Exam 4: Cerebral Dysfunction NCLEX Questions

d

A 23-month-old child is admitted to the hospital with a diagnosis of meningitis. She is lethargic and very irritable with a temperature of 102 F. What should the nurses care plan include? a. Observing the childs voluntary movement b. Checking the Babinski reflex every 4 hours c. Checking the Brudzinski reflex every 1 hour d. Assessing the level of consciousness (LOC) and vital signs every 2 hours

c

A 3 year old is recovering from a concussion. The persistence of which finding would the nurse consider as being a normal finding for a 3 year old? a. lack interest in favorite toys b. change in eating habits c. inability to hop d. increased temper tantrums

c

After a seizure in a child over 3 years of age, the Babinski reflex often a. remains positive b. remains negative c. fluctuates d. is unable to be tested correctly

c

After a tonic-clonic seizure, what symptoms should the nurse expect the child to experience? a. Diarrhea and abdominal discomfort b. Irritability and hunger c. Lethargy and confusion d. Nervousness and excitability

c

As the nurse assigned to a child diagnosed with bacterial meningitis, you know that a. the child will not need to be placed in isolation because antibiotics have been started b. enteric precautions will remain in place for up to 48 hours c. respiratory isolation will remain in place for 24 hours d. due to headache, the child will want the head of the bed elevated with two pillows

a

Because of the ability of the cranium to expand, very young children may tolerate which of the following neurologic conditions better than an adult? a. cerebral edema b. hypoxic brain damage c. epilepsy d. subdural hemorrhage

d

Family support for the child who has suffered head injury includes all of the following except encouraging the parents to a. hold and cuddle the child b. bring familiar belongings into the child's room c. make a tape recording of familiar voices or sounds d. search for clues that the child is recovering

a c d

Nursing care management of the child with bacterial meningitis includes which interventions? Select all that apply a. administration of IV antibiotics b. IV fluids at 1 1/2 times maintenance c. decreasing environmental stimuli d. neurologic checks every 4 hours e. administrating of IV anticonvulsants

c

Reye syndrome is widely believed is be linked to a. administration of nonsteroidal medications for fever during an acute viral infection b. encephalitis c. administration of aspirin for fever in children varicella or influenza d. bacterial infections

c d e

The nurse is teaching the parents of a child with a seizure disorder about the triggers that can cause a seizure. What should the nurse include in the teaching session? Select all that apply a. Cold b. Sugared drinks c. Emotional stress d. Flickering lights e. Hyperventilation

a

The primary diagnostic tool for detecting hydrocephalus in older infants and children is a. computed tomography or magnetic resonance imaging b. measuring head circumference c. echoencephalography d. ultrasonography

b

The primary risk factor for the development of cerebral palsy is a. maternal chorioamnionitis b. premature birth c. birth asphyxia d. intraventricular hemorrhage

a

The priority nursing consideration for the child in the acute phase of GBS is a. careful observation for difficulty in swallowing and respiratory involvement b. prevention of contractures c. prevention of bowel and bladder complications d. prevention of sensory impairment

c

What statement is descriptive of a concussion? a. Petechial hemorrhages cause amnesia. b. Visible bruising and tearing of cerebral tissue occur. c. It is a transient and reversible neuronal dysfunction. d. It is a slight lesion that develops remote from the site of trauma.

a e

Which priority item should be placed at the bedside of a newborn with myelomeningocele? Select all that apply a. a bottle of normal saline b. a rectal thermometer c. extra blankets d. a blood pressure cuff e. latex-free gloves

d

You are caring for a child with a hydrocephalus who is postoperative from a shunt revision. Which assessment finding is your priority for increased intracranial pressure? a. nausea and refusal to eat postoperatively b. complaint of a headache c. irritability and wanting to sleep d. decrease in heart rate over the last hour

a b c

A nurse is caring for a child who has absence seizures. Which of the following findings should the nurse expect? Select all that apply a. loss of consciousness b. appearance of daydreaming c. dropping held objects d. falling to the floor e. having a piercing cry

d

A nurse is caring for an infant who has a myelomeningocele. Which of the following actions should the nurse include in the preoperative plan of care? a. assist the caregiver with cuddling the infant b. assess the infant's temperature rectally c. place the infant in a supine position d. apply a sterile, moist dressing on the sac

b

A nurse is developing a plan of care for a toddler who has cerebral palsy. Which of the following actions should the nurse include? a. structure interventions according to the toddler's chronological age b. evaluate the toddler's need for an evaluation of hearing ability c. monitor the toddler's pain level routinely using a numeric rating scale d. provide total care for daily hygiene activities

a b c d

A nurse is reviewing treatment options with the guardian of a child who has worsening seizures. Which of the following treatment options should the nurse include in the discussion? Select all that apply a. vagal nerve stimulator b. additional antiepileptic medications c. corpus callosotomy d. focal resection e. radiation therapy

a b c

A nurse is teaching a group of caregivers about the risk factors for seizures. Which of the following factors should the nurse include in the teaching? Select all that apply a. febrile episodes b. hypoglycemia c. sodium imbalances d. low blood lead levels e. presence of diphtheria

b

The goal of therapeutic management for the child with CP is a. assisting with motor control of voluntary muscle b. promoting an optimal developmental course to enable children to achieve their maximal potential c. delaying the development of sensory deprivation d. surgically correcting deformities

b

Upon the delivery of an infant with myelomeningocele, which one of the following nursing actions is contraindicated? a. examination of the membraneous cyst for intactness b. diapering the infant c. keeping moist, sterile, normal saline dressings on the defect d. keeping the infant in the prone position

c

When positioning a neonate with an unrepaired myelomeningocele, which position is most appropriate? a. supine with the hips at 90 degree flexion b. right side-lying position with knees flexed c. prone with hips in abduction d. supine with semi-Fowler's position with chest and abdomen elevated

c

Which of the following is a true statement about Guillan-Barre syndrome? a. It is an autosomal recessive inherited disease b. it is more likely to affect children than adults, with children under the age of 4 years having the higher susceptibility c. it is an acute demyelinatng polyneuropathy with a progressive, usually ascending, flaccid paralysis d. it is an autoimmune disorder associated with the attack of circulating antibodies on the acetylcholine receptors

b

Which should the nurse do first when caring for an infant who just had a repair of a myelomeningocele? a. weigh diapers for 24 hour urine output b. measure head circumference c. offer clear liquids d. assess for infection

b

Which should the nurse tell the parent of an infant with spina bifida? a. "bone growth will be more than that of babies who are not sick because your baby will be less active" b. "physical and occupational therapy will be helpful to stimulate the senses and improve cognitive skills" c. "nutritional needs for your infant will be calculated based on activity level" d. "fine motor skills will be delayed because of the disability"

d

A 6-year-old child is admitted for revision of a ventriculoperitoneal shunt for noncommunicating hydrocephalus. What sign or symptom does the child have that indicates a revision is necessary? a. Tachycardia b. Gastrointestinal upset c. Hypotension d. Alteration in level of consciousness

a b e

A nurse is reviewing cerebrospinal fluid analysis for a client who has suspected meningitis. Which of the following should the nurse identify as indicating viral meningitis? Select all that apply a. negative gram stain b. normal glucose content c. cloudy odor d. decreased WBC count e. normal protein content

d

Emergency care of the child during a seizure includes a. giving ice chips slowly b. restraining the child c. putting a tongue blade in the child's mouth d. loosening restrictive clothing

c

The infant with hydrocephalus has which of the following clinical manifestations? a. upward eye slanting b. stabismus c. setting-sun sign d. decreased head circumference

b

The nurse is caring for a 3 year old with an altered state of consciousness. The nurse determines that the child is oriented by asking the child to a. name the president of the United States b. identify her parents and state her own name c. state her full name and phone number d. identify the current month but not the date

c

The nurse is caring for a child with multiple injuries who is comatose. What information is accurate related to pain in this child? a. Cannot occur if the child is comatose. b. May occur if the child regains consciousness. c. Requires astute nursing assessment and management. d. Is best assessed by family members who are familiar with the child.

c

The parents of a child recently diagnosed with cerebral palsy ask the nurse about the limitations of the disorder. The nurse responds by explaining that the limitations occur as a result of which pathophysiological process? a. an infectious disease of the central nervous system b. an inflammation of the brain as a result of a viral illness c. a chronic disability characterized by impaired muscle movement and posture d. a congenital condition that results in moderate to severe intellectual disabilities

b

What clinical manifestations suggest hydrocephalus in an infant? a. Closed fontanel and high-pitched cry b. Bulging fontanel and dilated scalp veins c. Constant low-pitched cry and restlessness d. Depressed fontanel and decreased blood pressure

b

A 2-year-old child starts to have a tonic-clonic seizure. The childs jaws are clamped. What is the most important nursing action at this time? a. Place a padded tongue blade between the childs jaws. b. Stay with the child and observe his respiratory status. c. Prepare the suction equipment. d. Restrain the child to prevent injury.

c

A 5-year-old girl sustained a concussion when she fell out of a tree. In preparation for discharge, the nurse is discussing home care with her mother. What sign or symptom is considered a manifestation of postconcussion syndrome and does not necessitate medical attention? a. Vomiting b. Blurred vision c. Behavioral changes d. Temporary loss of consciousness

b

A 6-month-old infant does not smile, has poor head control, has a persistent Moro reflex, and often gags and chokes while eating. What are these findings are most suggestive of in this infant? a. Hypotonia b. Cerebral palsy c. Spinal cord injury d. Neonatal myasthenia gravis

a

A child having a complex partial seizure rather than a simple partial seizure is most likely to exhibit a. impaired consciousness b. clonic movements c. a seizure duration of less than 1 minute d. all of the above

c

A child in a very deep comatose state would exhibit a. hyperkinetic activity b. purposeless plucking movements c. few spontaneous movements d. combative behavior

c

A child with GBS has had lots of oral fluids but has not urinated for 8 hours. Which is the nurse's first action? a. check the child's serum blood urea nitrogen level b. check the child's complete blood count c. catheterize the child in and out d. run water in the bathroom to stimulate urination

a

A child with a seizure disorder has been having episodes during which she drops her pencil and simply appears to be daydreaming. This is most likely a a. absence seizure b. akinetic seizure c. non-epileptic seizure d. simple spasm seizure

a

A lumbar puncture (LP) is being done on an infant with suspected meningitis. The nurse expects which results for the cerebrospinal fluid that can confirm the diagnosis of meningitis? a. WBCs; glucose b. RBCs; normal WBCs c. glucose; normal RBCs d. Normal RBCs; normal glucose

d

A nurse is assessing a 4 month old infant who has meningitis. Which of the following manifestations should the nurse expect? a. depressed anterior fontanel b. constipation c. presence of the rooting reflex d. high-pitched cry

c

A nurse is reviewing the medical record of a client who has Reye syndrome. Which of the following findings should the nurse identify as a risk factor for Reye syndrome? a. recent history of infectious cystitis caused by Candida b. recent history of bacterial otitis media b. recent episode of gastroenteritis d. recent episode of Haemophilus Influenzae meningitis

c

A school-age child has sustained a head injury and multiple fractures after being thrown from a horse. The childs level of consciousness is variable. The parents tell the nurse that they think their child is in pain because of periodic crying and restlessness. What is the most appropriate nursing action? a. Explain that analgesia is contraindicated with a head injury. b. Have the parents describe the childs previous experiences with pain. c. Consult with a practitioner about what analgesia can be safely administered. d. Teach the parents that analgesia is unnecessary when the child is not fully awake and alert.

b

A toddler is admitted to the pediatric unit with presumptive bacterial meningitis. The initial orders include isolation, intravenous access, cultures, and antimicrobial agents. The nurse knows that antibiotic therapy will begin when? a. After the diagnosis is confirmed b. When the medication is received from the pharmacy c. After the childs fluid and electrolyte balance is stabilized d. As soon as the practitioner is notified of the culture results

a

Children with CP often have manifestations that include alterations of muscle tone. Which of the following is an example of a finding in a child with altered muscle tone? a. demonstrates increased or decreased resistance to passive movements b. develops hand dominance by the age of 5 months c. has an asymmetric crawl d. when placed in prone position, maintains hips higher than trunk, with legs and arms flexed or drawn under the body

c

Children with spina bifida who are confined to a wheelchair are at increased risk for a. tethered cord syndrome b. chiari maformation c. skin breakdown d. orthopedic deformities

a

Emergency treatment of a child with a head injury would generally not include a. administering analgesics b. checking pupils' reaction to light c. stabilizing the neck and spine d. checking level of consciousness

c

Nursing intervention for a child during a tonic-clonic seizure should include attempts to a. halt the seizure as soon as it begins b. restrain the child c. remain calm and prevent the child from sustaining any harm d. place an oral airway in the child's mouth

c

Of the following activities, the one that has been shown to increase intracranial pressure is a. using earplugs to eliminate noise b. range-of-motion exercise c. suctioning d. osmotherapy

c

Of the following symptoms, the one that would not be considered a hallmark of concussion in a child is a. alteration of mental status b. amnesia c. loss of consciousness d. confusion

c

The most common complication that should be anticipated and observed for in an infant with myelomeningocele after surgical repair of the defect is a. urinary stress b. chiari malformation c. hydrocephalus d. latex allergy

a

The most common mode of transmission for bacterial meningitis is a. vascular dissemination of a respiratory tract infection b. direct implantation from an invasive procedure c. direct extension from an infection in the mastoid sinuses d. direct extension from an infection in the nasal sinuses

d

The mother of an unconscious child has been calling her name repeatedly and gently shaking her shoulders in an attempt to wake her up. The nurse notes that the child is flexing her arms and wrists while bringing her arms closer to the midline of her body. The child's mother asks, "What's going on?" Select the nurse's best repsonse a. "I think your daughter hears you, and she is attempting to reach out to you" b. "Your child is responding to you; please continue to try to stimulate her" c. "It appears that your child is having a seizure" d. "Your child is demonstrating a reflex that indicates she is overwhelmed with the stimulation she is receiving"

c

The nurse is admitting a young child to the hospital because bacterial meningitis is suspected. What is a priority of nursing care? a. Initiate isolation precautions as soon as diagnosis is confirmed. b. Provide environmental stimulation to keep the child awake. c. Administer antibiotic therapy as soon as it is available. d. Administer sedatives and analgesics on a preventive schedule to manage pain.

b

The nurse is caring for a 2-year-old girl who is unconscious but stable after a car accident. Her parents are staying at the bedside most of the time. What is an appropriate nursing intervention? a. Suggest that the parents go home until she is alert enough to know they are present. b. Encourage the parents to hold, talk, and sing to her as they usually would. c. Use ointment on her lips but do not attempt to cleanse her teeth until swallowing returns. d. Position her with proper body alignment and the head of the bed lowered 15 degrees.

a d e

The nurse is caring for a child with increased intracranial pressure (ICP). What interventions should the nurse plan for this child? Select all that apply a. Avoid jarring the bed. b. Keep the room brightly lit. c. Keep the bed in a flat position. d. Administer prescribed stool softeners. e. Administer a prescribed antiemetic for nausea.

a c e

The nurse is caring for a child with meningitis. What acute complications of meningitis should the nurse continuously assess the child for? Select all that apply a. Seizures b. Cerebral palsy c. Cerebral edema d. Hydrocephalus e. Cognitive impairments

c

The nurse is caring for an infant with myelomeningocele who is going to surgery later today for closure of the sac. Which would be a priority nursing diagnosis before surgery? a. alteration in parent-infant bonding b. altered growth and development c. risk of infection d. risk for weight loss

a c e

The nurse is creating a plan of care for a child who is at risk for seizures. Which interventions apply if the child has a seizure? Select all that apply a. time the seizure b. restrain the child c. stay with the child d. place the child in a prone position e. move furniture away from the child f. insert a padded tongue blade in the child's mouth

d

The nurse is discussing long-term care with the parents of a child who has a ventriculoperitoneal shunt. What issues should be addressed? a. Most childhood activities must be restricted. b. Cognitive impairment is to be expected with hydrocephalus. c. Wearing head protection is essential until the child reaches adulthood. d. Shunt malfunction or infection requires immediate treatment.

a d e

The nurse is monitoring an infant with meningitis for signs of increased intracranial pressure. The nurse should assess the infant for which signs or symptoms? Select all that apply a. irritability b. headache c. mood swings d. bulging fontanel e. emesis

a

The nurse is planning care for a school-age child with bacterial meningitis. What intervention should be included? a. Keep environmental stimuli to a minimum. b. Have the child move her head from side to side at least every 2 hours. c. Avoid giving pain medications that could dull sensorium. d. Measure head circumference to assess developing complications.

b

The nurse is preparing the long-term care plan for the child with CP. Which of the following is included in the plan? a. no delay in the gross motor development is expected b. the illness is not progressively degenerative c. there will be no persistence of primitive infantile reflexes d. all children will need genetic counseling as they get older before planning for a family

c

The nurse is reviewing the record of a child with increased intracranial pressure and notes that the child has exhibited signs of deceberate posturing. On assessment of the child, the nurse expects to note which characteristic of this type of posturing? a. flaccid paralysis of all extremities b. adduction of the arms at the shoulders c. rigid extension and pronation of the arms and legs d. abnormal flexion of the upper extremities and extension and adduction of the lower extremities

c

The nurse is teaching the parents of a 3-year-old child who has been diagnosed with tonic-clonic seizures. What statement by the parent should indicate a correct understanding of the teaching? a. I should attempt to restrain my child during a seizure. b. My child will need to avoid contact sports until adulthood. c. I should place a pillow under my childs head during a seizure. d. My child will need to be taken to the emergency department [ED] after each seizure.

c

The nurse knows that further education is needed about Reye syndrome when a mother states a. "I will have my children immunized against varicella and influenza" b. "I will make sure not to give my child any products containing aspirin" c. "I will give aspirin to my child to treat a headache" d. "Children with Reye syndrome are admitted to the hospital"

b

The nurse reports to the healthcare provider signs of increased intracranial pressure in an infant with a myelomeningocele who has which finding? a. minimal lower extremity movement b. a high-pitched cry c. overflow voiding only d. a fontanel that budges with crying

d

The nurse teaches an adolescent about returning to school after a concussion. Which statement by the client reflects the need for more teaching? a. "I should limit my activities that require concentration" b. "I must slowly return to my previous activity level as my symptoms improve" c. "my symptoms may reemerge with exhaustion" d. "time is the most important factor in my recovery"

a

The parents of a child with occasional generalized seizures wants to send the child to summer camp. The parents contact the nurse for advice on planning for the camping experience. Which type of activity should the nurse and family decide the child should avoid? a. rock climbing b. hiking c. swimming d. tennis

c

Urinary system distress (neurogenic bladder) in children with spinal bifida is managed by a. DDAVP (1-deamino-8-D-arginine vasopressin) b. clean intermittent catheterization c. continuous urinary catheterization d. mitrofanoff procedure

d

What findings would indicate to the nurse further assessment and treatment is needed for a child with mild head injury? a. Vomiting b. Sleepiness c. Headache, even if slight d. Confusion or abnormal behavior

d

What intervention should be beneficial in reducing the risk of Reye syndrome? a. Immunization against the disease b. Medical attention for all head injuries c. Prompt treatment of bacterial meningitis d. Avoidance of aspirin for children with varicella or those suspected of having influenza

c

What term refers to seizures that involve both hemispheres of the brain? a. Absence b. Acquired c. Generalized d. Complex partial

a

What type of seizure may be difficult to detect? a. Absence b. Generalized c. Simple partial d. Complex partial

b

When developing the plan of care for a child who is unconscious after a serious head injury, in which position should the nurse expect to place the child? a. prone with hips and knees slightly elevated b. lying on the side, with the head of the bed elevated c. lying on the back, in the Trendelenburg position d. in the semi-fowler's position, with arms at the side

c

Which action should the nurse take when providing postoperative nursing care to a child after insertion of a ventriculoperitoneal shunt? a. administer narcotics for pain control b. check the urine for glucose and protein c. monitoring for increased temperature d. test cerebrospinal fluid leakage for protein

d

A child is being admitted with the diagnosis of meningitis. Select the procedure the nurse should do first a. administration of IV antibiotics b. administration of maintenance IV fluids c. placement of a Foley catheter d. send the spinal fluid and blood samples to the laboratory for cultures

c

A child in the PICU with a head injury is comatose and unresponsive. The parent asks if he needs pain medication. Select the nurse's best response a. "pain medication is not necessary because he is unresponsive and cannot feel pain" b. "pain medication may interfere with his ability to respond and may mask any signs of improvement" c. "pain medication is necessary to make him comfortable" d. "pain medication is necessary for comfort, but we use it cautiously because it increases the demand for oxygen"

d

Associated disabilities and problems related to the child with CP include which of the following? a. all children with CP have intelligence testing in the abnormal range b. a large number of eye cataracts are associated with CP and require surgical correction c. seizures are a common occurrence among children with athetosis and diplegia d. coughing and choking, especially while eating, predispose children with CP to aspiration

a b c e

The nurse is preparing to admit a neonate with bacterial meningitis. What clinical manifestations should the nurse expect to observe? Select all that apply a. Jaundice b. Cyanosis c. Poor tone d. Nuchal rigidity e. Poor sucking ability

a

A preschooler has been having periods during which he suddenly falls and appears to be weak for a short time after the event. The preschool teacher asks what she should do. Select the nurse's best response a. "have the parents follow up with his health care provider because this is likely an atonic seizure" b. "find out if there have been any new stressors in his life because it could be attention-seeking behavior" c. "have the parents follow up with his health care provider because this is likely an absence seizure" d. "the preschool years are a time of rapid growth, and many children appear clumsy. It would be best to watch him and see if it continues"

a

An example of a nonrecurrent acute seizure is a. febrile episodes b. idiopathic epilepsy c. epilepsy secondary to hemorrhage d. hypoglycemic status hypopituitarism

b

An infant with a diagnosis of hydrocephalus is scheduled for surgery. Which is the priority nursing intervention in the preoperative period? a. test the urine for protein b. resposition the infant frequently c. provide a stimulating environment d. assess blood pressure every 15 minutes

b

During the acute stage of meningitis, a 3 year old child is restless and irritable. Which intervention would be most appropriate to institute? a. limiting conversation with the child b. keeping extraneous noise to a minumum c. allowing the child to play in the bathtub d. performing treatments quickly

d

If a child is permanently unconscious, it would be inappropriate for the nurse to a. permit the parents to bring a child's favorite toy b. provide guidance and clarify information that the physician has already given c. suggest the parents plan for periodic relief from the continual care of their child d. use reflective muscle contractions as a sign of hope for recovery

b

One strategy that may provide a clue to the origin of a seizure is a. to attempt to place an airway in the mouth b. to gently open the eyes to observe their movement c. to provide a clear description of events before the seizure d. to provide a clear description of events after the seizure

d

The nurse is assessing a child who was just admitted to the hospital for observation after a head injury. What clinical manifestation is the most essential part of the nursing assessment to detect early signs of a worsening condition? a. Posturing b. Vital signs c. Focal neurologic signs d. Level of consciousness

c

A 10-year-old boy on a bicycle has been hit by a car in front of a school. The school nurse immediately assesses airway, breathing, and circulation. What should be the next nursing action? a. Place the child on his side. b. Take the childs blood pressure. c. Stabilize the childs neck and spine. d. Check the childs scalp and back for bleeding.

b

Which order would the nurse question for a child just admitted with the diagnosis of bacterial meningitis? a. maintain isolation precautions until 24 hours after receiving IV antibiotics b. IV fluids at 1 1/2 times regular maintenance c. neurologic checks every hour d. administer acetaminophen (Tylenol) for temperatures higher than 38 C

c e

Which signs best indicate increased intracranial pressure in an infant? Select all that apply a. sunken anterior fontanel b. complaints of blurred vision c. high-pitched cry d. increased appetite e. sleeping more than usual

a

A 10-year-old child, without a history of previous seizures, experiences a tonic-clonic seizure at school that lasts more than 5 minutes. Breathing is not impaired. Some postictal confusion occurs. What is the most appropriate initial action by the school nurse? a. Stay with child and have someone else call emergency medical services (EMS). b. Notify the parent and regular practitioner. c. Notify the parent that the child should go home. d. Stay with the child, offering calm reassurance.

a

A child diagnosed with meningitis is having a generalized tonic-clonic seizure. Which should the nurse do first? a. administer blow-by oxygen and call for additional help b. reassure the parents that seizures are common in children with meningitis c. call a code and ask the parents to leave the room d. assess the child's temperature and blood pressure

d

A child has a seizure disorder. What test should be done to gather the most specific information about the type of seizure the child is having? a. Sleep study b. Skull radiography c. Serum electrolytes d. Electroencephalogram (EEG)

d

A child is admitted for revision of a ventriculoperitoneal shunt for noncommunicating hydrocephalus. What is a common reason for elective revision of this shunt? a. Meningitis b. Gastrointestinal upset c. Hydrocephalus resolution d. Growth of the child since the initial shunting

c

A child is brought to the emergency department after experiencing a seizure at school. He has no history of seizures. The father tells the nurse that he cannot believe the child has epilepsy. What is the best response by the nurse? a. "Epilepsy is easily treated." b. "Very few children have actual epilepsy." c. "The seizure may or may not mean that your child has epilepsy." d. "Your child has had only one convulsion; it probably won't happen again."

d

A child is diagnosed with Reye syndrome. The nurse creates a nursing care plan for the child and should include which intervention in the plan? a. assessing hearing loss b. monitoring urine output c. changing body position every 2 hours d. providing a quiet atmosphere with dimmed lighting

c

A lumbar puncture is performed on a child suspected to have bacterial meningitis, and cerebrospinal fluid is obtained. The nurse reviews the results of the CSF analysis and determines that which results would verify the diagnosis? a. clear CSF, decreased pressure, and elevated protein b. clear CSF, elevated protein, and decreased glucose c. cloudy CSF, elevated protein, and decreased glucose d. cloudy CSF, decreased protein, and decreased glucose

a

A nurse is caring for a client who has suspected meningitis and a decreased level of consciousness. Which of the following actions should the nurse take? a. place the client on NPO status b. prepare the client for a liver biopsy c. position the client dorsal recumbent d. put the client in a protective environment

b

Before placement of a ventriculoperitoneal shunt for hydrocephalus, an infant is irritable, lethargic, and difficult to feed. To maintain the infant's nutritional status, which action would be most appropriate? a. feed the infant just before doing any procedures b. give the infant small, frequent feedings c. feed the infant in a horizontal position d. give large, less frequent feedings

a b d

You are working with a family who brought their child into the pediatric clinic. The mother describes what may be a type of seizure. What subjective data will help you determine the type? Select all that apply a. the presence or absence of an aura b. if the child appeared disoriented after the seizure c. presence of vomiting after the seizure d. the duration of the seizure e. if the seizure was related to certain foods or occurred after a certain activity

b

The clinical manifestation that indicates a progression from minor head injury to severe head injury is a. confusion b. mounting agitation c. an episode of vomiting d. pallor

a

The nurse is preparing a school-age child for computed tomography (CT) scan to assess cerebral function. The nurse should include what statement in preparing the child? a. The scan will not hurt. b. Pain medication will be given. c. You will be able to move once the equipment is in place. d. Unfortunately no one can remain in the room with you during the test.

a d e

The nurse is preparing to admit a 10-year-old child with absence seizures. What clinical features of absence seizures should the nurse recognize? Select all that apply a. There is no aura. b. There is a postictal state. c. They usually last longer than 30 seconds. d. There is a brief loss of consciousness. e. There is an occasional clonic movement.

a b c e

The nurse is preparing to admit a 6-month-old infant with increased intracranial pressure (ICP). What clinical manifestations should the nurse expect to observe in this infant? Select all that apply a. High-pitched cry b. Poor feeding c. Setting-sun sign d. Sunken fontanel e. Distended scalp veins f. Decreased head circumference

a b c e

The nurse is preparing to admit an adolescent with bacterial meningitis. What clinical manifestations should the nurse expect to observe? Select all that apply a. Fever b. Chills c. Headache d. Poor tone e. Drowsiness

a

The nurse is providing postoperative care for an infant who had a ventriculoperitoneal shunt placed to correct hydropcephalus. Which clinical finding warrants immediate intervention? a. abdominal distension b. lethargy c. facial edema d. headache

c

The nurse recognizes that which one of the following should be included in the postoperative care of a patient with a shunt? a. positioning the patient in a head-up position b. continuous pumping of the shunt to assess function c. monitoring for abdominal or peritoneal distention d. position the child on the side of the operative site to facilitate drainage

b d e

What cerebrospinal fluid (CSF) analysis should the nurse expect with viral meningitis? Select all that apply a. Color is turbid. b. Protein count is normal. c. Glucose is decreased. d. Gram stain findings are negative. e. White blood cell (WBC) count is slightly elevated.

c

What finding is a clinical manifestation of increased intracranial pressure (ICP) in children? a. Low-pitched cry b. Sunken fontanel c. Diplopia, blurred vision d. Increased blood pressure

a

What is a clinical manifestation of increased intracranial pressure (ICP) in infants? a. Irritability b. Photophobia c. Vomiting and diarrhea d. Pulsating anterior fontanel

d

What is a nursing intervention to reduce the risk of increasing intracranial pressure (ICP) in an unconscious child? a. Suction the child frequently. b. Turn the childs head side to side every hour. c. Provide environmental stimulation. d. Avoid activities that cause pain or crying.

a

What is important to incorporate in the plan of care for a child who is experiencing a seizure? a. Describe and record the seizure activity observed. b. Suction the child during a seizure to prevent aspiration. c. Place a tongue blade between the teeth if they become clenched. d. Restrain the child when seizures occur to prevent bodily harm.

c

What is the initial clinical manifestation of generalized seizures? a. Confusion b. Feeling frightened c. Loss of consciousness d. Seeing flashing lights

d

The nurse should suspect pain the comatose child if the child exhibits a. increased flaccidity b. increased oxygen saturation c. decreased blood pressure d. increased agitation

c

What nursing intervention is appropriate when caring for an unconscious child? a. Avoid using narcotics or sedatives to provide comfort and pain relief. b. Change the childs position infrequently to minimize the chance of increased intracranial pressure (ICP). c. Monitor fluid intake and output carefully to avoid fluid overload and cerebral edema. d. Give tepid sponge baths to reduce fevers above 38.3 C (101 F) because antipyretics are contraindicated.

b

Which activity should an adolescent just diagnosed with epilepsy avoid? a. swimming, even with a friend b. being in a car at night c. participating in any strenuous activities d. returning to school right away

d

Which of the following diagnostic tests, for the child presenting with head injury, is least helpful in providing a more definitive diagnosis of the type and extent of the trauma? a. CT scan b. MRI c. history and physical d. skull x-ray

b

Which of the following indicators is best to use to determine the depth of the comatose state? a. motor activity b. level of consciousness c. reflexes d. vital signs

c

Which of the following signs is used to evaluate increased intracranial pressure in the infant but not in the older child? a. projectile vomiting b. headache c. tense or bulging fontanel d. fatigue

b

Which of the following statements about the ketogenic diet is true? a. it is a high-carbohydrate, high-fat diet with adequate protein b. it has shown effectiveness for treatment of epilepsy c. consumption of the diet forces the body to shift from using fat as the primary source to using glucose, thus developing a state of ketosis d. vitamin supplements are rarely necessary with diet