolet light
D. White light
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. Bilirubin absorbs light most effectively in the Blue-Green spectrum (460-490 nm), converting it into water-soluble isomers (lumirubin) for excretion through bile and urine.
Source: www.logyanlo.in
Q21.Which of the following is a classic sign of "Necrotizing Enterocolitis" (NEC) in a premature infant?
A. Projectile vomiting
B. Abdominal distension and bloody stools
C. Currant jelly stool
D. Olive-shaped mass
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. NEC is a serious intestinal disease in preemies characterized by ischemia, inflammation, abdominal distension, and frank blood in the stool. Currant jelly stool is seen in intussusception and olive-shaped mass in pyloric stenosis.
Source: www.logyanlo.in
Q22."Lecithin/Sphingomyelin (L/S) Ratio" is used to assess:
A. Kidney function
B. Fetal Lung Maturity
C. Liver function
D. Neural tube defects
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. An L/S ratio of 2:1 or higher in amniotic fluid indicates sufficient surfactant production and fetal lung maturity, reducing the risk of RDS.
Source: www.logyanlo.in
Q23."Caput Succedaneum" differs from "Cephalhematoma" because Caput:
A. Does not cross suture lines
B. Crosses suture lines
C. Is caused by bleeding
D. Takes weeks to resolve
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. Caput Succedaneum is edema (fluid) of the scalp that crosses suture lines and resolves quickly. Cephalhematoma is blood collected under the periosteum that does not cross suture lines and takes weeks to resolve.
Source: www.logyanlo.in
Q24.Which is often the first subtle sign of Sepsis in a newborn?
A. High fever
B. Temperature instability (Hypothermia)
C. Seizures
D. Bulging fontanelle
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. Unlike older children who spike fevers, newborns with sepsis often present with temperature instability (especially hypothermia), lethargy, and poor feeding as the earliest signs.
Source: www.logyanlo.in
Q25."Erb's Palsy" involves injury to which nerve roots during birth trauma?
A. C3-C4
B. C5-C6
C. C8-T1
D. T1-T2
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. Injury to the upper brachial plexus (C5-C6) causes Erb's Palsy, resulting in the characteristic "Waiter's Tip" position of the arm. C8-T1 injury causes Klumpke's Palsy.
Source: www.logyanlo.in
Q26.The drug "Caffeine Citrate" is primarily used in the NICU to treat:
A. Neonatal Seizures
B. Apnea of Prematurity
C. Patent Ductus Arteriosus
D. Hypoglycemia
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. Caffeine stimulates the respiratory center in the brainstem and is the standard treatment for Apnea of Prematurity in preterm infants.
Source: www.logyanlo.in
Q27.Which of the following is physiologic in the first few days of life but pathological if prolonged?
A. Weight gain
B. Weight loss (5-10%)
C. Hyperglycemia
D. Hypertension
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. Term neonates normally lose 5-10% of their birth weight in the first week due to fluid shifts and adjustment to extrauterine life. Loss greater than 10% suggests dehydration or feeding issues.
Source: www.logyanlo.in
Q28."Harlequin Color Change" is a transient benign phenomenon where:
A. The baby turns completely blue
B. One half of the body is red/pink and the other half is pale
C. The face is purple and limbs are white
D. The skin peels off
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. It is a vasomotor instability phenomenon where a clear line of demarcation separates a red half and a pale half of the body. It is benign and self-limiting.
Source: www.logyanlo.in
Q29.An infant with "Choanal Atresia" typically presents with:
A. Inability to pass stool
B. Cyanosis at rest that improves with crying
C. Projectile vomiting
D. Excessive drooling
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. Choanal Atresia is the blockage of the nasal passage. Since neonates are obligate nose breathers, they become cyanotic when quiet or feeding but turn pink when crying (mouth breathing).
Source: www.logyanlo.in
Q30.The presence of "Single Palmar Crease" (Simian Crease) is a soft marker for:
A. Turner Syndrome
B. Down Syndrome
C. Edward Syndrome
D. Normal variation only
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. While it can occur in normal individuals, a single transverse palmar crease is found in about 45% of infants with Down Syndrome (Trisomy 21) and is considered a soft marker.
Source: www.logyanlo.in
Q31.Which vitamin is injected at birth to prevent "Hemorrhagic Disease of the Newborn"?
A. Vitamin A
B. Vitamin D
C. Vitamin K
D. Vitamin E
View Answer & Rationale
Answer: C
Rationale: Answer C is correct. Newborns have a sterile gut and low Vitamin K stores. Vitamin K (1 mg IM) is administered at birth to prevent Hemorrhagic Disease of the Newborn (HDN).
Source: www.logyanlo.in
Q32."Ophthalmia Neonatorum" is a conjunctivitis in the newborn usually caused by:
A. Staphylococcus
B. Neisseria gonorrhoeae or Chlamydia
C. Streptococcus
D. Candida
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. It is an infection acquired during passage through an infected birth canal. Prophylaxis with Erythromycin eye ointment is mandatory to prevent this condition.
Source: www.logyanlo.in
Q33."Retinopathy of Prematurity" (ROP) screening is recommended for infants born:
A. Term infants
B. Post-term infants
C. Preterm infants <32 weeks or <1500g
D. Any infant with jaundice
View Answer & Rationale
Answer: C
Rationale: Answer C is correct. ROP screening guidelines typically target infants less than 32 weeks gestation or less than 1500g birth weight, as they are most susceptible to retinal damage from oxygen therapy.
Source: www.logyanlo.in
Q34.Which of the following is a sign of "Hypoglycemia" in a newborn?
A. High-pitched cry
B. Hypotonia and Poor feeding
C. Hypertonia
D. Bulging fontanelle
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. Hypoglycemia deprives the brain and muscles of energy, leading to hypotonia (floppiness), lethargy, and poor feeding. A high-pitched cry is often associated with neurological conditions such as increased intracranial pressure.
Source: www.logyanlo.in
Q35."Meconium Aspiration Syndrome" (MAS) is most common in:
A. Preterm infants
B. Post-term infants
C. Infants born by C-section
D. Low birth weight infants
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. Post-term fetuses are more likely to pass meconium in utero due to hypoxia and stress, and aspirate it during delivery, causing chemical pneumonitis.
Source: www.logyanlo.in
Q36.The normal "Apgar Score" range for a healthy newborn at 1 minute is:
A. 0-3
B. 4-6
C. 7-10
D. 12-15
View Answer & Rationale
Answer: C
Rationale: Answer C is correct. A score of 7-10 indicates the infant is adapting well to extrauterine life. A score of 4-6 indicates moderate depression, and 0-3 indicates severe distress requiring immediate resuscitation.
Source: www.logyanlo.in
Q37."Epstein Pearls" are small white cysts found on the:
A. Nose
B. Gums and Hard Palate
C. Cheeks
D. Tongue
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. Epstein pearls are benign retention cysts of epithelial tissue found on the gums and midline of the hard palate. They disappear spontaneously and require no treatment.
Source: www.logyanlo.in
Q38.Which fontanelle is diamond-shaped and closes between 12-18 months?
A. Posterior
B. Anterior
C. Sphenoid
D. Mastoid
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. The Anterior Fontanelle (Bregma) is diamond-shaped and closes between 12-18 months. The Posterior Fontanelle (Lambda) is triangular and closes by 2-3 months.
Source: www.logyanlo.in
Q39."Milia" are tiny white papules on the nose and cheeks of a newborn caused by:
A. Infection
B. Retained sebum (Blocked sebaceous glands)
C. Allergic reaction
D. Vitamin deficiency
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. Milia are benign keratin/sebum-filled cysts caused by blocked sebaceous glands. They are distinct from Erythema Toxicum and resolve spontaneously without treatment.
Source: www.logyanlo.in
Q40.The drug used to treat "Neonatal Abstinence Syndrome" (Opioid withdrawal) is typically:
A. Naloxone
B. Morphine or Methadone (tapering dose)
C. Furosemide
D. Phenytoin
View Answer & Rationale
Answer: B
Rationale: Answer B is correct. Infants withdrawing from maternal opioids are treated with small, tapering doses of an opioid (like Morphine or Methadone) to manage severe withdrawal symptoms. Naloxone is contraindicated as it can precipitate acute withdrawal and seizures.
Source: www.logyanlo.in
🔗 Read Also: More Pediatric Nursing Questions (Milestones & Defects)
Frequently Asked Questions (Neonatology)
Q1: What is the priority nursing action for a baby receiving Phototherapy?
Ans: The priority is to Cover the Eyes and Genitals to prevent damage. The nurse must also ensure proper hydration and turn the baby every 2 hours for maximum skin exposure.
Q2: What is the classic sign of Respiratory Distress Syndrome (RDS) in a newborn?
Ans: Classic signs include Expiratory Grunting, Nasal Flaring, and Intercostal Retractions (Chest sinking in).
Q3: Why are newborns prone to Hypothermia (Silent Killer)?
Ans: Newborns have a large surface area-to-body weight ratio, thin skin, and limited subcutaneous fat (Brown Fat), making them lose heat rapidly.
Question for You:
Which drug is administered to a pregnant mother to accelerate fetal lung maturity (Surfactant production) if preterm delivery is expected?
A. Oxytocin
B. Betamethasone / Dexamethasone
C. Magnesium Sulfate
D. Terbutaline
👉 Comment your answer below!
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Dexamethasone
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