ADVANCED PEDIATRIC ASSESSMENT 12
COMPREHENSIVE EXAM 2026 FULL
QUESTIONS AND CORRECT ANSWERS
ALREADY PASSED
◉ A 32-year-old white female presents to labor and delivery fully
effaced and delivers a 5.8-lb (2,500-gram) infant female with Apgar
scores of 6 and 8. The mother has had no prenatal care and in the
nursery you perform the newborn examination. With the Ballard
scoring system, the neuromuscular examination score is 15. Looking
at physical maturity, you see superficial peeling and few veins on the
skin. The lanugo hair has bald areas and the plantar surface of the
foot has creases on two thirds of it. The areola is stippled with a 2-
mm bud. The pinna is well curved, is firm, and has instant recoil. The
labia majora and minora are equally prominent.
Add the score of the neuromuscular components to your score of
physical maturity to determine weeks of gestation. How many weeks
of gestation has this child had?
A) 34 weeks
B) 36 weeks
C) 40 weeks.
Answer: Ans: B
page 806,
, Superficial peeling with few veins gives a score of 2 points; lanugo
with balding areas gives a score of 3 points; the plantar surface
being covered by two thirds gives a score of 3 points; the stippled
areola with a 2-mm bud gives a score of 2 points; the well-formed
pinna with instant recoil gives a score of 3 points. The equal labia
majora and labia minora give a score of 2 points. Adding these
numbers up gives a score of 15 points for physical maturity. Adding
that to the 15 points for neuromuscular maturity gives a point total
of 30, which correlates to a gestational age of 36 weeks. This would
be expected with a birth weight of 2,500 grams.
◉ A mother brings in her 3-year-old son for a well-child check-up.
She is concerned that he seems different in size from all of the other
preschool boys. He was the product of an uneventful pregnancy and
vaginal delivery. He has hit all of his developmental milestones on
time. On examination he is 26 lbs (11.8 kg) and is 35 inches (89 cm)
tall. Otherwise his examination is unremarkable. You give the correct
education for his age and then discuss his size.
For his age, what are his growth chart percentiles?
A) Tall and heavy for his age (>95%)
B) Average height and weight for his age (5 to 95%)
C) Small and light for his age (<5%).
Answer: Ans: C
Chapter: 18
Page and Header: 806, Techniques of Examination (Children)
, Feedback: According to the growth charts, this child is less than the
fifth percentile for both height and weight, indicating that he is small
and light for his age. This can be from a growth hormone deficiency
but is usually due to genetic factors (such as short, light parents). It
is most important to follow the trend of growth. It is more significant
if this child was previously at the 50th percentile for height and
weight than if he has always been about the same percentile and
following a line parallel to expected growth lines.
◉ A mother brings her 4-year-old daughter to your office because of
fever and decreased eating and drinking. When you ask the little girl
what is wrong, she says her mouth and throat hurt. On examination
her temperature is 101 degrees. Her ears and nose examinations are
unremarkable. Her mouth has ulcerations on the buccal mucosa and
the tongue. She also has cervical lymphadenopathy. Her cardiac and
pulmonary examinations are normal. She is up to date on her
childhood vaccinations.
What mouth abnormality does she most likely have?
A) Strep throat
B) Herpetic stomatitis
C) Oral candidiasis (thrush)
D) Diphtheria.
Answer: Ans: B
Chapter: 18
Page and Header: 862, Table 18-7
COMPREHENSIVE EXAM 2026 FULL
QUESTIONS AND CORRECT ANSWERS
ALREADY PASSED
◉ A 32-year-old white female presents to labor and delivery fully
effaced and delivers a 5.8-lb (2,500-gram) infant female with Apgar
scores of 6 and 8. The mother has had no prenatal care and in the
nursery you perform the newborn examination. With the Ballard
scoring system, the neuromuscular examination score is 15. Looking
at physical maturity, you see superficial peeling and few veins on the
skin. The lanugo hair has bald areas and the plantar surface of the
foot has creases on two thirds of it. The areola is stippled with a 2-
mm bud. The pinna is well curved, is firm, and has instant recoil. The
labia majora and minora are equally prominent.
Add the score of the neuromuscular components to your score of
physical maturity to determine weeks of gestation. How many weeks
of gestation has this child had?
A) 34 weeks
B) 36 weeks
C) 40 weeks.
Answer: Ans: B
page 806,
, Superficial peeling with few veins gives a score of 2 points; lanugo
with balding areas gives a score of 3 points; the plantar surface
being covered by two thirds gives a score of 3 points; the stippled
areola with a 2-mm bud gives a score of 2 points; the well-formed
pinna with instant recoil gives a score of 3 points. The equal labia
majora and labia minora give a score of 2 points. Adding these
numbers up gives a score of 15 points for physical maturity. Adding
that to the 15 points for neuromuscular maturity gives a point total
of 30, which correlates to a gestational age of 36 weeks. This would
be expected with a birth weight of 2,500 grams.
◉ A mother brings in her 3-year-old son for a well-child check-up.
She is concerned that he seems different in size from all of the other
preschool boys. He was the product of an uneventful pregnancy and
vaginal delivery. He has hit all of his developmental milestones on
time. On examination he is 26 lbs (11.8 kg) and is 35 inches (89 cm)
tall. Otherwise his examination is unremarkable. You give the correct
education for his age and then discuss his size.
For his age, what are his growth chart percentiles?
A) Tall and heavy for his age (>95%)
B) Average height and weight for his age (5 to 95%)
C) Small and light for his age (<5%).
Answer: Ans: C
Chapter: 18
Page and Header: 806, Techniques of Examination (Children)
, Feedback: According to the growth charts, this child is less than the
fifth percentile for both height and weight, indicating that he is small
and light for his age. This can be from a growth hormone deficiency
but is usually due to genetic factors (such as short, light parents). It
is most important to follow the trend of growth. It is more significant
if this child was previously at the 50th percentile for height and
weight than if he has always been about the same percentile and
following a line parallel to expected growth lines.
◉ A mother brings her 4-year-old daughter to your office because of
fever and decreased eating and drinking. When you ask the little girl
what is wrong, she says her mouth and throat hurt. On examination
her temperature is 101 degrees. Her ears and nose examinations are
unremarkable. Her mouth has ulcerations on the buccal mucosa and
the tongue. She also has cervical lymphadenopathy. Her cardiac and
pulmonary examinations are normal. She is up to date on her
childhood vaccinations.
What mouth abnormality does she most likely have?
A) Strep throat
B) Herpetic stomatitis
C) Oral candidiasis (thrush)
D) Diphtheria.
Answer: Ans: B
Chapter: 18
Page and Header: 862, Table 18-7
