Pediatric Exam Neurology

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Sample questions from Pediatric Exam Neurology

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.Which finding is expected in a healthy 2-month-old infant during a neurologic assessment?

   • A.The infant has no response to a loud sound
   • B.The infant has a persistent asymmetric Moro reflex
   • C.The anterior fontanel is soft and flat when the infant is calm
   • D.The infant demonstrates a persistent Babinski reflex after age 2 years

   Rationale: A soft, flat anterior fontanel is an expected finding in a calm infant. An asymmetric Moro reflex can indicate injury or neurologic dysfunction, and absent response to sound requires evaluation. An extensor plantar response can be normal in young infants but should not persist beyond the expected developmental period.

2. 2.Refer to the client's chart. Which findings require prompt follow-up for possible increased intracranial pressure? Select all that apply.

   • A.The infant is feeding eagerly at both assessments
   • B.Head circumference increased 1.2 cm in 24 hours
   • C.The fontanel is tense and bulging while the infant is quiet and upright
   • D.The infant has repeated episodes of vomiting
   • E.The infant is consolable and has a strong cry

   Rationale: A bulging fontanel when calm, rapid head growth, and repeated vomiting are concerning for increased intracranial pressure; the chart shows these findings developing over time. Eager feeding and a strong, consolable cry are reassuring findings and do not indicate deterioration in this record. Serial head circumference and neurologic findings should be escalated promptly.

3. 3.Which gross motor skill is generally expected of a 6-month-old infant?

   • A.Walking independently
   • B.Hopping on one foot
   • C.Climbing stairs using alternating feet
   • D.Sitting briefly while leaning on the hands

   Rationale: Many infants sit briefly with support from their hands around 6 months. Independent walking, hopping, and alternating-foot stair climbing occur later as balance and coordination mature. Developmental milestones are ranges; assess the overall pattern rather than judging a child by one skill alone.

4. 4.During a home visit, a parent asks how to reduce the risk of injury as a newly mobile 10-month-old explores. Which recommendation is most appropriate?

   • A.Place small objects and medications out of reach and secure stairs with gates
   • B.Offer whole grapes as a convenient finger food
   • C.Use a pillow to prop the infant in an adult bed during naps
   • D.Allow exploration near an open stairway while the parent watches from another room

   Answer and rationale are in the full material.

5. 5.Which approach is best when assessing pain in a nonverbal 18-month-old after surgery?

   • A.Assume the child is comfortable if no crying is heard
   • B.Use an age-appropriate behavioral pain scale and observe facial expression, activity, and consolability
   • C.Ask the child to rate pain from 0 to 10
   • D.Use the caregiver's pain rating as the only assessment

   Answer and rationale are in the full material.