ADVANCED PEDIATRIC ASSESSMENT 12 EXAM
SCRIPT 2026 TEST PAPER QUESTIONS AND
SOLUTIONS GRADED A+
◉ A 24-year-old mother who is a smoker and cocaine addict gave
birth at 39 weeks to a 2,000-gram female infant who is in the
neonatal intensive care unit. Using the Intrauterine Growth Curve
chart, you determine whether the infant's weight is appropriate for
her gestational age.
In which category does the infant best fit?
A) Large for gestational age
B) Normal for gestational age
C) Small for gestational age.
Answer: Ans: C
Chapter: 18
Page and Header: 746, Assessing the Newborn
Feedback: For a 39-week infant, any weight less than 2,500 grams
would be considered small. Intrauterine growth retardation and low
birth weight would be expected in a smoker who also abuses
cocaine.
◉ A mother brings her 16-month-old son in for an evaluation. She is
afraid he is not meeting his developmental milestones and wants to
,know if he should be sent to therapy. He was the product of an
uneventful pregnancy and a spontaneous vaginal delivery. His Apgar
scores were 7 and 9. Until reaching a year old the mother believes he
was hitting his milestones appropriately. You decide to administer
the Denver Developmental Screening Test. You find that he is using a
spoon to eat with and can take off his own shoes and shirt. He can
build a tower of two cubes and dump raisins. His vocabulary
consists of at least 10 words. He can stand alone and stoop and
recover, but he is unable to walk without holding onto someone's
hand.
What type of developmental delay does he have?
A) Personal/social
B) Fine motor
C) Language
D) Gross motor.
Answer: Ans: D
Chapter: 18
Page and Header: 751, The Health History
Feedback: By 16 months a child should be able to walk unaided and
even walk backwards and run. This child was referred to physical
therapy and did well.
◉ A foster mother brings a 4-year-old child to see you for an
evaluation. She has had custody of the girl for 2 weeks. She knows
that the child was born in your state and that her maternal
,grandmother had custody for 6 months. She received good medical
care during that time, but after her biologic mother obtained
custody the child was abused and has had no further medical care.
She says the child has had many behavioral problems and seems to
be very behind on her developmental tasks. When you examine the
child you notice short palpebral fissures, a wide nasal philtrum, and
thin lips. Her cardiac, pulmonary, musculoskeletal, and abdominal
examinations are normal. Her Denver Developmental Screening Test
shows most of her milestones have occurred only through the 24th
month.
What form of congenital retardation is she most likely to have?
A) Fetal alcohol syndrome
B) Congenital hypothyroidism
C) Down syndrome.
Answer: Ans: A
Chapter: 18
Page and Header: 767, Assessing the Infant
Feedback: The facial appearance in fetal alcohol syndrome shows
short palpebral fissures, a wide and flattened philtrum, and thin lips.
These children often have mild retardation even with good care, but
with abuse they may have more profound retardation. This
condition may occur with only modest alcohol consumption.
◉ A young Hispanic mother brings in her 2-month-old son. She is
upset because her neighbors have threatened to call the Child
Protective Agency because they think his birthmark is a bruise. On
, examination you see a large, smooth-bordered bluish mark on his
buttock and lower back. Otherwise his examination is unremarkable.
What form of birthmark is this likely to be?
A) Cafe-au-lait spot
B) Salmon patch
C) Mongolian spot.
Answer: Ans: C
Chapter: 18
Page and Header: 762, Newborn Skin Findings
Feedback: Mongolian spots are large, smooth-bordered birthmarks
found on the back and/or buttocks. They are found more often in
darker-pigmented infants such as in the Hispanic or Asian
population. They are commonly mistaken for bruises.
◉ 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.
SCRIPT 2026 TEST PAPER QUESTIONS AND
SOLUTIONS GRADED A+
◉ A 24-year-old mother who is a smoker and cocaine addict gave
birth at 39 weeks to a 2,000-gram female infant who is in the
neonatal intensive care unit. Using the Intrauterine Growth Curve
chart, you determine whether the infant's weight is appropriate for
her gestational age.
In which category does the infant best fit?
A) Large for gestational age
B) Normal for gestational age
C) Small for gestational age.
Answer: Ans: C
Chapter: 18
Page and Header: 746, Assessing the Newborn
Feedback: For a 39-week infant, any weight less than 2,500 grams
would be considered small. Intrauterine growth retardation and low
birth weight would be expected in a smoker who also abuses
cocaine.
◉ A mother brings her 16-month-old son in for an evaluation. She is
afraid he is not meeting his developmental milestones and wants to
,know if he should be sent to therapy. He was the product of an
uneventful pregnancy and a spontaneous vaginal delivery. His Apgar
scores were 7 and 9. Until reaching a year old the mother believes he
was hitting his milestones appropriately. You decide to administer
the Denver Developmental Screening Test. You find that he is using a
spoon to eat with and can take off his own shoes and shirt. He can
build a tower of two cubes and dump raisins. His vocabulary
consists of at least 10 words. He can stand alone and stoop and
recover, but he is unable to walk without holding onto someone's
hand.
What type of developmental delay does he have?
A) Personal/social
B) Fine motor
C) Language
D) Gross motor.
Answer: Ans: D
Chapter: 18
Page and Header: 751, The Health History
Feedback: By 16 months a child should be able to walk unaided and
even walk backwards and run. This child was referred to physical
therapy and did well.
◉ A foster mother brings a 4-year-old child to see you for an
evaluation. She has had custody of the girl for 2 weeks. She knows
that the child was born in your state and that her maternal
,grandmother had custody for 6 months. She received good medical
care during that time, but after her biologic mother obtained
custody the child was abused and has had no further medical care.
She says the child has had many behavioral problems and seems to
be very behind on her developmental tasks. When you examine the
child you notice short palpebral fissures, a wide nasal philtrum, and
thin lips. Her cardiac, pulmonary, musculoskeletal, and abdominal
examinations are normal. Her Denver Developmental Screening Test
shows most of her milestones have occurred only through the 24th
month.
What form of congenital retardation is she most likely to have?
A) Fetal alcohol syndrome
B) Congenital hypothyroidism
C) Down syndrome.
Answer: Ans: A
Chapter: 18
Page and Header: 767, Assessing the Infant
Feedback: The facial appearance in fetal alcohol syndrome shows
short palpebral fissures, a wide and flattened philtrum, and thin lips.
These children often have mild retardation even with good care, but
with abuse they may have more profound retardation. This
condition may occur with only modest alcohol consumption.
◉ A young Hispanic mother brings in her 2-month-old son. She is
upset because her neighbors have threatened to call the Child
Protective Agency because they think his birthmark is a bruise. On
, examination you see a large, smooth-bordered bluish mark on his
buttock and lower back. Otherwise his examination is unremarkable.
What form of birthmark is this likely to be?
A) Cafe-au-lait spot
B) Salmon patch
C) Mongolian spot.
Answer: Ans: C
Chapter: 18
Page and Header: 762, Newborn Skin Findings
Feedback: Mongolian spots are large, smooth-bordered birthmarks
found on the back and/or buttocks. They are found more often in
darker-pigmented infants such as in the Hispanic or Asian
population. They are commonly mistaken for bruises.
◉ 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.
