Neonatal Intensive Care Nurse Exam Neonatal Neurological Assessment and Care

Question 1

Hypoxic-ischemic encephalopathy (HIE) is graded using the Sarnat classification. Grade II (moderate) HIE is characterized by:

Accepted Answer

Lethargy, hypotonia, absent Moro reflex, and possible seizures

Answer

Hyperalertness and normal tone

Answer

Coma, flaccidity, and absent primitive reflexes

Answer

Mild irritability with normal feeding

Question 2

The anterior fontanelle normally closes at approximately:

Accepted Answer

12–18 months of age

Answer

2–3 months of age

Answer

At birth

Answer

24–36 months of age

Question 3

A bulging anterior fontanelle in a febrile neonate is a sign of:

Accepted Answer

Increased intracranial pressure (e.g., meningitis)

Answer

Normal hydration status

Answer

Dehydration

Answer

Normal variant of head shape

Question 4

Intraventricular hemorrhage (IVH) in preterm infants is most commonly associated with:

Accepted Answer

Gestational age under 32 weeks and respiratory distress

Answer

Term birth complicated by prolonged labor

Answer

Hyperoxia during delivery

Answer

Hyperthermia in the first hour

Question 5

Neonatal seizures most commonly manifest as:

Accepted Answer

Subtle seizures (eye deviation, lip smacking, cycling limb movements)

Answer

Grand mal tonic-clonic convulsions

Answer

Absence episodes

Answer

Myoclonic jerks only

Question 6

Grade III IVH is distinguished from Grade II by the presence of:

Accepted Answer

Blood filling and distending the ventricles (intraventricular clot with ventricular dilation)

Answer

Blood only in the germinal matrix

Answer

Blood in the subdural space

Answer

Blood limited to the choroid plexus