North American Registry of Midwives (NARM) Practice Exam

What is considered the most common sign of neurological compromise in newborns?

1. Inability to feed

2. Seizure activity

3. Poor muscle tone

4. Excessive crying

The correct answer is: Seizure activity

Seizure activity is recognized as one of the most concerning indicators of neurological compromise in newborns. This sign can manifest as rhythmic jerking movements, unusual posturing, or abnormal eye movements, and indicates that the infant's brain may not be functioning properly. Monitoring for seizures is crucial because they can be a sign of underlying issues such as hypoxia, infection, or metabolic disturbances that require immediate medical attention. In contrast, the other signs listed can also indicate various problems but are not as specifically associated with neurological compromise as seizure activity. Inability to feed can occur for many reasons, including feeding difficulties unrelated to neurological function. Poor muscle tone, while a potential sign of neurological issues, can also arise from other factors unrelated to the brain itself. Excessive crying can be indicative of discomfort, hunger, or other non-neurological conditions, making it a less specific sign of neurological issues compared to seizure activity. Thus, recognizing seizure activity as a primary sign allows for timely intervention and care for newborns experiencing neurological distress.