Midwife Licensure Exam Midwifery Pharmacology & Newborn Procedures — Mandated Newborn Procedures by the MidwifeExam Answer Templates

Marks

1

Topic

Newborn Screening (RA 9288)

Difficulty

easy

Template Id

T1

Examiner Tip

The examiner wants the exact numeric range. Always write '24 to 72 hours after birth' — never approximate with 'first few days.'

Model Answer

The ideal timing for newborn screening sample collection under RA 9288 is 24 to 72 hours after birth.

Question Type

very_short_answer

Answer Structure

• State the exact time range: 24 to 72 hours after birth [1 mark]

Scoring Breakdown

Common Mark Deductions

• Writing only '24 hours' or only '72 hours' without stating the full range
• Writing '1 to 3 days' instead of '24 to 72 hours' — vague and earns no mark
• Confusing the timing with newborn hearing screening

Key Phrases To Include

• 24 to 72 hours after birth
• RA 9288
• heel-prick

Marks

1

Topic

Vitamin K Prophylaxis

Difficulty

easy

Template Id

T2

Examiner Tip

For drug questions, memorize the dose-route-site trio. Giving 2 out of 3 elements is usually not enough for the single mark.

Model Answer

Vitamin K1 (phytomenadione) 1 mg is given intramuscularly into the anterolateral thigh (vastus lateralis) as a single dose to a full-term newborn.

Question Type

very_short_answer

Answer Structure

• State dose (1 mg), route (IM), and site (vastus lateralis) in one sentence [1 mark]

Scoring Breakdown

Common Mark Deductions

• Writing the wrong dose (0.5 mg is for preterm/LBW, not term)
• Omitting the injection site
• Writing 'deltoid' or 'buttock' as the site — incorrect for newborns

Key Phrases To Include

• 1 mg
• intramuscularly
• anterolateral thigh
• vastus lateralis
• single dose

Marks

1

Topic

APGAR Score

Difficulty

easy

Template Id

T3

Examiner Tip

Learn all three APGAR ranges: 7–10 normal, 4–6 moderately depressed, 0–3 severely depressed. Examiners may test any of the three.

Model Answer

An APGAR score of 0 to 3 indicates a severely depressed newborn who needs active resuscitation and immediate referral.

Question Type

very_short_answer

Answer Structure

• State the correct score range (0–3) and its interpretation (severely depressed) [1 mark]

Scoring Breakdown

Common Mark Deductions

• Writing '0–5' — confuses moderately and severely depressed ranges
• Writing only the number without the clinical interpretation
• Confusing 4–6 (moderately depressed) with 0–3 (severely depressed)

Key Phrases To Include

• 0 to 3
• severely depressed
• active resuscitation

Marks

2

Topic

Newborn Hearing Screening (RA 9709)

Difficulty

easy

Template Id

T4

Examiner Tip

The two major newborn laws (RA 9288 and RA 9709) are frequently confused. Use this memory aid: 9288 = 'eight letters in heel-prick' (metabolic), 9709 = 'sounds/hearing.'

Model Answer

The Universal Newborn Hearing Screening and Intervention Act of 2009, also known as RA 9709, mandates hearing screening for every newborn in the Philippines. The screening should be done before discharge or within the first month of life, and at the latest by 3 months of age.

Question Type

short_answer

Answer Structure

• Line 1: Name the law — RA 9709 / Universal Newborn Hearing Screening and Intervention Act of 2009 [1 mark]
• Line 2: State the recommended timing — before discharge/within 1 month, latest 3 months [1 mark]

Scoring Breakdown

Common Mark Deductions

• Confusing RA 9709 (hearing) with RA 9288 (newborn metabolic screening)
• Stating only 'before discharge' without mentioning the 3-month latest deadline
• Writing 'RA 9278' or other incorrect law numbers

Key Phrases To Include

• RA 9709
• Universal Newborn Hearing Screening
• before discharge
• within 1 month
• 3 months at the latest

Marks

2

Topic

Eye Prophylaxis

Difficulty

medium

Template Id

T5

Examiner Tip

The 'do not irrigate' instruction is a classic trap in MLE questions. Always include it in your answer to show you know the complete protocol.

Model Answer

Every newborn receives erythromycin 0.5% ophthalmic ointment to prevent ophthalmia neonatorum. A thin ribbon of ointment is applied from the inner to the outer canthus into the lower conjunctival sac of each eye. The eyes are NOT irrigated afterward. It is applied after the first breastfeed and bonding, ideally within the first hour of life.

Question Type

short_answer

Answer Structure

• Line 1: Name the drug and its concentration — erythromycin 0.5% ophthalmic ointment [1 mark]
• Line 2: Describe correct application technique — inner to outer canthus, lower conjunctival sac, both eyes, no irrigation [1 mark]

Scoring Breakdown

Common Mark Deductions

• Writing 'eye drops' instead of 'ointment'
• Omitting the direction of application (inner to outer canthus)
• Stating that the eye should be rinsed or irrigated afterward — this is incorrect and loses the mark

Key Phrases To Include

• erythromycin 0.5% ophthalmic ointment
• ophthalmia neonatorum
• inner to outer canthus
• lower conjunctival sac
• do not irrigate

Marks

2

Topic

EINC / Unang Yakap Protocol

Difficulty

medium

Template Id

T6

Examiner Tip

Examiners award marks per step. Write them as a numbered list — never as a paragraph — so the examiner can quickly check each step.

Model Answer

The four core steps of EINC/Unang Yakap in correct sequence are: 1. Immediate and thorough drying of the newborn for the first 30 seconds to prevent hypothermia and stimulate breathing. 2. Early skin-to-skin contact — place the naked, dried baby prone on the mother's bare chest and cover both with a warm dry cloth. 3. Properly timed cord clamping — clamp and cut the cord only after pulsations stop, approximately 1 to 3 minutes after birth. 4. Non-separation of mother and baby to support early breastfeeding, with first latch ideally within 90 minutes of birth.

Question Type

short_answer

Answer Structure

• Step 1: Immediate drying — 30 seconds [0.5 mark]
• Step 2: Skin-to-skin contact [0.5 mark]
• Step 3: Delayed cord clamping — 1 to 3 minutes [0.5 mark]
• Step 4: Non-separation and early breastfeeding within 90 minutes [0.5 mark]

Scoring Breakdown

Common Mark Deductions

• Writing steps out of sequence — sequence is specifically tested
• Omitting the timing details (30 seconds for drying, 1–3 min for cord, 90 min for breastfeed)
• Writing 'cord cutting' instead of 'delayed cord clamping'

Key Phrases To Include

• immediate drying
• 30 seconds
• skin-to-skin contact
• delayed cord clamping
• 1 to 3 minutes
• non-separation
• early breastfeeding
• 90 minutes

Marks

2

Topic

Vitamin K Prophylaxis

Difficulty

medium

Template Id

T7

Examiner Tip

The 0.5 mg vs 1 mg distinction is a high-frequency MLE item. Connect the lower dose to the lower weight: smaller baby, smaller dose.

Model Answer

For a full-term newborn (birth weight ≥ 1.5 kg), Vitamin K1 (phytomenadione) is given at 1 mg intramuscularly into the anterolateral thigh as a single dose. For a preterm or low-birth-weight newborn (less than 1.5 kg), the dose is reduced to 0.5 mg intramuscularly into the same site. Both are given within the first hours after birth to prevent Vitamin K Deficiency Bleeding (VKDB).

Question Type

short_answer

Answer Structure

• Line 1: Term dose — 1 mg IM, vastus lateralis [1 mark]
• Line 2: Preterm/LBW dose — 0.5 mg IM, same site, weight criterion < 1.5 kg [1 mark]

Scoring Breakdown

Common Mark Deductions

• Reversing the doses (writing 0.5 mg for term and 1 mg for preterm)
• Not stating the weight criterion for the reduced dose
• Writing the wrong injection site (e.g., deltoid or gluteal)

Key Phrases To Include

• 1 mg IM for term
• 0.5 mg IM for preterm
• less than 1.5 kg
• anterolateral thigh
• Vitamin K Deficiency Bleeding
• VKDB

Marks

3

Topic

Cord Care

Difficulty

medium

Template Id

T8

Examiner Tip

DOH updated cord care to 'dry cord care' — no alcohol, no antiseptic. This policy change is frequently tested. Stating the old practice of alcohol application will lose marks.

Model Answer

After properly timed cord clamping (at 1–3 minutes or when pulsations stop), the midwife cuts the cord with a sterile blade or scissors between two sterile clamps or ties. DOH policy promotes dry cord care: the stump is kept clean and dry and exposed to air. The diaper is folded below the stump to prevent urine contamination. Nothing is applied to the stump — no alcohol, no antiseptic solution, no traditional preparations such as powders or herbal applications. The midwife then teaches the mother the danger signs of omphalitis: redness, swelling, foul-smelling discharge around the cord stump, and fever. If any of these signs appear, the mother is advised to return immediately to the health facility. The cord stump normally separates within 5 to 15 days.

Question Type

short_answer

Answer Structure

• Point 1: Properly timed clamping and cutting with sterile instrument [1 mark]
• Point 2: Dry cord care — keep clean and dry, expose to air, diaper folded below, apply nothing [1 mark]
• Point 3: Health teachings — signs of omphalitis (redness, swelling, foul discharge, fever) and instruction to return immediately [1 mark]

Scoring Breakdown

Common Mark Deductions

• Recommending alcohol or betadine application — this contradicts current DOH dry cord care policy
• Omitting health teachings about omphalitis danger signs
• Not mentioning the timing of normal cord separation (5–15 days)

Key Phrases To Include

• dry cord care
• clean and dry
• do not apply anything
• sterile blade or scissors
• omphalitis
• redness, swelling, foul discharge
• 5 to 15 days
• diaper folded below stump

Marks

3

Topic

APGAR Score

Difficulty

medium

Template Id

T9

Examiner Tip

Use a table format for the five APGAR components — it is faster to write, easier for the examiner to read, and less likely to have errors than paragraph form.

Model Answer

The APGAR score is a rapid assessment tool used at 1 minute and 5 minutes after birth to evaluate the newborn's condition during transition to extrauterine life. The five components and their scoring (0, 1, or 2) are: 1. Appearance (Color): 0 = blue/pale all over; 1 = body pink, extremities blue; 2 = completely pink. 2. Pulse (Heart Rate): 0 = absent; 1 = less than 100/min; 2 = 100/min or more. 3. Grimace (Reflex Irritability): 0 = no response; 1 = grimace only; 2 = cry, cough, or sneeze. 4. Activity (Muscle Tone): 0 = limp/flaccid; 1 = some flexion of extremities; 2 = active motion. 5. Respiration: 0 = absent; 1 = slow, irregular, or weak cry; 2 = good, strong cry. Total score interpretation: - 7 to 10: Good/Normal — routine newborn care. - 4 to 6: Moderately depressed — needs stimulation and possible support. - 0 to 3: Severely depressed — needs active resuscitation and immediate referral.

Question Type

short_answer

Answer Structure

• Part 1: State what APGAR is, when it is scored (1 and 5 minutes) [0.5 mark]
• Part 2: List all 5 components with correct 0-1-2 scoring for each [1.5 marks — 0.3 per component]
• Part 3: Interpret all three score ranges with clinical action [1 mark]

Scoring Breakdown

Common Mark Deductions

• Mixing up the 0 and 2 score descriptions for any component
• Stating only one or two score ranges instead of all three
• Writing that resuscitation should wait for the 1-minute APGAR — incorrect, resuscitation begins immediately based on breathing and HR

Key Phrases To Include

• Appearance, Pulse, Grimace, Activity, Respiration
• 1 minute and 5 minutes
• 7–10 normal
• 4–6 moderately depressed
• 0–3 severely depressed
• active resuscitation
• immediate referral

Marks

3

Topic

Newborn Screening (RA 9288)

Difficulty

hard

Template Id

T10

Examiner Tip

Memorize the six core ENBS disorders by the acronym CH-CAH-GAL-PKU-G6PD-MSUD. Write them in this order so you do not skip any.

Model Answer

Under RA 9288 (Newborn Screening Act of 2004), the expanded newborn screening (ENBS) panel screens for metabolic and genetic conditions that cause death or irreversible intellectual disability if undetected, but are treatable when identified early. The core disorders screened include: 1. Congenital Hypothyroidism (CH) 2. Congenital Adrenal Hyperplasia (CAH) 3. Galactosemia (GAL) 4. Phenylketonuria (PKU) 5. Glucose-6-Phosphate Dehydrogenase Deficiency (G6PD) 6. Maple Syrup Urine Disease (MSUD) (Expanded panel also includes hemoglobinopathies and biotinidase deficiency.) Significance of early CH detection: Congenital hypothyroidism is the most common preventable cause of intellectual disability in newborns. Without early detection, the infant will develop severe, irreversible cognitive impairment (cretinism). However, if detected through newborn screening and treated promptly with oral thyroxine, the child can develop completely normally. This makes it the classic example of why newborn screening is life-changing.

Question Type

short_answer

Answer Structure

• Part 1: Name the law (RA 9288) and the purpose of ENBS [0.5 mark]
• Part 2: List at least 5 disorders correctly (1 mark per 2-3 disorders, at least 5 needed) [1.5 marks]
• Part 3: Explain significance of CH — untreated causes intellectual disability, treated with thyroxine → normal development [1 mark]

Scoring Breakdown

Common Mark Deductions

• Listing fewer than 5 disorders — always aim for the full list
• Confusing CH with CAH in the explanation
• Failing to state that CH is treatable with thyroxine — the treatment is key to earning the mark

Key Phrases To Include

• RA 9288
• congenital hypothyroidism
• G6PD deficiency
• PKU
• CAH
• galactosemia
• MSUD
• thyroxine
• irreversible intellectual disability
• treatable if detected early

Marks

5

Topic

Complete Newborn Care Sequence

Difficulty

hard

Template Id

T11

Examiner Tip

For a 5-mark long answer, organize by time bands (immediate, first hour, 24 hours, 24–72 hours, pre-discharge). This structure mirrors the EINC protocol and ensures you cover all points systematically. Each time band should earn approximately 1 mark.

Model Answer

Under RA 7392 and the EINC/Unang Yakap protocol, the midwife performs the following mandated procedures in sequence for a vigorous newborn: IMMEDIATELY AFTER BIRTH (0–30 seconds): 1. Immediate and thorough drying: The midwife dries the baby's body and head for the first 30 seconds using a clean, warm, dry cloth to prevent hypothermia and stimulate breathing. The vernix is NOT wiped off. The wet cloth is removed and replaced with a dry one. FIRST FEW MINUTES (0–5 minutes): 2. APGAR Assessment at 1 minute and 5 minutes: The midwife quickly assesses Appearance, Pulse, Grimace, Activity, and Respiration. A score of 7–10 is normal. Since the baby is vigorous, resuscitation is not needed. 3. Early skin-to-skin contact: The naked, dried baby is placed prone on the mother's bare abdomen or chest and both are covered with a warm dry cloth. A bonnet is placed on the baby's head. 4. Properly timed cord clamping: The cord is clamped and cut only after pulsations cease, approximately 1 to 3 minutes after birth, using sterile instruments. The stump is kept clean and dry (dry cord care — nothing applied). FIRST HOUR: 5. Non-separation and early breastfeeding: The dyad is kept together. The midwife supports the newborn's crawl reflex and first latch. Breastfeeding should occur within 90 minutes of birth. 6. Vitamin K1 (phytomenadione) 1 mg IM: Given as a single dose into the anterolateral thigh (vastus lateralis) to prevent Vitamin K Deficiency Bleeding (VKDB). 7. Eye prophylaxis: Erythromycin 0.5% ophthalmic ointment is applied as a thin ribbon from inner to outer canthus into the lower conjunctival sac of each eye. Eyes are not irrigated. Given after first breastfeed. WITHIN FIRST 24 HOURS: 8. BCG vaccine (0.05 mL intradermal, right deltoid) and Hepatitis B birth dose (0.5 mL IM, anterolateral thigh) — both given within 24 hours of birth. 9. Anthropometric measurements: Weight (normal 2,500–4,000 g), length, head circumference. A complete head-to-toe assessment is performed, including checking anus patency and normal vitals (RR 40–60/min, HR 120–160/min, axillary temp 36.5–37.5°C). 10. Bathing is delayed at least 6 hours (ideally 24 hours) to prevent heat loss. AT 24–72 HOURS: 11. Newborn Screening (RA 9288): A heel-prick capillary blood sample is collected onto a filter-paper card between 24 and 72 hours after birth. The midwife informs the parents of its purpose, their rights, and ensures the sample is sent to the screening center. BEFORE DISCHARGE OR WITHIN 1 MONTH: 12. Newborn Hearing Screening (RA 9709): OAE or AABR hearing test is performed. If equipment is unavailable at the BHS, the midwife refers the newborn to a screening facility and documents the referral. Throughout all procedures, maintaining warmth (warm chain) and supporting breastfeeding are the overriding priorities. The midwife recognizes any danger signs (hypothermia, apnea, cyanosis, jaundice within 24 hours, bleeding) and refers the newborn to a higher-level facility immediately.

Question Type

long_answer

Answer Structure

• Part 1 — Immediate (0–30 sec): Drying, vernix care, APGAR timing [1 mark]
• Part 2 — First few minutes: Skin-to-skin, delayed cord clamping with timing, dry cord care [1 mark]
• Part 3 — First hour: Breastfeeding within 90 min, Vitamin K1 dose/route/site, eye prophylaxis technique [1 mark]
• Part 4 — 24 hours: BCG and HepB vaccines, measurements, delayed bathing [1 mark]
• Part 5 — 24–72 hrs and pre-discharge: NBS heel-prick (RA 9288), NHS (RA 9709), referral if needed, danger signs [1 mark]

Scoring Breakdown

Common Mark Deductions

• Omitting the law numbers (RA 9288, RA 9709) — this costs marks in comprehensive answers
• Mixing up sequences — e.g., putting NBS before EINC steps
• Omitting any one of the vaccines (BCG or HepB)
• Stating that routine suctioning is done — this is an EINC 'do not do'
• Writing that the eye is irrigated after prophylaxis
• Omitting the danger signs and referral component — this reflects the midwife's scope of practice

Key Phrases To Include

• EINC / Unang Yakap
• 30 seconds drying
• skin-to-skin contact
• 1 to 3 minutes delayed cord clamping
• dry cord care
• 90 minutes breastfeeding
• Vitamin K1 1 mg IM vastus lateralis
• erythromycin 0.5% ophthalmic ointment
• BCG and Hepatitis B within 24 hours
• RA 9288 heel-prick 24–72 hours
• RA 9709 OAE AABR before discharge
• warm chain
• recognize and refer

Marks

5

Topic

Newborn Resuscitation and Referral

Difficulty

hard

Template Id

T12

Examiner Tip

Case study questions always require you to address the midwife's scope of practice. No matter how well you describe the resuscitation steps, if you omit 'arrange urgent referral,' you will lose the scope-of-practice mark.

Model Answer

This scenario presents a non-breathing newborn with thick meconium-stained amniotic fluid — a neonatal emergency requiring immediate action within the 'golden minute' (first 60 seconds of life). The midwife's immediate actions are as follows: STEP 1 — CALL FOR HELP AND PREPARE THE ENVIRONMENT: The midwife immediately calls for assistance and activates the referral system to transfer the baby to a BEmONC or CEmONC facility. A warm, firm resuscitation surface is prepared under a radiant warmer or in a warm area. STEP 2 — PROMPT CORD CLAMPING (exception to delayed clamping): Because the baby is NOT vigorous, the midwife does NOT delay cord clamping. She clamps and cuts the cord promptly to move the baby to the resuscitation area immediately. STEP 3 — DO NOT SUCTION FOR MECONIUM (if baby is not vigorous): For a non-vigorous baby with meconium, the current evidence-based protocol does NOT recommend routine tracheal suctioning. The midwife proceeds with standard resuscitation steps. STEP 4 — WARM, DRY, STIMULATE, AND POSITION: - Place the baby on a warm, dry surface. - Dry thoroughly and remove wet cloth. - Position the baby with the neck slightly extended (sniffing position) to open the airway. - Suction only if there is obvious airway obstruction (mouth first, then nose), using a bulb syringe or suction device. - Stimulate by rubbing the back or flicking the soles of the feet. STEP 5 — ASSESS BREATHING AND HEART RATE: If after 30 seconds of stimulation the baby is still not breathing or gasping, or if the heart rate is less than 100/min, the midwife begins: STEP 6 — POSITIVE PRESSURE VENTILATION (PPV): Using a bag-and-mask with 100% oxygen or room air, give PPV at 40–60 breaths per minute. Ensure a proper mask seal over the mouth and nose. STEP 7 — CONTINUOUS MONITORING AND REASSESSMENT: Reassess breathing and heart rate every 30 seconds. Document all interventions and their timing. STEP 8 — ARRANGE URGENT REFERRAL: While resuscitation is ongoing, the midwife or her assistant arranges immediate transport to the nearest BEmONC or CEmONC facility with a written referral slip documenting the situation, all actions taken, and the baby's response. Note: The APGAR score is NOT used to decide when to start resuscitation. The decision is based on breathing, tone, and heart rate assessed immediately at birth. The overriding priority is establishing breathing within the golden minute.

Question Type

case_study

Answer Structure

• Point 1: Recognize emergency — non-vigorous baby, call for help, activate referral [1 mark]
• Point 2: Prompt (not delayed) cord clamping for non-vigorous baby [1 mark]
• Point 3: Warm, dry, position (sniffing position), stimulate — correct technique [1 mark]
• Point 4: Assess breathing/HR at 30 seconds, begin PPV with bag and mask if needed [1 mark]
• Point 5: Urgent referral to BEmONC/CEmONC with documentation — midwife's scope of practice [1 mark]

Scoring Breakdown

Common Mark Deductions

• Writing that delayed cord clamping is done even for a non-vigorous baby — this is incorrect and loses the mark
• Stating that routine tracheal suctioning is done for meconium — this is outdated practice
• Omitting the referral component — this is critical to RA 7392 midwife scope of practice
• Writing that the midwife 'manages' the case at the BHS without referral — this exceeds the midwife's scope

Key Phrases To Include

• golden minute
• non-vigorous
• prompt cord clamping
• sniffing position
• positive pressure ventilation
• bag and mask
• 40–60 breaths per minute
• BEmONC referral
• do not wait for APGAR
• call for help

Marks

2

Topic

Newborn Screening (RA 9288) — Legal Provisions

Difficulty

medium

Template Id

T13

Examiner Tip

The MLE frequently tests who bears legal responsibility under specific laws. For RA 9288, it is the birth attendant — make this explicit in your answer.

Model Answer

Under RA 9288, the birth attendant (midwife) bears the legal responsibility to ensure that every newborn under her care undergoes newborn screening. Specifically, she must: (1) inform the parents of the availability, benefits, and purpose of newborn screening; (2) ensure the heel-prick blood sample is collected between 24 and 72 hours after birth; and (3) document the screening or, if parents refuse after being fully informed, document the refusal. The attendant — not the hospital or clinic — is legally accountable for this procedure.

Question Type

short_answer

Answer Structure

• Line 1: State legal accountability — the birth attendant/midwife is legally responsible under RA 9288 [1 mark]
• Line 2: Enumerate specific duties — inform parents, ensure sample taken at 24–72 hours, document or document refusal [1 mark]

Scoring Breakdown

Common Mark Deductions

• Not mentioning legal responsibility — the question asks specifically about legal duty
• Omitting that the midwife must inform parents before the procedure
• Failing to mention documentation of refusal if parents decline

Key Phrases To Include

• RA 9288
• legally responsible
• birth attendant
• inform parents
• 24 to 72 hours
• document refusal
• heel-prick

Marks

3

Topic

EINC / Unang Yakap — Prohibited Practices

Difficulty

medium

Template Id

T14

Examiner Tip

For 'do not do' questions, always pair the prohibited action with its evidence-based rationale. A list without reasons earns only half marks.

Model Answer

The following four practices are prohibited under the EINC/Unang Yakap protocol: 1. Do NOT suction routinely: Routine suctioning is no longer recommended for vigorous newborns because it is unnecessary and can cause bradycardia, laryngospasm, and trauma. The airway is cleared only if there is visible obstruction. 2. Do NOT bathe the baby early: Bathing is delayed for at least 6 hours (ideally 24 hours) because early bathing causes rapid evaporative heat loss leading to hypothermia, which is dangerous in newborns. 3. Do NOT separate mother and baby: Separation interrupts skin-to-skin contact, delays breastfeeding initiation, and increases the risk of hypothermia, infection, and breastfeeding failure. 4. Do NOT wipe off the vernix: Vernix caseosa acts as a natural moisturizer, temperature insulator, and protects the newborn's skin. It is left on and absorbed naturally.

Question Type

short_answer

Answer Structure

• Item 1: No routine suctioning — reason stated (bradycardia, trauma, unnecessary for vigorous baby) [0.75 mark]
• Item 2: Delayed bathing — reason stated (prevents hypothermia from heat loss) [0.75 mark]
• Item 3: No mother-baby separation — reason stated (supports breastfeeding, warmth, bonding) [0.75 mark]
• Item 4: Do not wipe vernix — reason stated (natural moisturizer, temperature protection) [0.75 mark]

Scoring Breakdown

Common Mark Deductions

• Listing the 'do not do' items without explaining the rationale — the question asks WHY
• Writing 'no bathing at all' instead of 'delayed bathing for at least 6 hours' — this is incorrect
• Not including vernix as a prohibited action

Key Phrases To Include

• routine suctioning
• early bathing delayed at least 6 hours
• separation of mother and baby
• vernix caseosa
• hypothermia
• breastfeeding failure
• evaporative heat loss

Marks

2

Topic

Newborn Assessment — Normal Values

Difficulty

easy

Template Id

T15

Examiner Tip

Newborn normals are different from adult normals — examiners deliberately test this distinction. Memorize the exact ranges with their units.

Model Answer

The normal vital signs of a healthy full-term newborn are: - Respiratory Rate: 40 to 60 breaths per minute - Heart Rate: 120 to 160 beats per minute - Axillary Temperature: 36.5 to 37.5°C Normal anthropometric measurements: - Birth Weight: 2,500 to 4,000 grams (a newborn weighing less than 2,500 g is classified as low birth weight) - Length: approximately 48 to 52 cm - Head Circumference: approximately 33 to 35 cm

Question Type

short_answer

Answer Structure

• Line 1: Vital signs — RR 40–60/min, HR 120–160/min, axillary temp 36.5–37.5°C [1 mark]
• Line 2: Measurements — weight 2,500–4,000 g (LBW < 2,500 g), length and HC normal ranges [1 mark]

Scoring Breakdown

Common Mark Deductions

• Writing RR as 20–30/min (adult range) instead of 40–60/min
• Writing HR as 60–100/min (adult range) instead of 120–160/min
• Omitting the LBW threshold (< 2,500 g)

Key Phrases To Include

• 40 to 60 breaths per minute
• 120 to 160 beats per minute
• 36.5 to 37.5°C
• 2,500 to 4,000 grams
• low birth weight less than 2,500 g
• axillary temperature