CLINICAL KNOWLEDGE NEWEST VERSION
ACTUAL 140 2026 PRACTICE TEST PAPER
PATIENT CARE AND CLINICAL DECISION
MAKING REVIEW SHEET FULL SOLUTIONS
◉ Infant Reflexes. Answer: The fencing reflex (tonic neck reflex) is
done by turning the head to one side with the jaw over the shoulder.
This should cause the arm and leg on the side where the head is
turned to extend and the arm and leg on the opposite side to flex.
I. Reflexes
A. Foot
1. Stroke Inner Sole (Grasp)
a. Toes curl around ("grasp") examiner's finger
2. Stroke Outer Sole (Babinski)
a. Toes spread, great toe dorsiflexion
B. Walking Reflex
1. Hold baby up with one hand across chest
2. As feet touch ground, baby makes walking motion ("stepping")
C. Rooting Reflex
,1. Touch newborn on either side of cheek
2. Baby turns to find Breast
3. Sucking Mechanism on finger is divided into 3 steps:
a. Front of Tongue laps on finger
b. Back of Tongue massages middle of the finger
c. Esophagus pulls on tip of finger
D. Tonic Neck (Fencing) Reflex
1. If the Babies' head is rotated leftward
a. The left arm (face side) stretches into extension
b. The right arm flexes up above head
2. Opposite reaction if head is rotated rightward
E. Moro Reflex (Startle Reflex)
1. Hold supine infant by arms a few inches above bed
a. Gently drop infant back to elicit startle
2. Baby throws Arms out in extension and baby grimaces
F. Hand-to-Mouth (Babkin) Reflex
1. Stroke newborns cheek or put finger in babies palm
2. Baby will bring his fist to mouth and suck a finger
G. Swimmer's (Gallant) Response
1. Hold baby prone while supporting belly with hand
a. Stroke along one side of babies' spine
2. Baby flexes whole body toward the stroked side
,◉ Nodes on Interphalangeal Joints. Answer: Bouchard's nodes are
bony nodules on the proximal interphalangeal joints. Heberden's
nodes are bony nodules on the distal interphalangeal joints.
◉ Prostatic Disease Herbal Remedies. Answer:
◉ Pertussis. Answer:
◉ Baker Cyst. Answer:
◉ Koplik Spots. Answer: They are small, white spots (often on a
reddened background) that occur on the inside of the cheeks early in
the course of *measles*.
◉ Salter-Harris Fractures. Answer: Fractures through a growth
plate; therefore, they are unique to pediatric patients. These
fractures are categorized according to the involvement of the physis,
metaphysis, and epiphysis. The classification of the injuries is
important, because it affects patient treatment and provides clues to
possible long-term complications.
◉ Pernicious Anemia (B12 Deficiency). Answer: A. Symptoms:
1. Initial: Generalized Weakness, Paresthesias
, 2. Next: Leg Stiffness, Ataxia
3. Late: Memory Impairment, Personality Change, Depressed Mood
B. Signs: (Mnemonic: "The 5 P's")
1. Pancytopenia (decrease in all blood cell lines)
2. Peripheral Neuropathy
3. Posterior Spinal Column Neuropathy (Dorsal Column
Degeneration, Decreased proprioception, Decreased Vibration
Sense, Ataxia, Hyporeflexia {e.g. Decreased Ankle Jerk})
4. Pyramidal Tract Signs
5. Papillary Atrophy of Tongue (Atrophic Glossitis) *red, beefy
tongue*
C. Labs:
1. CBC
a. MCV >100 (macrocytic)
b. Leukopenia (decreased white blood cells)
c. Thrombocytopenia (decreased platelets)
2. Serum B12
a. Megaloblastosis (oval macrocytes)
D. Risk Factors:
ACTUAL 140 2026 PRACTICE TEST PAPER
PATIENT CARE AND CLINICAL DECISION
MAKING REVIEW SHEET FULL SOLUTIONS
◉ Infant Reflexes. Answer: The fencing reflex (tonic neck reflex) is
done by turning the head to one side with the jaw over the shoulder.
This should cause the arm and leg on the side where the head is
turned to extend and the arm and leg on the opposite side to flex.
I. Reflexes
A. Foot
1. Stroke Inner Sole (Grasp)
a. Toes curl around ("grasp") examiner's finger
2. Stroke Outer Sole (Babinski)
a. Toes spread, great toe dorsiflexion
B. Walking Reflex
1. Hold baby up with one hand across chest
2. As feet touch ground, baby makes walking motion ("stepping")
C. Rooting Reflex
,1. Touch newborn on either side of cheek
2. Baby turns to find Breast
3. Sucking Mechanism on finger is divided into 3 steps:
a. Front of Tongue laps on finger
b. Back of Tongue massages middle of the finger
c. Esophagus pulls on tip of finger
D. Tonic Neck (Fencing) Reflex
1. If the Babies' head is rotated leftward
a. The left arm (face side) stretches into extension
b. The right arm flexes up above head
2. Opposite reaction if head is rotated rightward
E. Moro Reflex (Startle Reflex)
1. Hold supine infant by arms a few inches above bed
a. Gently drop infant back to elicit startle
2. Baby throws Arms out in extension and baby grimaces
F. Hand-to-Mouth (Babkin) Reflex
1. Stroke newborns cheek or put finger in babies palm
2. Baby will bring his fist to mouth and suck a finger
G. Swimmer's (Gallant) Response
1. Hold baby prone while supporting belly with hand
a. Stroke along one side of babies' spine
2. Baby flexes whole body toward the stroked side
,◉ Nodes on Interphalangeal Joints. Answer: Bouchard's nodes are
bony nodules on the proximal interphalangeal joints. Heberden's
nodes are bony nodules on the distal interphalangeal joints.
◉ Prostatic Disease Herbal Remedies. Answer:
◉ Pertussis. Answer:
◉ Baker Cyst. Answer:
◉ Koplik Spots. Answer: They are small, white spots (often on a
reddened background) that occur on the inside of the cheeks early in
the course of *measles*.
◉ Salter-Harris Fractures. Answer: Fractures through a growth
plate; therefore, they are unique to pediatric patients. These
fractures are categorized according to the involvement of the physis,
metaphysis, and epiphysis. The classification of the injuries is
important, because it affects patient treatment and provides clues to
possible long-term complications.
◉ Pernicious Anemia (B12 Deficiency). Answer: A. Symptoms:
1. Initial: Generalized Weakness, Paresthesias
, 2. Next: Leg Stiffness, Ataxia
3. Late: Memory Impairment, Personality Change, Depressed Mood
B. Signs: (Mnemonic: "The 5 P's")
1. Pancytopenia (decrease in all blood cell lines)
2. Peripheral Neuropathy
3. Posterior Spinal Column Neuropathy (Dorsal Column
Degeneration, Decreased proprioception, Decreased Vibration
Sense, Ataxia, Hyporeflexia {e.g. Decreased Ankle Jerk})
4. Pyramidal Tract Signs
5. Papillary Atrophy of Tongue (Atrophic Glossitis) *red, beefy
tongue*
C. Labs:
1. CBC
a. MCV >100 (macrocytic)
b. Leukopenia (decreased white blood cells)
c. Thrombocytopenia (decreased platelets)
2. Serum B12
a. Megaloblastosis (oval macrocytes)
D. Risk Factors:
