LE 1 - Randoms

Question 1

A newborn presents with tiny white bumps on the face, primarily on the nose, cheeks, and chin. The pediatrician diagnoses the condition as milia. Which of the following statements is true?
a. Milia are large, fluid-filled cysts that require surgical removal.
b. Milia typically resolve within a few days after birth.
c. Milia are seen in approximately 33% of infants.
d. Milia are a sign of underlying infectious disease.

Answer 1

c. Milia are seen in approximately 33% of infants.

Question 2

A 2-week-old infant presents with a persistent diaper rash characterized by erythematous plaques with sharply demarcated edges. The pediatrician suspects Candida albicans infection. Which of the following statements is true?
a. The rash is typically contained within the diaper area and does not involve skin folds.
b. The condition is best treated with frequent diaper changes and keeping the area dry.
c. Skin folds are usually spared in this type of diaper rash.
d. Antifungal treatment is often required to resolve the rash.

Answer 2

d. Antifungal treatment is often required to resolve the rash.

Question 3

A newborn is found to have vesicopustules that rupture, leaving behind a scaling halo and eventually hyperpigmented macules. The diagnosis is transient neonatal pustular melanosis. Which of the following statements is true?
a. The condition typically requires intensive antibiotic therapy.
b. It is a benign and self-limiting condition requiring no specific therapy.
c. Lesions are often concentrated on the infant’s limbs only.
d. Hyperpigmentation following the lesions does not resolve and is permanent.

Answer 3

b. It is a benign and self-limiting condition requiring no specific therapy.

Question 4

An infant presents with comedones and papules on the cheeks, chin, and forehead, diagnosed as acne neonatorum. Which of the following statements is true?
a. The condition is usually severe and requires aggressive treatment with oral antibiotics.
b. Acne neonatorum often results in significant scarring.
c. The condition is usually benign and self-resolving, with severe cases possibly requiring mild keratolytic agents.
d. Treatment with topical steroids is the first-line therapy.

Answer 4

c. The condition is usually benign and self-resolving, with severe cases possibly requiring mild keratolytic agents.

Question 5

A newborn exhibits a vesicular rash in areas where a fetal scalp monitor was placed during delivery. The pediatrician is concerned about herpes simplex infection. Which of the following statements is true?
a. The rash typically resolves on its own without antiviral treatment.
b. Lesions are most commonly found in the abdominal area.
c. Antiviral treatment is necessary due to the risk of systemic involvement.
d. Herpes simplex infection in newborns is typically acquired postnatally.

Answer 5

c. Antiviral treatment is necessary due to the risk of systemic involvement.

Question 6

During a routine check-up, a parent expresses concern about pink patches on their infant’s neck and eyelids. Which of the following statements is true regarding macular hemangiomas, commonly known as “Stork Bites”?
a. They are a collection of dilated blood vessels that will persist throughout life.
b. They are commonly located on the limbs and torso and increase in size with age.
c. They typically resolve spontaneously within the first year of life.
d. They often require surgical removal due to medical complications.

Answer 6

c. They typically resolve spontaneously within the first year of life.

Question 7

A newborn presents with a flat, red to purple lesion on their face that does not blanch when pressed. Which statement is correct about Port-Wine Stains (Nevus Flammeus)?
a. They are likely to disappear by the age of 2.
b. They are highly responsive to topical treatments and usually resolve within months.
c. They do not blanch with pressure and do not disappear with time.
d. They are usually indicative of underlying neurological abnormalities.

Answer 7

c. They do not blanch with pressure and do not disappear with time.

Question 8

A pediatrician examines a child with dark blue patches on the lower back. What is true about Mongolian Spots?
a. They are most commonly found on the face and neck and are indicative of metabolic disease.
b. They often persist into adulthood, requiring cosmetic treatment.
c. They are present in nearly 90% of Black and Asian infants and typically fade by 4 years of age.
d. They are a form of malignant melanoma and require immediate intervention.

Answer 8

c. They are present in nearly 90% of Black and Asian infants and typically fade by 4 years of age.

Question 9

An infant is brought to the clinic with a large, raised, red lesion on the back. Which statement about cavernous hemangioma is accurate?
a. They are superficial vascular lesions that are always present at birth.
b. They are typically a cosmetic concern and do not regress.
c. The majority of these lesions regress with age and do not require treatment.
d. They are primarily found in the mucous membranes of the mouth and nose.

Answer 9

c. The majority of these lesions regress with age and do not require treatment.

Question 10

A baby is noted to have a bright red, sharply demarcated lesion on their cheek. What is true about Strawberry Hemangiomas?
a. They typically darken and thicken over time, eventually turning into deep vascular nodules.
b. They are flat vascular malformations that will likely require laser removal.
c. The lesions are most common on the torso and usually require corticosteroid treatment.
d. Spontaneous regression is common, with most disappearing by the age of 7.

Answer 10

d. Spontaneous regression is common, with most disappearing by the age of 7.

Question 11

During a pediatric rotation, you notice a newborn with a swollen scalp that crosses suture lines. In discussing this observation with your attending, you note that this swelling can be differentiated from other scalp conditions by which of the following characteristics?
a. The swelling is limited to the area above one cranial bone and does not cross suture lines.
b. The swelling is a result of blood collected beneath the periosteum of the cranial bone.
c. The swelling is a soft, diffuse, edematous area on the scalp that may cross suture lines.
d. The swelling is associated with a high risk of jaundice in the newborn.

Answer 11

c. The swelling is a soft, diffuse, edematous area on the scalp that may cross suture lines.

Question 12

You are examining a newborn with a well-defined, fluctuant swelling on the head. To determine whether this is a cephalohematoma, which characteristic would you expect to find?
a. The swelling crosses the cranial suture lines.
b. The swelling fluctuates significantly with crying.
c. The swelling is confined to the surface of one cranial bone and does not cross suture lines.
d. The swelling typically resolves within the first few hours after birth.

Answer 12

c. The swelling is confined to the surface of one cranial bone and does not cross suture lines.

Question 13

A newborn has an unusual contour of the skull that you are evaluating. What finding on physical examination would suggest the presence of “step-offs” in the skull?
a. A smooth, rounded contour of the skull without abrupt changes.
b. An abrupt change in the contour that feels like an edge or step in the skull bones.
c. A diffuse swelling that extends across the suture lines of the skull.
d. A soft, boggy mass that changes in size with palpation.

Answer 13

b. An abrupt change in the contour that feels like an edge or step in the skull bones.

Question 14

When assessing the skull of a newborn, you notice that the sutures are more palpable and wider than usual. Which of the following could be a potential implication of widely-spaced sutures?
a. They are indicative of normal intracranial pressure and healthy skull development.
b. They could signify increased intracranial pressure or a genetic syndrome.
c. They are typically associated with a smaller than average head circumference.
d. They usually suggest premature closure of the cranial sutures.

Answer 14

b. They could signify increased intracranial pressure or a genetic syndrome.

Question 15

During a routine checkup, a parent expresses concern about their infant’s head shape, noting a flattening on one side. You understand that this condition, known as plagiocephaly, is often due to:
a. Genetic factors leading to asymmetric growth of the skull.
b. Frequent and prolonged time spent on the infant’s back.
c. An early closure of the cranial sutures.
d. A vitamin D deficiency in the infant.

Answer 15

b. Frequent and prolonged time spent on the infant’s back.

Question 16

You’re observing infants in the NICU and note that some have elongated head shapes. You recognize this as dolichocephaly, which can be caused by:
a. Habitual sleeping on the stomach.
b. Consistently turning the head to one side while lying in the NICU.
c. Premature closure of the sagittal suture.
d. Excessive growth of the coronal sutures.

Answer 16

b. Consistently turning the head to one side while lying in the NICU.

Question 17

A pediatrician examines an infant with an abnormally shaped head and suspects premature suture closure. Which condition is often associated with this finding?
a. Plagiocephaly
b. Craniosynostosis, as seen in conditions like Apert’s syndrome.
c. Dolichocephaly, due to NICU positioning.
d. Caput succedaneum, due to birth trauma.

Answer 17

b. Craniosynostosis, as seen in conditions like Apert’s syndrome.

Question 18

In a newborn exam, you note that gentle pressure on the parietal bones elicits a “ping-pong ball” effect. This finding is known as craniotabes and may be:
a. A normal variant in a newborn’s skull.
b. Always indicative of hydrocephalus.
c. Typically associated with a high risk of intracranial hemorrhage.
d. A sign of rickets, congenital syphilis, or hydrocephalus if other symptoms are present.

Answer 18

d. A sign of rickets, congenital syphilis, or hydrocephalus if other symptoms are present

Question 19

A pregnant woman has elevated levels of MSAFP at 19 weeks of gestation. This finding most strongly suggests an increased risk for which of the following conditions in the fetus?
a. Neural tube defects
b. Congenital heart disease
c. Gastrointestinal malformations
d. Trisomy 13 (Patau syndrome)

Answer 19

a. Neural tube defects

Question 20

In prenatal screening, elevated levels of β-HCG are most commonly associated with an increased risk for which chromosomal abnormality?
a. Trisomy 18 (Edwards syndrome)
b. Trisomy 21 (Down syndrome)
c. Turner syndrome (45, X)
d. Klinefelter syndrome (47, XXY)

Answer 20

b. Trisomy 21 (Down syndrome)

Question 21

A quad screen reveals low levels of unconjugated estriol in a pregnant woman. This result is most suggestive of an increased risk for:
a. Neural tube defects
b. Trisomy 21 (Down syndrome)
c. Fetal adrenal hyperplasia
d. Ovarian dysgenesis

Answer 21

b. Trisomy 21 (Down syndrome)

Question 22

High levels of inhibin A in a maternal serum screen are most indicative of an increased risk for which condition?
a. Trisomy 13 (Patau syndrome)
b. Trisomy 18 (Edwards syndrome)
c. Trisomy 21 (Down syndrome)
d. Monosomy X (Turner syndrome)

Answer 22

c. Trisomy 21 (Down syndrome)

Question 23

Low levels of MSAFP, β-HCG, unconjugated estriol, and inhibin A together would most likely suggest an increased risk for:
a. Trisomy 18 (Edwards syndrome)
b. Trisomy 21 (Down syndrome)
c. Trisomy 13 (Patau syndrome)
d. Neural tube defects

Answer 23

a. Trisomy 18 (Edwards syndrome)

Question 24

A fetal heart rate consistently above 160 bpm could indicate several conditions. Which of the following is a possible cause of fetal baseline tachycardia?
a. Maternal hypothyroidism
b. Fetal complete heart block
c. Maternal use of sympathomimetic medication
d. Fetal bradycardia

Answer 24

c. Maternal use of sympathomimetic medication

Baseline Tachycardia (>160 bpm): Can indicate
* maternal fever,
* infection,
* fetal hypoxia,
* maternal use of sympathomimetic medication,
* hyperthyroidism.

Question 25

During a routine prenatal visit, a fetal heart rate of more than 200 bpm is noted. This finding is most suggestive of:
a. Maternal fever
b. Fetal dysrhythmias or supraventricular arrhythmias
c. Umbilical cord compression
d. Early deceleration due to head compression

Answer 25

b. Fetal dysrhythmias or supraventricular arrhythmias

Severe Tachycardia (>200 bpm): May suggest fetal dysrhythmias or supraventricular arrhythmias.

Question 26

A fetal heart rate consistently below 110 bpm may be concerning. What condition could this FHR pattern indicate?
a. Fetal hypoxia
b. Maternal use of beta blockers
c. Fetal response to maternal hyperthyroidism
d. Variable decelerations due to cord compression

Answer 26

b. Maternal use of beta blockers

Bradycardia (<110 bpm): Could indicate
* Complete FH block associated with congenital heart disease (CHD)
* maternal systemic lupus erythematosus (SLE),
* side effect of maternal use of beta blockers.

Question 27

Which of the following statements best describes the significance of accelerations in fetal heart rate (FHR) monitoring?
a. They signal fetal distress.
b. They are indicative of fetal well-being.
c. They suggest umbilical cord compression.
d. They are a response to maternal hypotension.

Answer 27

b. They are indicative of fetal well-being.

Question 28

Early decelerations in the fetal heart rate are considered benign. What is the primary cause of early decelerations?
a. Fetal hypoxia
b. Uteroplacental insufficiency
c. Vagal response to physiologic head compression during active labor
d. Maternal use of sympathomimetic drugs

Answer 28

c. Vagal response to physiologic head compression during active labor

Early Decelerations: Considered benign; a vagal response to minor transient fetal hypoxic episodes or physiologic head compression during active labor.

Question 29

Variable decelerations in FHR are associated with which condition?
a. Fetal sleep cycles
b. Maternal fever
c. Umbilical cord compressions
d. Fetal hyperactivity

Answer 29

c. Umbilical cord compressions

Variable Decelerations: Associated with umbilical cord compressions and considered severe if:
* The HR decreases to <60 bpm.
* The decrease is >60 bpm from the baseline.
* The slow HR lasts longer than 60 seconds.
* Presence of beat-to-beat variability suggests fetal compensation.

Question 30

Severe variable decelerations are characterized by all of the following EXCEPT:
a. Heart rate decreases to <60 bpm.
b. Decrease is >60 bpm from the baseline.
c. The slow heart rate lasts less than 60 seconds.
d. Presence of beat-to-beat variability suggesting fetal compensation.

Answer 30

c. The slow heart rate lasts less than 60 seconds.

Variable Decelerations: Associated with umbilical cord compressions and considered severe if:
* The HR decreases to <60 bpm.
* The decrease is >60 bpm from the baseline.
* The slow HR lasts longer than 60 seconds.
* Presence of beat-to-beat variability suggests fetal compensation.

Question 31

Late decelerations noted on FHR monitoring are most indicative of:
a. Fetal head compression
b. Umbilical cord compressions
c. Transient fetal hypoxic episodes
d. Fetal hypoxia from uteroplacental insufficiency

Answer 31

d. Fetal hypoxia from uteroplacental insufficiency

Late Decelerations:
* With beat-to-beat variability, suggest a sudden insult to a fetus that is unable to compensate physiologically.
* With decreased or absent variability, indicate fetal hypoxia from uteroplacental insufficiency. Decelerations last longer, begin sooner following the onset of uterine contraction, and take longer to return to baseline.

Question 32

When does the Palmar Grasp Reflex first appear in gestation?
a. 24 weeks
b. 28 weeks
c. 32 weeks
d. 36 weeks

Answer 32

b. 28 weeks

Palmar Grasp Reflex
* Onset: 28 weeks gestation
* Fully Developed: 32 weeks gestation
* Duration: 2-3 months

Question 33

The rooting reflex is fully developed by what gestational age?
a. 30 weeks
b. 32 weeks
c. 36 weeks
d. 40 weeks

Answer 33

c. 36 weeks

Rooting Reflex
* Onset: 32 weeks gestation
* Fully Developed: 36 weeks gestation
* Duration: Becomes less prominent after 1 month

Question 34

The Moro reflex is known to disappear at what age?
a. 3-4 months
b. 5-6 months
c. 7-8 months
d. 9-10 months

Answer 34

b. 5-6 months

Moro Reflex
* Onset: 28-32 weeks gestation
* Fully Developed: 37 weeks gestation
* Duration: 5-6 months

Question 35

How long does the Tonic Neck Reflex last after its appearance?
a. 3-4 months
b. 5-6 months
c. 6-7 months
d. 8-9 months

Answer 35

c. 6-7 months

Tonic Neck Reflex
* Onset: 35 weeks gestation
* Fully Developed: 1 month after birth
* Duration: 6-7 months

Question 36

At what age does the Parachute Reflex first appear?
a. 5-6 months
b. 7-8 months
c. 9-10 months
d. 11-12 months

Answer 36

b. 7-8 months

Parachute Reflex
* Onset: 7-8 months after birth
* Fully Developed: 10-11 months
* Duration: Remains throughout life

Question 37

A newborn immediately after birth is observed to have a pink body but blue extremities, a heart rate of 120 beats per minute, pulls away when stimulated, exhibits some flexion of extremities, and has a strong cry. The APGAR score is:
a. 7
b. 8
c. 9
d. 10

Answer 37

b. 8

Explanation:

Appearance (color): Pink body but blue extremities indicate acrocyanosis, which is normal, scoring 1 point.
Pulse (heart rate): A heart rate of 120 beats per minute is within the normal range, scoring 2 points.
Grimace (reflex irritability): Pulling away when stimulated indicates a grimace response, scoring 2 points.
Activity (muscle tone): Some flexion of extremities indicates active movement, scoring 1
Respirations: A strong cry is a sign of good respiratory effort, scoring 2 points.

Question 38

Five minutes after birth, a baby is completely pink, has a heart rate of 150 bpm, grimaces and coughs when suctioned, is actively moving all extremities, and has a vigorous cry. The APGAR score is:
a. 7
b. 8
c. 9
d. 10

Answer 38

d. 10

Explanation:

Appearance (color): Completely pink, scoring 2 points.
Pulse (heart rate): A heart rate of 150 bpm is normal, scoring 2 points.
Grimace (reflex irritability): Grimaces and coughs when suctioned, scoring 2 points.
Activity (muscle tone): Actively moving all extremities, scoring 2 points.
Respirations: A vigorous cry, scoring 2 points.

Question 39

A newborn at 1 minute of life has a pale body, no heart rate detected, no response to stimulation, is limp, and has no respiratory effort. The APGAR score is:
a. 0
b. 2
c. 4
d. 6

Answer 39

a. 0

Explanation:

Appearance (color): Pale body, scoring 0 points.
Pulse (heart rate): No heart rate detected, scoring 0 points.
Grimace (reflex irritability): No response to stimulation, scoring 0 points.
Activity (muscle tone): Limp, scoring 0 points.
Respirations: No respiratory effort, scoring 0 points.

Question 40

At 5 minutes after birth, an infant is noted to have a body that is pink, but the hands and feet are blue, a heart rate of 100 bpm, makes a face when pinched, exhibits slight flexion in the arms and legs, and has a weak cry. The APGAR score is:
a. 5
b. 6
c. 7
d. 8

Answer 40

b. 6

Explanation:

Appearance (color): Body pink but hands and feet are blue (acrocyanosis), scoring 1 point.
Pulse (heart rate): A heart rate of 100 bpm, scoring 2 points.
Grimace (reflex irritability): Makes a face when pinched, scoring 1 point.
Activity (muscle tone): Slight flexion in arms and legs, scoring 1 point.
Respirations: Weak cry, scoring 1 point.

Question 41

An infant is observed to SUPPORT THEIR WEIGHT ON THEIR FOREARMS during tummy time, SPONTANEOUSLY OPENS THEIR HANDS, SMILES in response to their parent’s voice, and makes COOING sounds. This infant has achieved the developmental milestones typical for the age of:
a. 2 months
b. 3 months
c. 4 months
d. 5 months

Answer 41

b. 3 months

AGE 3 MONTHS
* Gross Motor: Supports weight on forearms.
* Fine Motor: Opens hands spontaneously.
* Social Skills: Smiles appropriately.
* Language: Coos, laughs.

Question 42

The child who TRANSFERS OBJECTS from hand to hand and BABBLES has achieved the developmental age of:
a. 4 months
b. 6 months
c. 8 months
d. 10 months

Answer 42

b. 6 months

AGE 6 MONTHS
* Gross Motor: Sits momentarily.
* Fine Motor: Transfers objects.
* Social Skills: Shows likes and dislikes.
* Language: Babbles.

Question 43

A baby who PULLS THEMSELVES UP TO STAND, uses a PINCER GRASP to pick up small objects, and enjoys PLAYING PAT-A-CAKE and PEEK-A-BOO is most likely:
a. 6 months old
b. 9 months old
c. 12 months old
d. 15 months old

Answer 43

b. 9 months old

AGE 9 MONTHS
* Gross Motor: Pulls to stand.
* Fine Motor: Pincer grasp.
* Social Skills: Plays pat-a-cake, peek-a-boo.
* Language: Imitates sounds.

Question 44

An infant who WALKS WITH ONE HAND HELD, can RELEASE AN OBJECT ON COMMAND, COMES WHEN CALLED, and uses 1-2 MEANINGFUL WORDS is demonstrating skills of a child aged:
a. 9 months
b. 10 months
c. 12 months
d. 14 months

Answer 44

c. 12 months

AGE 12 MONTHS
* Gross Motor: Walks with one hand held.
* Fine Motor: Releases an object on command.
* Social Skills: Comes when called.
* Language: 1-2 meaningful words.

Question 45

A toddler who WALKS UPSTAIRS WITH ASSISTANCE, FEEDS themselves with a SPOON, MIMICS THE ACTIONS OF OTHERS, and uses at LEAST 6 WORDS is showing developmental milestones typical of:
a. 12 months
b. 15 months
c. 18 months
d. 20 months

Answer 45

c. 18 months

AGE 18 MONTHS
* Gross Motor: Walks upstairs with assistance.
* Fine Motor: Feeds from a spoon.
* Social Skills: Mimics actions of others.
* Language: At least 6 words.

Question 46

A child who RUNS confidently, BUILDS A TOWER OF 6 BLOCKS, PLAYS cooperatively with OTHERS, and speaks in 2-3 WORD SENTENCES is likely to be:
a. 18 months
b. 20 months
c. 22 months
d. 24 months

Answer 46

d. 24 months

AGE 24 MONTHS
* Gross Motor: Runs.
* Fine Motor: Builds a tower of 6 blocks.
* Social Skills: Plays with others.
* Language: 2-3 word sentences.

Question 47

A toddler who can walk alone, makes a tower of 3 cubes, follows simple commands, and hugs their parents is most likely:
a. 12 months
b. 15 months
c. 18 months
d. 24 months

Answer 47

b. 15 months (1 Year)

15 Months
* Motor: Walks alone; crawls up stairs.
* Adaptive: Makes tower of 3 cubes; makes a line with crayon; inserts raisin in bottle.
* Language: Jargon; follows simple commands; may name a familiar object (e.g., ball).
* Social: Indicates some desires or needs by pointing; hugs parents.

Question 48

A child who runs stiffly, sits on a small chair, uses 10 words on average, and feeds themselves is demonstrating developmental milestones typical of:
a. 15 months
b. 18 months
c. 24 months
d. 30 months

Answer 48

b. 18 months (1.5 Years)

18 Months
* Motor: Runs stiffly; sits on small chair; walks up stairs with one hand held; explores drawers and wastebaskets.
* Adaptive: Makes tower of 4 cubes; imitates scribbling; imitates vertical stroke; dumps raisin from bottle.
* Language: 10 words (average); names pictures; identifies one or more parts of the body.
* Social: Feeds self; seeks help when in trouble; may complain when wet or soiled; kisses parent with pucker.

Question 49

A toddler who runs well, builds a tower of 7 cubes, puts 3 words together in a sentence, and listens to stories when shown pictures is likely:
a. 18 months
b. 24 months
c. 30 months
d. 36 months

Answer 49

b. 24 months (2 Years)

24 Months
* Motor: Runs well, walks up and down stairs one step at a time; opens doors; climbs on furniture; jumps.
* Adaptive: Makes tower of 7 cubes (6 at 21 months); scribbles in circular pattern; imitates horizontal stroke; folds paper once imitatively.
* Language: Puts 3 words together (subject, verb, object).
* Social: Handles spoon well; often tells about immediate experiences; helps to undress; listens to stories when shown pictures.

Question 50

A child who goes up stairs alternating feet, makes vertical and horizontal strokes with a crayon, refers to themselves by pronoun “I”, and helps put things away is probably:
a. 24 months
b. 30 months
c. 36 months
d. 48 months

Answer 50

b. 30 months (2.5 Years)

30 Months
* Motor: Goes up stairs alternating feet.
* Adaptive: Makes tower of 9 cubes; makes vertical and horizontal strokes, but generally will not join them to make a cross; imitates circular stroke, forming a closed figure.
* Language: Refers to self by pronoun “I”; knows full name.
* Social: Helps put things away; pretends in play.

Question 51

A preschooler who rides a tricycle, stands momentarily on one foot, knows their age and sex, and plays simple games with other children is most likely:
a. 2 years
b. 3 years
c. 4 years
d. 5 years

Answer 51

b. 3 years (36 Months)

36 Months
* Motor: Rides tricycle; stands momentarily on one foot.
* Adaptive: Makes tower of 10 cubes; imitates construction of “bridge” of 3 cubes; copies circle; imitates cross.
* Language: Knows age and sex; counts 3 objects correctly; repeats 3 numbers or a sentence of 6 syllables.
* Social: Plays simple games (in “parallel” with other children); helps in dressing (unbuttons clothing and puts on shoes); washes hands.

Question 52

A child who hops on one foot, uses scissors to cut out pictures, counts 4 pennies accurately, and plays with several children in a social interaction is at the developmental age of:
a. 3 years
b. 4 years
c. 5 years
d. 6 years

Answer 52

b. 4 years (48 Months)

48 Months
* Motor: Hops on one foot; throws ball overhand; uses scissors to cut out pictures; climbs well.
* Adaptive: Copies bridge from model; imitates construction of “gate” of 5 cubes; copies cross and square; draws man with 2 to 4 parts besides the head; identifies the longer of 2 lines.
* Language: Counts 4 pennies accurately; tells a story.
* Social: Plays with several children, with the beginning of social interaction and role-playing; goes to toilet alone.

Question 53

A child who skips, draws a triangle from a copy, names 4 colors, and engages in domestic role-playing is likely:
a. 3 years
b. 4 years
c. 5 years
d. 6 years

Answer 53

c. 5 years (60 Months)

60 Months
* Motor: Skips.
* Adaptive: Draws a triangle from copy; names the heavier of 2 weights.
* Language: Names 4 colors; repeats a sentence of 10 syllables; counts 10 pennies correctly.
* Social: Dresses and undresses; asks questions about the meaning of words; engages in domestic role-playing.

Question 54

A 1-month-old infant typically demonstrates all of the following behaviors EXCEPT:
a. Holds chin up momentarily when on the stomach.
b. Begins to smile in response to social interaction.
c. Follows a moving object with their eyes.
d. Sits up alone without support.

Answer 54

d. Sits up alone without support.

AT 1 MONTH
* Prone: Legs more extended; holds chin up; turns head; head lifted momentarily to plane of body on ventral suspension.
* Supine: Tonic neck posture predominates; supple and relaxed; head lags when pulled to sitting position.
* Visual: Watches person; follows moving object.
* Social: Body movements in cadence with voice of other in social contact; beginning to smile.

Question 55

A 2-month-old baby is expected to exhibit all of the following patterns of behavior EXCEPT:
a. Smiles on social contact.
b. Raises head slightly farther when on the stomach.
c. Follows moving objects 180 degrees.
d. Forms polysyllabic vowel sounds.

Answer 55

d. Forms polysyllabic vowel sounds.

AT 2 MONTHS
* Prone: Raises head slightly farther; head sustained in plane of body on ventral suspension.
* Supine: Tonic neck posture predominates; head lags when pulled to sitting position.
* Visual: Follows moving object 180 degrees.
* Social: Smiles on social contact; listens to voice and coos.

Question 56

A 3-month-old infant typically shows all of the following behaviors EXCEPT:
a. Lifts head and chest with arms extended when prone.
b. Begins to babble and say “aah, ngah.”
c. Sits with full truncal support without head lag.
d. Reaches toward and misses objects.

Answer 56

c. Sits with full truncal support without head lag.

AT 3 MONTHS
* Prone: Lifts head and chest with arms extended; head above plane of body on ventral suspension.
* Supine: Tonic neck posture predominates; reaches toward and misses objects; waves at toy.
* Sitting: Head lag partially compensated when pulled to sitting position; early head control with bobbing motion; back rounded.
* Reflex: Typical Moro response has not persisted; makes defensive movements or selective withdrawal reactions.
* Social: Sustained social contact; listens to music; says “aah, ngah”.

Question 57

A 4-month-old baby is expected to have all of the following patterns of behavior EXCEPT:
a. Laughs out loud and may show displeasure if social contact is broken.
b. Lifts head and chest, with legs extended when prone.
c. Pulls to a standing position and “cruises.”
d. No head lag when pulled to a sitting position.

Answer 57

c. Pulls to a standing position and “cruises.”

AT 4 MONTHS
* Prone: Lifts head and chest, with head in approximately vertical axis; legs extended.
* Supine: Symmetric posture predominates, hands in midline; reaches and grasps objects and brings them to mouth.
* Sitting: No head lag when pulled to sitting position; head steady, tipped forward; enjoys sitting with full truncal support.
* Standing: When held erect, pushes with feet.
* Adaptive: Sees pellet, but makes no move to reach for it.
* Social: Laughs out loud; may show displeasure if social contact is broken; excited at sight of food.

Question 58

A 7-month-old baby is expected to have all of the following patterns of behavior EXCEPT:
a. Bangs and shakes a rattle.
b. Transfers objects from hand to hand.
c. Babbles and enjoys looking in a mirror.
d. Plays simple ball games.

Answer 58

d. Plays simple ball games.

AT 7 MONTHS
* Prone: Rolls over; pivots; crawls or creep-crawls.
* Supine: Lifts head; rolls over; squirms.
* Sitting: Sits briefly, with support of pelvis; leans forward on hands; back rounded.
* Standing: May support most of weight; bounces actively.
* Adaptive: Reaches out for and grasps large object; transfers objects from hand to hand; grasp uses radial palm; rakes at pellet.
* Language: Forms polysyllabic vowel sounds.
* Social: Prefers mother; babbles; enjoys mirror; responds to changes in emotional content of social contact.

Question 59

A 10-month-old infant typically demonstrates all of the following behaviors EXCEPT:
a. Sits up alone indefinitely without support.
b. Uses pincer movement to pick up objects.
c. Walks independently without any support.
d. Plays peek-a-boo or pat-a-cake.

Answer 59

c. Walks independently without any support.

AT 10 MONTHS
* Sitting: Sits up alone and indefinitely without support, with back straight.
* Standing: Pulls to standing position; “cruises” or walks holding on to furniture.
* Motor: Creeps or crawls.
* Adaptive: Uses pincer movement; uncovers and retrieves dropped objects.
* Language: Repetitive consonant sounds (e.g., “mama,” “dada”).
* Social: Responds to sound of name; plays peek-a-boo or pat-a-cake; waves bye-bye.

Question 60

A 1-year-old child is expected to exhibit all of the following patterns of behavior EXCEPT: a. Walks with one hand held.
b. Says a few words besides “mama” and “dada.”
c. Rides a tricycle.
d. Makes postural adjustments to dressing.

Answer 60

c. Rides a tricycle.

AT 1 YEAR
* Motor: Walks with one hand held; rises independently, takes several steps.
* Adaptive: Picks up pellet with unassisted pincer movement; releases object to other person on request or gesture.
* Language: Says a few words besides “mama,” “dada.”
* Social: Plays simple ball game; makes postural adjustment to dressing.

Question 61

A child who holds their chin up, turns their head while prone, watches a person and follows a moving object, and begins to smile in social contact is most likely:
a. 1 week
b. 1 month
c. 2 months
d. 3 months

Answer 61

b. 1 month

AT 1 MONTH
* Prone: Legs more extended; holds chin up; turns head; head lifted momentarily to plane of body on ventral suspension.
* Supine: Tonic neck posture predominates; supple and relaxed; head lags when pulled to sitting position.
* Visual: Watches person; follows moving object.
* Social: Body movements in cadence with voice of other in social contact; beginning to smile.

Question 62

A baby who raises their head slightly farther than before while prone, smiles on social contact, and listens to voice and coos is demonstrating skills typical of:
a. 1 month
b. 2 months
c. 3 months
d. 4 months

Answer 62

b. 2 months

AT 2 MONTHS
* Prone: Raises head slightly farther; head sustained in plane of body on ventral suspension.
* Supine: Tonic neck posture predominates; head lags when pulled to sitting position.
* Visual: Follows moving object 180 degrees.
* Social: Smiles on social contact; listens to voice and coos.

Question 63

An infant who lifts their head and chest with arms extended while prone, reaches toward and misses objects in the supine position, and says “aah, ngah” is likely:
a. 2 months
b. 3 months
c. 4 months
d. 5 months

Answer 63

b. 3 months

AT 3 MONTHS
* Prone: Lifts head and chest with arms extended; head above plane of body on ventral suspension.
* Supine: Tonic neck posture predominates; reaches toward and misses objects; waves at toy.
* Sitting: Head lag partially compensated when pulled to sitting position; early head control with bobbing motion; back rounded.
* Reflex: Typical Moro response has not persisted; makes defensive movements or selective withdrawal reactions.
* Social: Sustained social contact; listens to music; says “aah, ngah”.

Question 64

A child who lifts their head and chest with the head in approximately vertical axis while prone, enjoys sitting with full truncal support, and laughs out loud is at the developmental age of:
a. 3 months
b. 4 months
c. 5 months
d. 6 months

Answer 64

b. 4 months

AT 4 MONTHS
* Prone: Lifts head and chest, with head in approximately vertical axis; legs extended.
* Supine: Symmetric posture predominates, hands in midline; reaches and grasps objects and brings them to mouth.
* Sitting: No head lag when pulled to sitting position; head steady, tipped forward; enjoys sitting with full truncal support.
* Standing: When held erect, pushes with feet.
* Adaptive: Sees pellet, but makes no move to reach for it.
* Social: Laughs out loud; may show displeasure if social contact is broken; excited at sight of food.

Question 65

A baby who rolls over, pivots, crawls or creep-crawls while prone, sits briefly with support, and babbles, preferring their mother, is most likely:
a. 5 months
b. 6 months
c. 7 months
d. 8 months

Answer 65

c. 7 months

AT 7 MONTHS
* Prone: Rolls over; pivots; crawls or creep-crawls.
* Supine: Lifts head; rolls over; squirms.
* Sitting: Sits briefly, with support of pelvis; leans forward on hands; back rounded.
* Standing: May support most of weight; bounces actively.
* Adaptive: Reaches out for and grasps large object; transfers objects from hand to hand; grasp uses radial palm; rakes at pellet.
* Language: Forms polysyllabic vowel sounds.
* Social: Prefers mother; babbles; enjoys mirror; responds to changes in emotional content of social contact.

Question 66

A child who sits up alone indefinitely without support, pulls to a standing position, “cruises,” and plays peek-a-boo is demonstrating milestones typical of:
a. 8 months
b. 9 months
c. 10 months
d. 11 months

Answer 66

c. 10 months

AT 10 MONTHS
* Sitting: Sits up alone and indefinitely without support, with back straight.
* Standing: Pulls to standing position; “cruises” or walks holding on to furniture.
* Motor: Creeps or crawls.
* Adaptive: Uses pincer movement; uncovers and retrieves dropped objects.
* Language: Repetitive consonant sounds (e.g., “mama,” “dada”).
* Social: Responds to sound of name; plays peek-a-boo or pat-a-cake; waves bye-bye.

Question 67

A developmentally normal child who can walk with one hand held, rises independently, takes several steps, and plays simple ball games is observed most likely at this age:
a. 10 months
b. 11 months
c. 1 year
d. 18 months

Answer 67

c. 1 year

AT 1 YEAR
* Motor: Walks with one hand held; rises independently, takes several steps.
* Adaptive: Picks up pellet with unassisted pincer movement; releases object to other person on request or gesture.
* Language: Says a few words besides “mama,” “dada.”
* Social: Plays simple ball game; makes postural adjustment to dressing.

Question 68

A 32-year-old woman presents to her primary care physician with complaints of difficulty climbing stairs and lifting objects above her head. Upon examination, her physician notes that she can move her arms and legs against gravity but struggles when slight resistance is applied. Based on the Muscle Strength Grading, how would you classify her muscle strength?
a. Normal
b. Full range of motion against gravity with some resistance
c. Full range of motion against gravity
d. Flicker or slight contraction

Answer 68

b. Full range of motion against gravity with some resistance

Question 69

During a routine health check-up, a 45-year-old man reports that he can no longer perform his usual workouts at the gym, specifically mentioning difficulty with weightlifting exercises he could do before. Physical examination reveals that he can move his limbs freely in all directions without the influence of gravity but cannot sustain any movement when minimal resistance is introduced. According to the Muscle Strength Grading provided, what grade of muscle strength does this patient have?
a. Normal
b. Full range of motion against gravity with some resistance
c. Full range of motion against gravity
d. Power detectable only when gravity is excluded by postural adjustment

Answer 69

d. Power detectable only when gravity is excluded by postural adjustment

Question 70

A 25-year-old professional dancer visits a sports medicine clinic after experiencing a sudden loss of strength in her legs, which affects her performance. She demonstrates the ability to perform full leg movements when lying down but cannot maintain these movements if any resistance is added. Based on the Muscle Strength Grading, which of the following best describes her condition?
a. Normal
b. Full range of motion against gravity with some resistance
c. Full range of motion against gravity
d. Power detectable only when gravity is excluded by postural adjustment

Answer 70

b. Full range of motion against gravity with some resistance

Question 71

A 70-year-old retired construction worker with a history of chronic back pain is evaluated for new-onset weakness in his arms. He is able to slightly contract his biceps muscles, but no significant movement at the elbow joint is observed. Referring to the Muscle Strength Grading, how would this patient’s muscle strength be categorized?
a. Normal
b. Full range of motion against gravity with some resistance
c. Full range of motion against gravity
d. Flicker or slight contraction

Answer 71

d. Flicker or slight contraction

Question 72

An 18-year-old female gymnast is recovering from a severe arm injury and is undergoing physical therapy. Initially, she was unable to move her arm at all, but after several weeks of therapy, she can now move her arm in all directions without any resistance. However, she still struggles with exercises that involve lifting weights. According to the Muscle Strength Grading, what is her current level of muscle strength?
a. Normal
b. Full range of motion against gravity with some resistance
c. Full range of motion against gravity
d. Power detectable only when gravity is excluded by postural adjustment

Answer 72

c. Full range of motion against gravity

Question 73

Dr. Lee gently strokes the cheek of a 2-week-old infant during a routine check-up. The infant turns her head toward the side being stroked and opens her mouth. This behavior is an example of which reflex?

A) Sucking Reflex
B) Moro Reflex
C) Rooting Reflex
D) Tonic Neck Reflex

Answer 73

C) Rooting Reflex

Question 74

During a pediatric examination, a neonatologist observes that when the tip of a pacifier touches the lips of a 1-month-old baby, the baby starts sucking on it immediately. This reflexive action is known as:

A) Grasp Reflex
B) Sucking Reflex
C) Moro Reflex
D) Rooting Reflex

Answer 74

B) Sucking Reflex

Sucking Reflex:
* Involves cranial nerves 7, 9, and 12.

Question 75

A pediatrician holds a 3-month-old infant semi-upright and simulates a falling movement by letting the baby’s head drop slightly. The baby responds by extending and then quickly bringing her arms together as if embracing. This reaction is indicative of:

A) Tonic Neck Reflex
B) Grasp Reflex
C) Moro Reflex
D) Stepping Reflex

Answer 75

C) Moro Reflex

Moro Reflex:
* Place the infant in a semi-upright position.
* Allow the head to fall backward momentarily with immediate support by the examiner’s hand.
* Response: extension and abduction of the arms and extension of the fingers followed by flexion and adduction of the arms at the shoulder.
* Disappears by 5 months of age.
* Asymmetric response may signify fractured clavicle, peripheral nerve lesion (brachial plexus injury), or LMN lesion (hemiparesis).
* Absence in a term newborn suggests significant CNS dysfunction.

Question 76

During a newborn’s physical examination, the doctor places a finger in the palm of the baby’s hand. The baby immediately grasps the finger tightly. This involuntary action demonstrates the:

A) Grasp Reflex
B) Rooting Reflex
C) Sucking Reflex
D) Moro Reflex

Answer 76

A) Grasp Reflex

Grasp Reflex:
* Place the examiner’s finger or an object on the palm of the infant’s hand or the ball of the foot adjacent to the toes.
* Response: flexion response of fingers or toes.
* Palmar disappears by 6 months.
* Plantar disappears by 9-10 months.

Question 77

A nurse observes that when she turns the head of a 2-month-old infant to one side while the infant is lying on his back, the arm on the side to which the head is turned extends, while the opposite arm bends at the elbow. This response is known as:

A) Reflex Stepping
B) Tonic Neck Reflex
C) Grasp Reflex
D) Galant Reflex

Answer 77

B) Tonic Neck Reflex

Tonic Neck Reflex:
* Turn the head to one side while the child is supine.
* Response: extension of the arm on the ipsilateral side and flexion of the contralateral extremities.
* Disappears by 5-6 months.
* An obligatory tonic neck response, where the infant remains locked in the fencer’s position, is abnormal and implies a CNS disorder.

Question 78

A healthcare provider lifts a newborn slightly off the examination table and places the tops of the baby’s feet against the edge of the table. The baby lifts one foot after the other in a walking motion. This observed behavior is an example of:

A) Tonic Neck Reflex
B) Moro Reflex
C) Reflex Stepping
D) Rooting Reflex

Answer 78

C) Reflex Stepping

Reflex Placing and Stepping Response:
* Reflex placing is seen when the dorsum of the foot is placed against the edge of the exam table.
* Reflex stepping is seen when the sole of the foot is placed on the table, and the infant appears to be walking.
* Disappears by 4-5 months.

Question 79

In a routine newborn examination, a pediatrician holds an infant in a prone position and strokes one side of the baby’s back. The baby curves toward the stimulated side. This reflex is identified as:

A) Tonic Neck Reflex
B) Galant Reflex
C) Grasp Reflex
D) Moro Reflex

Answer 79

B) Galant Reflex

Galant Reflex:
* Baby in ventral suspension, then stroke the skin on one side of the back.
* Response: baby’s trunk and hips swing towards the side of the stimulus.
* Disappears by 4-6 months.

Question 80

1. Which cranial nerve is involved in the jaw jerk reflex?
   A) CN III (Oculomotor Nerve)
   B) CN V (Trigeminal Nerve)
   C) CN VII (Facial Nerve)
   D) CN X (Vagus Nerve)

Answer 80

B) CN V (Trigeminal Nerve)

Question 81

2. The biceps reflex tests the integrity of which spinal nerve segments?
   A) C3-C4
   B) C5-C6
   C) C7-C8
   D) L1-L2

Answer 81

B) C5-C6

Question 82

3. A neurologist tests the triceps reflex to evaluate the function of which spinal nerve segments?
   A) C1-C3
   B) C4-C5
   C) C6-C8
   D) L2-L4

Answer 82

C) C6-C8

Question 83

4. During a neurological examination, the patellar reflex is assessed to check the functioning of which lumbar segments?
   A) L1-L2
   B) L2-L4
   C) L4-L5
   D) L5-S1

Answer 83

B) L2-L4

Question 84

5. The ankle reflex primarily tests the integrity of which sacral nerve segments?
   A) S1-S2
   B) S2-S4
   C) S3-S5
   D) L5-S1

Answer 84

A) S1-S2