NNP 2 QUIZ 3 (2025) COMPREHENSIVE QUESTIONS AND
VERIFIED ANSWERS (RECENTLY TESTING REAL EXAM
QUESTIONS)|GET IT 100% ACCURATE!!
Surgical intervention for brachial plexus injury is best done at which age? - (ANSWERS)4#$%^&
months
of age; A brachial plexus injury occurs when there is mechanical trauma to the spinal roots of
the 5th cervical through the 1st thoracic nerves. The injury results in paralysis, with the precise
location dependent on the spinal nerve roots damaged. It typically occurs due to birth trauma
or in utero position secondary to compression force on the fetal arms and thorax. The most
common type is Ducehnne-Erb paralysis, which causes upper arm paralysis. Klumpke
paralysis involves the lower arm. Entire arm paralysis can also occur. Infants with brachial
plexus injury are initially treated conservatively and are monitored monthly. However, if surgical
intervention is determined to be necessary it should be done around four months of age, as the
success rate decreases over time
The best predictors of outcome from neonatal seizures include underlying etiology, gestational
age and: - (ANSWERS)Interictal EEG pattern; The interictal EEG patterns seen in-between
seizures can be highly predictive of outcome. Major background abnormalities like burst
suppression are highly predictive of poor outcome, especially if present on serial studies.
Abnormal EEG patterns during seizures alone are not as accurate at predicting outcome.
In the neurologic portion of the neonatal physical exam, assessment of the scarf sign is used in
evaluating: - (ANSWERS)Phasic tone; Part of a thorough neurologic exam is evaluation of tone
through examining resting posture, passive tone and active tone. Examining phasic tone by
performing the scarf sign and deep tendon reflexes provides information on passive tone and
tests the resistance of the upper extremities to movement. Postural tone is tested by response
to traction (pull-to-sit maneuver). An acutely encephalopathic infant often has poor tone and
absent reflexes initially, which then improves. Later it can become increased or significantly
exaggerated.
The anterior fontanel normally closes by what age? - (ANSWERS)24 months; normal newborn
findings include an open, soft and flat anterior fontanel. Bulging may indicate increased
intracranial pressure. Depression may be indicative of dehydration. The anterior fontanel
normally closes at 6-24 months of age.
The optimal time to perform a neurological assessment of a 32 week GA infant is: -
(ANSWERS)30-60 minutes before a feeding; The infant's state is important in performing a
neurologic exam, with the quiet alert state optimal for the exam. Timing the exam to 30-60
minutes before an exam may increase the chance of the infant being in a quiet alert state. Note
that the premature infant does not have predictable sleep-awake cycles prior to 28 weeks.
Sleep-wake cycles become more apparent from 28 weeks on, with clear sleep-awake cycles by
32 weeks.
The most common type of seizure seen in premature infants is: - (ANSWERS)Subtle seizures;
subtle seizures are the most common type of seizure seen in neonates, particularly among
, NNP 2 QUIZ 3 (2025) COMPREHENSIVE QUESTIONS AND
VERIFIED ANSWERS (RECENTLY TESTING REAL EXAM
QUESTIONS)|GET IT 100% ACCURATE!!
premature infants. This type of seizure is often missed because the clinical manifestations
#$%^&may
be difficult to recognize. Behaviors most often seen with subtle seizures are (1) tonic, horizontal
deviations of the eyes with or without nystagmoid jerking; (2) repetitive blinking or fluttering of
the eyelids; (3) drooling, sucking, and/or tongue thrusting; and (4) swimming or rowing
movements of the legs. Apnea may occur but is usually the result of the underlying cause of the
seizure rather than of the seizure and rarely occurs as an isolated seizure event. The types of
seizures seen in the neonate are, (1) subtle, (2) tonic, (3) clonic (multifocal and focal), and (4)
myoclonic
The best time to obtain an ultrasound to confidently identify periventricular-intraventricular
hemorrhage is: - (ANSWERS)Seven days of age; The onset of periventricular-intraventricular
hemorrhage occurs within 1 week of age in more than 90% of affected infants, many within 24
hours of birth. Thus, the optimal time to screen for hemorrhage is 7 days of age. Otherwise,
serial ultrasounds would need to be done over the first week of life. If hemorrhage is detected,
ventricular dilation appears between 10-20 days after the bleeding. The presence of ventricular
dilation is optimally ascertained at 2-4 weeks of age. If present, weekly serial scans are useful
in delineating whether the ventricular dilation is transient, static, or progressive.
Following a severe intraventricular hemorrhage (IVH), the most common sequelae is: -
(ANSWERS)Hemiparesis on the side contralateral to the hemorrhage; The mortality rate for
infants with severe hemorrhage is high, thus data on developmental outcomes of these infants
are meager. Overall, approximately 80% of infants with severe hemorrhage manifest a major
neurodevelopmental disability. Hemiparesis on the side contralateral to the hemorrhage is the
most common abnormality. Cerebral palsy is less frequent. The rate of neurodevelopmental
disability for children with severe hemorrhage decreases with increasing chronologic age.
Which clinical presentation of intraventricular hemorrhage in a premature infant is most
common? - (ANSWERS)Asymptomatic; In general, infants with intraventricular hemorrhage
present one of three ways: 1) catastrophic deterioration with a sudden, dramatic decline in
clinical status, 2) salutatory syndrome presentation, in which there is a gradual change in
spontaneous movement, or 3) they are asymptomatic. Twenty-five to 50% of infants are
asymptomatic, and this is the most frequent presentation
A cystic dilation of the meninges associated with spinal midline bony defect and a defect in the
overlying skin defines the presentation of: - (ANSWERS)Meningocele; A meningocele is a cystic
dilation of the meninges associated with a spinal defect and a defect in the overlying skin. The
structure and position of the spinal cord and nerve roots within the spinal canal are normal.
Therefore, infants with this defect typically do not show neurological deficits. A
meningomyelocele is a lesion identical to the meningocele but with associated abnormalities
in the structure and position of the spinal cord or nerve roots (cauda equina). Infants with this
type of defect typically show neurological deficits below the level of the lesion, and there may
VERIFIED ANSWERS (RECENTLY TESTING REAL EXAM
QUESTIONS)|GET IT 100% ACCURATE!!
Surgical intervention for brachial plexus injury is best done at which age? - (ANSWERS)4#$%^&
months
of age; A brachial plexus injury occurs when there is mechanical trauma to the spinal roots of
the 5th cervical through the 1st thoracic nerves. The injury results in paralysis, with the precise
location dependent on the spinal nerve roots damaged. It typically occurs due to birth trauma
or in utero position secondary to compression force on the fetal arms and thorax. The most
common type is Ducehnne-Erb paralysis, which causes upper arm paralysis. Klumpke
paralysis involves the lower arm. Entire arm paralysis can also occur. Infants with brachial
plexus injury are initially treated conservatively and are monitored monthly. However, if surgical
intervention is determined to be necessary it should be done around four months of age, as the
success rate decreases over time
The best predictors of outcome from neonatal seizures include underlying etiology, gestational
age and: - (ANSWERS)Interictal EEG pattern; The interictal EEG patterns seen in-between
seizures can be highly predictive of outcome. Major background abnormalities like burst
suppression are highly predictive of poor outcome, especially if present on serial studies.
Abnormal EEG patterns during seizures alone are not as accurate at predicting outcome.
In the neurologic portion of the neonatal physical exam, assessment of the scarf sign is used in
evaluating: - (ANSWERS)Phasic tone; Part of a thorough neurologic exam is evaluation of tone
through examining resting posture, passive tone and active tone. Examining phasic tone by
performing the scarf sign and deep tendon reflexes provides information on passive tone and
tests the resistance of the upper extremities to movement. Postural tone is tested by response
to traction (pull-to-sit maneuver). An acutely encephalopathic infant often has poor tone and
absent reflexes initially, which then improves. Later it can become increased or significantly
exaggerated.
The anterior fontanel normally closes by what age? - (ANSWERS)24 months; normal newborn
findings include an open, soft and flat anterior fontanel. Bulging may indicate increased
intracranial pressure. Depression may be indicative of dehydration. The anterior fontanel
normally closes at 6-24 months of age.
The optimal time to perform a neurological assessment of a 32 week GA infant is: -
(ANSWERS)30-60 minutes before a feeding; The infant's state is important in performing a
neurologic exam, with the quiet alert state optimal for the exam. Timing the exam to 30-60
minutes before an exam may increase the chance of the infant being in a quiet alert state. Note
that the premature infant does not have predictable sleep-awake cycles prior to 28 weeks.
Sleep-wake cycles become more apparent from 28 weeks on, with clear sleep-awake cycles by
32 weeks.
The most common type of seizure seen in premature infants is: - (ANSWERS)Subtle seizures;
subtle seizures are the most common type of seizure seen in neonates, particularly among
, NNP 2 QUIZ 3 (2025) COMPREHENSIVE QUESTIONS AND
VERIFIED ANSWERS (RECENTLY TESTING REAL EXAM
QUESTIONS)|GET IT 100% ACCURATE!!
premature infants. This type of seizure is often missed because the clinical manifestations
#$%^&may
be difficult to recognize. Behaviors most often seen with subtle seizures are (1) tonic, horizontal
deviations of the eyes with or without nystagmoid jerking; (2) repetitive blinking or fluttering of
the eyelids; (3) drooling, sucking, and/or tongue thrusting; and (4) swimming or rowing
movements of the legs. Apnea may occur but is usually the result of the underlying cause of the
seizure rather than of the seizure and rarely occurs as an isolated seizure event. The types of
seizures seen in the neonate are, (1) subtle, (2) tonic, (3) clonic (multifocal and focal), and (4)
myoclonic
The best time to obtain an ultrasound to confidently identify periventricular-intraventricular
hemorrhage is: - (ANSWERS)Seven days of age; The onset of periventricular-intraventricular
hemorrhage occurs within 1 week of age in more than 90% of affected infants, many within 24
hours of birth. Thus, the optimal time to screen for hemorrhage is 7 days of age. Otherwise,
serial ultrasounds would need to be done over the first week of life. If hemorrhage is detected,
ventricular dilation appears between 10-20 days after the bleeding. The presence of ventricular
dilation is optimally ascertained at 2-4 weeks of age. If present, weekly serial scans are useful
in delineating whether the ventricular dilation is transient, static, or progressive.
Following a severe intraventricular hemorrhage (IVH), the most common sequelae is: -
(ANSWERS)Hemiparesis on the side contralateral to the hemorrhage; The mortality rate for
infants with severe hemorrhage is high, thus data on developmental outcomes of these infants
are meager. Overall, approximately 80% of infants with severe hemorrhage manifest a major
neurodevelopmental disability. Hemiparesis on the side contralateral to the hemorrhage is the
most common abnormality. Cerebral palsy is less frequent. The rate of neurodevelopmental
disability for children with severe hemorrhage decreases with increasing chronologic age.
Which clinical presentation of intraventricular hemorrhage in a premature infant is most
common? - (ANSWERS)Asymptomatic; In general, infants with intraventricular hemorrhage
present one of three ways: 1) catastrophic deterioration with a sudden, dramatic decline in
clinical status, 2) salutatory syndrome presentation, in which there is a gradual change in
spontaneous movement, or 3) they are asymptomatic. Twenty-five to 50% of infants are
asymptomatic, and this is the most frequent presentation
A cystic dilation of the meninges associated with spinal midline bony defect and a defect in the
overlying skin defines the presentation of: - (ANSWERS)Meningocele; A meningocele is a cystic
dilation of the meninges associated with a spinal defect and a defect in the overlying skin. The
structure and position of the spinal cord and nerve roots within the spinal canal are normal.
Therefore, infants with this defect typically do not show neurological deficits. A
meningomyelocele is a lesion identical to the meningocele but with associated abnormalities
in the structure and position of the spinal cord or nerve roots (cauda equina). Infants with this
type of defect typically show neurological deficits below the level of the lesion, and there may
