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

Sarnat Grade II HIE presents with lethargy, hypotonia, suppressed primitive reflexes, and seizures occurring within 24 hours of birth.

Question 2

The anterior fontanelle normally closes at approximately:

Accepted Answer

12–18 months of age

Answer

The anterior fontanelle closes between 12–18 months as the frontal and parietal bones complete ossification.

Question 3

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

Accepted Answer

Increased intracranial pressure (e.g., meningitis)

Answer

A tense, bulging fontanelle indicates elevated intracranial pressure, which in a febrile neonate is a warning sign of meningitis.

Question 4

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

Accepted Answer

Gestational age under 32 weeks and respiratory distress

Answer

IVH risk is highest in the most immature neonates; fragile germinal matrix capillaries rupture under hemodynamic and hypoxic stress.

Question 5

Neonatal seizures most commonly manifest as:

Accepted Answer

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

Answer

Due to immature cortical organization, neonatal seizures most often present as subtle signs rather than classic tonic-clonic activity.

Neonatal Intensive Care Nurse Exam Practice Test