Neonatal Nurse Practitioner Exam Neonatal Neurology and Developmental Care 1

Question 1

Hypoxic-ischemic encephalopathy (HIE) in a term neonate is most accurately assessed using which scoring system?

Accepted Answer

Sarnat or Thompson staging of HIE severity

Answer

Sarnat and Thompson staging systems assess the severity of HIE based on neurological signs, guiding decisions about therapeutic hypothermia.

Question 2

Therapeutic hypothermia (whole-body cooling) for HIE is initiated within what time window to be effective?

Accepted Answer

Within 6 hours of birth

Answer

Therapeutic hypothermia must be initiated within 6 hours of birth to interrupt the secondary energy failure phase and reduce neuronal death.

Question 3

Which neonatal seizure type is most commonly missed because it lacks classic convulsive movements?

Accepted Answer

Subtle seizures (lip smacking, eye deviation, bicycling movements)

Answer

Subtle seizures manifest as lip smacking, eye deviation, bicycling of the legs, or apnea and are easily missed without continuous EEG monitoring.

Question 4

Intraventricular hemorrhage (IVH) is most commonly graded using which system in neonates?

Accepted Answer

Papile grading system (Grades I-IV)

Answer

The Papile grading system classifies IVH from Grade I (subependymal only) to Grade IV (parenchymal involvement), guiding prognosis and management.

Question 5

Which factor is the strongest predictor of IVH in premature neonates?

Accepted Answer

Lower gestational age and birth weight

Answer

IVH risk is inversely related to gestational age and birth weight; extremely premature infants have the most fragile germinal matrix vasculature.

Neonatal Nurse Practitioner Exam Practice Test