Neonatal Nursing Demonstration – Viva Questions & Answers

Important viva questions and short answers for nursing demonstrations on normal newborn care, neonatal resuscitation, low-birth-weight babies, common neonatal disorders, organization of the neonatal unit, and prevention of infection in the nursery.

1. Nursing Care of a Normal Newborn

Basic Questions

Q1. What is a newborn/neonate?
Answer: A newborn or neonate is a baby from birth up to 28 days of life.

Q2. What is a normal newborn?
Answer: A healthy newborn who is born at term and is adapting normally to extrauterine life without significant abnormalities.

Q3. What is the normal gestational age of a term baby?
Answer: 37 completed weeks to less than 42 weeks.

Q4. What is the normal birth weight?
Answer: A term newborn commonly weighs around 2.5–4 kg, although individual variation occurs.

Q5. What are the normal vital signs of a newborn?
Answer: Temperature approximately 36.5–37.5°C, respiratory rate about 30–60/minute, and heart rate generally 100–160/minute.

Q6. Why is immediate newborn care important?
Answer: It helps the baby establish breathing, maintain temperature, start feeding and prevent complications.

Temperature-Related Questions

Q7. Why is a newborn prone to hypothermia?
Answer: Because newborns have a relatively large body surface area, little subcutaneous fat and immature temperature-regulating mechanisms.

Q8. How does a newborn lose heat?
Answer: By evaporation, conduction, convection and radiation.

Q9. What is evaporation?
Answer: Heat loss when moisture on the baby's skin changes into vapour.

Q10. How can evaporation be prevented?
Answer: By immediately drying the newborn and removing wet linen.

Q11. What is conduction?
Answer: Heat loss through direct contact with a colder surface.

Q12. What is convection?
Answer: Heat loss to moving surrounding air.

Q13. What is radiation?
Answer: Heat loss to nearby colder surfaces without direct contact.

Q14. How can you prevent hypothermia?
Answer: Dry the baby, provide skin-to-skin contact, use warm clothing and linen, cover the head and maintain an appropriate environmental temperature.

Assessment Questions

Q15. What do you assess immediately after birth?
Answer: Breathing, heart rate, muscle tone, colour and overall condition.

Q16. What is APGAR score?
Answer: It is a rapid assessment of the newborn performed at 1 and 5 minutes, using Appearance, Pulse, Grimace, Activity and Respiration.

Q17. What is the maximum APGAR score?
Answer: 10.

Q18. What does an APGAR score of 7–10 generally indicate?
Answer: Usually good adaptation; routine care and observation are appropriate while continuing clinical assessment.

Q19. What are signs of a healthy newborn?
Answer: Good muscle tone, spontaneous breathing or crying, good colour, active movement and effective feeding.

Breastfeeding Questions

Q20. When should breastfeeding ideally be initiated?
Answer: Within the first hour after birth, when mother and baby are stable.

Q21. What is colostrum?
Answer: Colostrum is the first breast milk produced after delivery. It is rich in antibodies and protective factors.

Q22. Why is colostrum called “liquid gold”?
Answer: Because it is highly nutritious and rich in immune-protective substances.

Q23. What is exclusive breastfeeding?
Answer: Giving only breast milk, except medicines or supplements when medically indicated.

Q24. How long is exclusive breastfeeding recommended?
Answer: For the first 6 months.

Q25. What are signs of good breastfeeding attachment?
Answer: The baby's mouth is wide open, chin touches the breast, more areola is visible above than below the mouth, and sucking is effective without significant maternal pain.

Q26. Why should breastfeeding be encouraged?
Answer: It provides adequate nutrition, hydration and immune protection and promotes mother-baby bonding.

Cord Care

Q27. Why is cord care important?
Answer: To prevent umbilical infection and complications.

Q28. How should the umbilical cord be cared for?
Answer: Keep it clean and dry and observe it regularly for infection or bleeding.

Q29. What should not be applied to the cord?
Answer: Unnecessary substances such as oil, ash, powder or traditional preparations should not be applied.

Q30. What are signs of cord infection?
Answer: Redness, swelling, warmth, pus or foul-smelling discharge around the umbilicus.

Other Normal Newborn Care

Q31. What is meconium?
Answer: The first stool of a newborn; it is usually dark greenish-black, thick and sticky.

Q32. Why do we monitor urine and stool?
Answer: To assess feeding, hydration, gastrointestinal function and overall adaptation.

Q33. Why is newborn weight measured?
Answer: To establish a baseline and monitor growth and nutritional status.

Q34. What is low birth weight?
Answer: Birth weight less than 2.5 kg, regardless of gestational age.

Q35. What are newborn danger signs?
Answer: Difficulty breathing, poor feeding, convulsions, marked lethargy, temperature instability, severe jaundice and other signs of serious illness.

2. Neonatal Resuscitation

Q36. What is neonatal resuscitation?
Answer: It is the immediate assistance given to a newborn who fails to establish adequate breathing and circulation after birth.

Q37. What is the primary goal of neonatal resuscitation?
Answer: To establish effective ventilation and oxygenation and maintain circulation.

Q38. What is the most important intervention in neonatal resuscitation?
Answer: Effective ventilation of the lungs.

Q39. What equipment is required?
Answer: Radiant warmer, towels, suction equipment, bag-and-mask device, appropriate airway equipment, oxygen/air supply, pulse oximeter and other resuscitation equipment.

Q40. Why should resuscitation equipment be checked before delivery?
Answer: To ensure that equipment is available and functioning immediately when needed.

Resuscitation Procedure

Q41. What are the initial steps of newborn resuscitation?
Answer: Provide warmth, dry the baby, position the airway, stimulate if needed and clear the airway only when obstruction is present.

Q42. When is positive-pressure ventilation indicated?
Answer: When the newborn is apneic or gasping, or has inadequate breathing requiring ventilation.

Q43. What is PPV?
Answer: Positive-pressure ventilation is assisted ventilation delivered to the newborn using a device such as a bag and mask.

Q44. How do you know whether ventilation is effective?
Answer: By observing chest movement and, most importantly, an improvement in heart rate.

Q45. What is the significance of heart rate during resuscitation?
Answer: Heart rate is the key indicator used to assess the response to ventilation and determine the next step.

Q46. When are chest compressions considered?
Answer: When the heart rate remains below 60/minute despite effective ventilation, according to the neonatal resuscitation algorithm.

Q47. What is the compression-to-ventilation ratio?
Answer: 3:1.

Q48. What is the preferred technique for chest compression?
Answer: The two-thumb encircling technique is preferred.

Q49. When are medications such as epinephrine considered?
Answer: When the heart rate remains below 60/minute despite effective ventilation and coordinated chest compressions, according to the resuscitation protocol.

Q50. Why should suction not be routinely performed?
Answer: Routine suctioning can cause bradycardia, airway trauma and delay effective ventilation. It is generally reserved for suspected airway obstruction.

3. Nursing Management of a Low-Birth-Weight Baby

Q51. Define low-birth-weight baby.
Answer: A baby with birth weight less than 2.5 kg, regardless of gestational age.

Q52. What problems are commonly seen in LBW babies?
Answer: Hypothermia, hypoglycemia, feeding difficulties, infection and respiratory problems.

Q53. Why are LBW babies prone to hypothermia?
Answer: They have less body fat and immature temperature-regulating mechanisms.

Q54. What is KMC?
Answer: Kangaroo Mother Care is prolonged skin-to-skin contact with the mother or caregiver, along with appropriate feeding and monitoring.

Q55. What are the benefits of KMC?
Answer: It helps maintain temperature, supports breastfeeding, promotes bonding and may reduce complications associated with prematurity or low birth weight.

Q56. How do you feed an LBW baby?
Answer: Breastfeeding is preferred when the baby can suck effectively. If direct breastfeeding is not possible, expressed breast milk may be given by an appropriate method according to the baby's condition and clinical advice.

Q57. Why is breast milk preferred for LBW babies?
Answer: It is easily digestible and provides important nutrients and immune protection.

Q58. Why is an LBW baby at risk of hypoglycemia?
Answer: Because of limited energy stores, increased metabolic needs and possible feeding difficulties.

Q59. How do you prevent hypoglycemia?
Answer: Ensure timely and adequate feeding and monitor blood glucose in babies at risk according to protocol.

Q60. What should you monitor in an LBW baby?
Answer: Temperature, respiration, heart rate, oxygenation when indicated, feeding, blood glucose when indicated, urine/stool and weight.

4. Nursing Management of Common Neonatal Disorders

Neonatal Jaundice

Q61. What is neonatal jaundice?
Answer: Yellow discoloration of the skin and sclera caused by elevated bilirubin levels.

Q62. What is bilirubin?
Answer: A yellow pigment produced mainly from the breakdown of red blood cells.

Q63. What are the signs of jaundice?
Answer: Yellow discoloration of the skin and sclera.

Q64. What is phototherapy?
Answer: Treatment using specific wavelengths of light to convert bilirubin into forms that can be more easily eliminated.

Q65. What are nursing responsibilities during phototherapy?
Answer: Protect the eyes, expose the appropriate skin area, monitor temperature and hydration, encourage feeding and monitor bilirubin as ordered.

Q66. When is neonatal jaundice dangerous?
Answer: Early-onset, rapidly increasing or severe jaundice can indicate serious disease and requires prompt assessment.

Respiratory Distress

Q67. What is respiratory distress?
Answer: Difficulty or increased effort in breathing in a newborn.

Q68. What are signs of respiratory distress?
Answer: Tachypnea, grunting, nasal flaring, chest retractions, cyanosis and apnea.

Q69. What is grunting?
Answer: A sound produced during expiration as the baby attempts to maintain airway pressure and improve lung function.

Q70. What is chest retraction?
Answer: Inward movement of the chest wall during inspiration due to increased work of breathing.

Q71. What is the nursing management of respiratory distress?
Answer: Maintain airway, monitor breathing and oxygen saturation, maintain warmth, provide prescribed respiratory support and report deterioration promptly.

Hypothermia

Q72. What is hypothermia in a newborn?
Answer: A newborn body temperature below the normal range, generally below 36.5°C.

Q73. What are complications of hypothermia?
Answer: Increased oxygen and glucose consumption, hypoglycemia, respiratory problems and worsening illness.

Q74. How can hypothermia be prevented?
Answer: Drying, skin-to-skin care, warm clothing/linen, appropriate environmental temperature and minimizing unnecessary exposure.

Hypoglycemia

Q75. What is neonatal hypoglycemia?
Answer: An abnormally low blood glucose concentration in a newborn; the clinically important threshold depends on age, symptoms and the clinical protocol being used.

Q76. What are signs of hypoglycemia?
Answer: Jitteriness, poor feeding, lethargy, weak cry, apnea, abnormal movements or seizures.

Q77. How is hypoglycemia managed?
Answer: Check blood glucose according to protocol and provide feeding or glucose treatment as clinically indicated.

Neonatal Sepsis

Q78. What is neonatal sepsis?
Answer: A serious systemic infection occurring in a newborn.

Q79. What are signs of neonatal sepsis?
Answer: Poor feeding, lethargy, temperature instability, respiratory difficulty, colour changes, apnea or other signs of systemic illness.

Q80. What is the nursing management of neonatal sepsis?
Answer: Maintain infection-control measures, monitor vital signs, assist with investigations, administer prescribed antibiotics and supportive treatment, and observe for deterioration.

Q81. Why is neonatal sepsis dangerous?
Answer: It can rapidly progress to severe systemic illness, shock and death if not treated promptly.

5. Organization of a Neonatal Unit

Q82. What is a neonatal unit?
Answer: A specialized area where newborns receive observation, routine care and, when necessary, treatment and intensive care.

Q83. What are the important areas of a neonatal unit?
Answer: Reception/assessment area, newborn care area, intensive care area where applicable, feeding area, hand-washing facilities, equipment/supply areas and appropriate waste/utility areas.

Q84. What are the important principles of neonatal unit organization?
Answer: Cleanliness, infection prevention, adequate staffing, proper equipment, appropriate environment, safety and good documentation.

Q85. Why is proper layout important?
Answer: It allows efficient movement of staff and equipment, reduces infection risk and promotes safe patient care.

Q86. Why is a hand-washing facility important?
Answer: It allows staff to perform hand hygiene conveniently and helps prevent infection transmission.

Q87. Why should overcrowding be avoided?
Answer: It increases the risk of cross-infection and makes proper observation and care more difficult.

Q88. What equipment should be available in a neonatal unit?
Answer: Equipment appropriate to the level of care, such as radiant warmers/incubators, oxygen and respiratory-support equipment, monitoring devices, suction equipment, feeding equipment and emergency/resuscitation equipment.

Q89. Why should equipment be checked regularly?
Answer: To ensure it is clean, functional, safe and immediately available during emergencies.

Q90. What records are maintained in a neonatal unit?
Answer: Patient records, vital-sign charts, feeding records, intake/output records, medication records, treatment records and other required documentation.

6. Prevention of Infection in the Nursery

Q91. Why are newborns highly susceptible to infection?
Answer: Their immune system is immature and their protective skin and mucosal barriers are still developing.

Q92. What is the most important measure for preventing infection?
Answer: Proper hand hygiene.

Q93. When should hand hygiene be performed?
Answer: Before and after touching the baby, before procedures, after exposure to body fluids and after touching the baby's surroundings.

Q94. What is cross-infection?
Answer: Transmission of infection from one person or source to another, particularly within a healthcare setting.

Q95. How can cross-infection be prevented?
Answer: Through hand hygiene, appropriate cleaning and disinfection, aseptic technique, proper waste disposal, appropriate isolation and avoiding unnecessary contact.

Q96. Why should visitors be restricted?
Answer: To reduce unnecessary exposure of newborns to infectious agents.

Q97. What precautions should visitors take?
Answer: Perform hand hygiene and avoid visiting when they are ill, according to hospital policy.

Q98. How should linen be handled?
Answer: Soiled linen should be handled carefully, kept separate from clean linen and processed according to infection-control policy.

Q99. How should waste be disposed of?
Answer: According to biomedical waste-management and institutional protocols.

Q100. Why is cord care important in infection prevention?
Answer: The umbilical stump can provide an entry point for microorganisms, so clean and dry care helps reduce infection risk.

Important “Why?” Questions

Q101. Why do you wash your hands before touching the newborn?
Answer: To prevent transmission of microorganisms.

Q102. Why do you dry the newborn immediately?
Answer: To prevent evaporative heat loss and hypothermia.

Q103. Why do you remove wet linen?
Answer: Wet linen increases heat loss through evaporation and conduction.

Q104. Why do you cover the newborn's head?
Answer: The head can contribute significantly to heat loss, so covering it helps maintain warmth.

Q105. Why is skin-to-skin contact encouraged?
Answer: It helps maintain body temperature, supports breastfeeding and promotes bonding.

Q106. Why should breastfeeding be started early?
Answer: It provides nutrition, supports bonding and allows the baby to receive colostrum early.

Q107. Why do you observe the baby after feeding?
Answer: To assess feeding effectiveness and detect problems such as poor sucking, vomiting or respiratory difficulty.

Q108. Why do you monitor urine and stool?
Answer: To assess hydration, feeding and normal gastrointestinal and renal function.

Q109. Why do you monitor the baby's weight?
Answer: To assess growth and nutritional status and identify abnormal weight loss or inadequate intake.

Q110. Why do you maintain aseptic technique in neonatal care?
Answer: Newborns are particularly vulnerable to infection.

Questions That Test Your Understanding

Q111. What is the difference between a term and a preterm baby?
Answer: A term baby is born at 37 to less than 42 completed weeks, while a preterm baby is born before 37 weeks.

Q112. What is the difference between LBW and prematurity?
Answer: LBW is defined by birth weight below 2.5 kg, while prematurity is defined by gestational age below 37 weeks. They are not the same.

Q113. Can a term baby have low birth weight?
Answer: Yes.

Q114. Can a preterm baby weigh more than 2.5 kg?
Answer: Yes, depending on gestational age and growth.

Q115. What is the difference between routine newborn care and resuscitation?
Answer: Routine care is provided to a stable newborn, whereas resuscitation is required when a newborn does not establish adequate breathing or circulation.

Q116. What is the priority in a newborn who is not breathing?
Answer: Provide effective ventilation according to the neonatal resuscitation algorithm.

Q117. What are the four methods of heat loss?
Answer: Evaporation, conduction, convection and radiation.

Q118. What is the normal respiratory rate of a newborn?
Answer: 30–60 breaths per minute.

Q119. What is the normal heart rate?
Answer: 100–160 beats per minute.

Q120. What is the normal temperature?
Answer: Approximately 36.5–37.5°C.

Quick Viva Revision

1. Neonate: Birth to 28 days.
2. Term baby: 37 to less than 42 weeks.
3. LBW: Birth weight less than 2.5 kg.
4. Normal temperature: 36.5–37.5°C.
5. Normal respiratory rate: 30–60/minute.
6. Normal heart rate: 100–160/minute.
7. First milk: Colostrum.
8. Exclusive breastfeeding: Only breast milk for the first 6 months, except medically indicated medicines or supplements.
9. First stool: Meconium.
10. APGAR: Appearance, Pulse, Grimace, Activity, Respiration.
11. Most important intervention in neonatal resuscitation: Effective ventilation.
12. Chest compression : ventilation: 3:1.
13. Most important infection-prevention measure: Hand hygiene.
14. Four methods of heat loss: Evaporation, conduction, convection and radiation.
15. KMC: Skin-to-skin contact plus appropriate feeding and monitoring.

Demonstration Tip:
For every nursing action, explain both what you are doing and why you are doing it.

Example: “I am drying the newborn immediately to prevent evaporative heat loss and hypothermia.”