Chapter 17: Alterations of Neurologic Function in Children
MULTIPLE CHOICE
1. Which reflex of infancy will disappear first?
a. Stepping
b. Rooting
c. Palmar grasp
d. Moro reflex
ANS: A
The stepping reflex should no longer be obtainable at 6 weeks. The rooting reflex should
no longer be obtainable at 4 months. The palmar grasp should no longer be obtainable at 6
months. The Moro reflex should no longer be obtainable at 3 months.
REF: p. 423, Table 17-1
2. A 10-month-old infant presents for a well-baby visit. Which of the following reflexes should
be present at this age?
a. Stepping
b. Sucking
c. Landau
d. Palmar grasp
ANS: C
The Laundau reflex would beNpUreRsSenIt NupGuTntil.2C4 OmMonths. The
stepping reflex should no longer be obtainable at 6 weeks. The sucking reflex should have
disappeared by 10 months.
The palmar grasp should no longer be obtainable at 6 months.
REF: p. 423, Table 17-1
3. During infancy, what is the fastest growing part of the human body?
a. Spinal cord
b. Limb bones
c. Head
d. Vertebral column
ANS: C
The head, not the spinal cord, limb bones, or vertebral column, is the fastest growing part
of the body during infancy.
REF: p. 422
4. A nurse is preparing to teach about the most common defects of neural tube closure.
Which one should the nurse discuss?
a. Anterior
b. Posterior
c. Lateral
d. Superior
, ANS: B
Posterior neural tube defects are the most common. Neural tube defects associated with
the other options are not as common.
REF: p. 424
5. An infant has an anterior midline defect of neural tube closure. What term will the
nurse observe written on the chart?
a. Anencephaly
b. Myelodysplasia
c. Cyclopia
d. Hydrocephalus
ANS: C
Cyclopia is an example of an anterior midline defect that may cause brain and face
abnormalities. In anencephaly, the soft, bony component of the skull and part of the brain are
missing. Myelodysplasia is a posterior neural tube disorder. Hydrocephalus is associated with
accelerated head growth.
REF: p. 424
6. What nutrient should the nurse encourage a woman in the early stages of pregnancy
to consume to prevent neural tube defects?
a. Protein
b. Iron
c. Vitamin D
d. Folic acid
ANS: D
Folic acid deficiency during early stages of pregnancy increases the risk for neural tube
defects. Neural tube defects are not associated with deficiencies of protein, iron, or vitamin
D.
REF: pp. 424-425
7. What term is used to document a herniation of brain and meninges through a defect in the
occipital area of the skull?
a. Encephalocele
b. Meningocele
c. Myelomeningocele
d. Craniosynostosis
ANS: A
An encephalocele refers to a herniation or protrusion of brain and meninges through a defect
in the occipital region of the skull, resulting in a saclike structure. A meningocele is a saclike
cyst of meninges filled with spinal fluid, a mild form of posterior neural tube closure defect.
These can occur throughout the cervical, thoracic, and lumbar spine areas. A
myelomeningocele is a hernial protrusion of a saclike cyst (containing meninges, spinal fluid,
and a portion of the spinal cord with its nerves) through a defect in the posterior arch of a
vertebra in the lower spine. Craniosynostosis is the premature closure of one or more of the
cranial sutures (saggital, coronal, lambdoid, and metopic) during the first 18-20 months of the
infant’s life.
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