Peds Neuro - exam 3

A nursing instructor is teaching about eye disorders in childhood. Which statement made by a student indicates a need for further instruction?

"Cataracts are only present in adults."

The nurse is caring for a child diagnosed with aseptic meningitis. When explaining the treatment plan to the parents, which information would the nurse likely include?

"We will monitor your child closely and keep your child comfortable."

The nurse is caring for a 10-year-old child who was admitted to the unit after experiencing a tonic-clonic seizure. When developing this child's plan of care, the nurse identifies the need to teach the child about diagnostic testing that may be prescribed. Which test(s) would the nurse include in the teaching plan? Select all that apply.

-Electroencephalogram -Computed tomography -Magnetic resonance imaging

A nurse is caring for a 1-year-old child with a head injury. The child was previously unconscious but is now alert and oriented. Oral feedings are prescribed. The nurse determines that the child's risk for aspiration is low based on the presence of which reflex(es)?

-gag -cough -swallow

Antibiotic therapy to treat meningitis should be instituted immediately after which event?

Collection of cerebrospinal fluid (CSF) and blood for culture

The nurse is providing care to an infant with microcephaly. When reviewing the prenatal and birth history, the nurse would identify the mother's exposure to which infection as a potential contributing factor?

Cytomegalovirus

Which of the following would a nurse assess in a child with pneumococcal meningitis?

Nuchal rigidity

The nurse is caring for a preschooler who has developed a high fever and has just had a seizure. What is the best action by the nurse? Remove any blankets or heavy clothing and replace with a thin sheet Place the child in a bathtub filled with cool water. Apply ice packs to the child's axillary and groin area. Administer acetaminophen by mouth as prescribed.

Remove any blankets or heavy clothing and replace with a thin sheet

A child has been diagnosed with strabismus. After further examination, the client is told that the resting position of the right eye is convergent. The nurse further explains that this means which of the following?

The resting position of the eye is turned in.

A 12-year-old child has been prescribed phenytoin. What information should be included in discussion about this medication?

Use a soft toothbrush.

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The nurse is caring for a child with suspected increased intracranial pressure (ICP). Which assessment finding would indicate increased ICP?

hypertension

The nurse is assessing a 4-year-old child whose mother reports that the child is more irritable lately. Which of the following questions would the nurse ask to elicit information suggesting possible increased intracranial pressure (ICP)?

"Does she have headaches when she gets out of bed?"

The nurse is caring for a child who has suffered a febrile seizure. While speaking with the child's parents, which statement by a parent indicates a need for further education?

"I hate to think that I will need to be worried about my child having seizures for the rest of his life."

The nurse is providing teaching to the parents of a child recently prescribed carbamazepine for a seizure disorder. Which statement by a parent indicates successful teaching?

"I need to watch for any new bruises or bleeding and let my health care provider know about it."

The parents of a 17-year-old adolescent diagnosed with bacterial meningitis tell the nurse, "We just do not understand how this could have happened. Our adolescent has always been healthy and just received a booster vaccine last year." How should the nurse respond?

"I understand your frustration. Unfortunately, immunizations are not 100% effective in preventing the infection."

A toddler is prescribed amoxicillin for bilateral otitis media. The parent reports that the toddler refuses to take the oral medication. The nurse knows that more education is needed when the parent makes which statement?

"I will shake the medication well, and draw up the medication to the top of the syringe. My spouse and I will hold our toddler down and force the medication down his throat."

A 1-year-old has just undergone surgery to correct craniosynostosis. When talking with the parents, which of the following would be most appropriate? "I'll be watching his hemoglobin and hematocrit closely." "I told you yesterday there would be facial swelling." "This condition only happens in 1 out of 2,000 births." "Now that the surgery was successful, do you have any questions?"

"Now that the surgery was successful, do you have any questions?"

The nurse is caring for an infant who is at risk for increased intracranial pressure. What statement by the parent would alert the nurse to further assess the child's neurological status?

"She has been irritable for the last hour....seems like she is just upset for some reason."

The nurse provides education to the parent of an infant being treated for hydrocephalus with a ventriculoperitoneal (VP) shunt. Which statement by the parent indicates the need for further instruction?

"This shunt is the only surgery my baby will need."

A nurse is providing discharge teaching to the parents of a child hospitalized with hydrocephalus, who had a ventriculoperitoneal (VP) shunt placed. The nurse should intervene if the parents make which statement?

"We expect our child to continue engaging in normal activities, including sports."

An infant is diagnosed with nasolacrimal duct obstruction. The nurse is instructing the parents on how to perform lacrimal massage. The nurse determines the need for additional teaching based on which statement by the parents?

"We will press on the outer corner of the eye for several seconds."

A 3-month-old infant is diagnosed with mild craniosynostosis. When teaching the parents about treatment, which information would the nurse likely include?

"Your infant will need to wear a helmet after the defect is corrected for most hours of the day."

The nurse is monitoring the cerebral perfusion pressure (CPP) of a 14-year-old admitted to the unit with a traumatic brain injury. Which CPP reading would lead the nurse to notify the practitioner immediately?

42 mm Hg

During physical assessment of a 2-year-old child, the nurse suspects that the child may have a cataract in one eye based on assessment of which of the following?

Absence of the red reflex.

To detect complications as early as possible in a child with meningitis who's receiving IV fluids, monitoring for which condition should be the nurse's priority?

Cerebral edema

A preschool-age child has just been admitted to the pediatric unit with a diagnosis of bacterial meningitis. The nurse would include which recommendation in the nursing plan?

Decrease environmental stimulation

The nurse is performing a neurologic assessment on a 7-month-old infant. Which task should the nurse perform last?

Elicit the gag reflex.

The nurse is preparing a room for a child being admitted with meningitis. What is the appropriate action by the nurse?

Gather appropriate equipment and signage for respiratory isolation precautions.

A 17-year-old is brought to the emergency department with a fever, headache, and stiff neck. Bacterial meningitis is suspected. The nurse would anticipate preparing the adolescent for which test to confirm the diagnosis?

Lumbar puncture

The nurse is collecting data from a child who may have a seizure disorder. Which nursing observations suggest an absence seizure?

Minimal or no alteration in muscle tone, with a brief loss of responsiveness or attention

A nurse suspects that a child has developed pneumococcal meningitis based on assessment of which of the following?

Nuchal rigidity

A parent calls the nurse triage line to say the child accidentally got hit in the eye and the parent believes the child will have a black eye. Which instruction is important for the nurse to provide this parent?

Place ice on the eye for 20 minutes/off the eye for 20 minutes for 24 hours.

The nurse is providing care to an infant with hydrocephalus who has had a ventriculoperitoneal shunt inserted. The nurse documents the infant's assessment. Which finding(s) would lead the nurse to notify the health care provider about the possibility that the child has developed a paralytic ileus? Select all that apply. temperature incisional sites level of consciousness abdominal circumference bowel sounds abdomen

abdomen bowel sounds abdominal circumference

The nurse is assessing the vision of 9-year-old boy. His vision appears normal on a vision screening test, although the nurse notices that he has to tilt his head occasionally as he is reading the chart. His mother tells the nurse that he has trouble reading and reports having a headache after doing his homework. Which condition should the nurse suspect in this boy?

astigmatism

A 4-year-old child is brought to the emergency department after being in a motor vehicle accident. The child experienced head trauma in the accident. When assessing the child, which will be the first change noted in the presence of increasing intercranial pressure?

change in level of consciousness

The nurse is caring for a child with hearing loss due to damage from chronic inner ear infections. The nurse knows that the child most likely has which type of hearing loss?

conductive

Which measures should receive priority when planning care for the child who is having surgery to remove a cataract?

evaluation of intraocular pressure (IOP) and adherence to the occlusive patch regimen

After administering eye drops to a child, the nurse applies gentle pressure to the inside corner of the eye at the nose for which reason?

to ensure the medication stays in the eye

A nurse is providing teaching to the parents of a 3-month-old infant diagnosed with deformational plagiocephaly (DP). What information should the nurse convey to the parents that will support the infant's growth and development?

Position the infant prone for a total of 30 to 60 minutes per day.

A nurse is assessing a 3-year-old child for possible bacterial meningitis. Which sign would indicate irritation of the meninges?

Positive Kernig sign

To give eardrops to a 4-year-old child, what would be the best technique to use?

Pull the pinna of the ear up and back.

A nurse is caring for a 1-year-old child with a head injury. The child was previously unconscious but is now alert and oriented. Oral feedings are prescribed. The nurse determines that the child's risk for aspiration is low based on the presence of which reflex(es)?

gag cough swallow

A 9-year-old child with a history of epilepsy is brought to the emergency department. The child has been having a series of tonic-clonic seizures over the past 5 minutes and has not recovered from them between episodes. Which medication would the nurse anticipate being used to control the child's seizures?

lorazepam

A child is brought to the emergency department and is experiencing status epilepticus. The nurse would expect to administer which treatment as first-line therapy?

lorazepam

After experiencing a head injury the child keeps falling asleep when no one is rousing him. When documenting this in the medical record which term is most appropriate?

obtunded

A child with a seizure disorder is being admitted to the inpatient unit. When preparing the room for the child, what should be included?

oxygen gauge and tubing suction at bedside padding for side rails

The nurse is caring for an infant with increased intracranial pressure. The mother is preparing to feed the child. What action by the mother indicates an understanding of the proper care of this infant?

placing the infant in an infant car seat after feeding the infant

A child is brought to the emergency department after experiencing a series of continuous seizures. The nurse is reviewing the orders for care and treatment. Which order would be of the highest priority? serum glucose level white blood cell count urinalysis hemoglobin level

serum glucose level

A nurse is preparing a presentation on neurologic development in children. What information should the nurse include in the presentation?

Poverty and caregiver mental illness are shown to contribute to developmental delays in children.

The nurse receives a call from the parent of a 4-month-old infant who underwent endoscopic surgery for craniosynostosis 2 months earlier. The parent reports that the infant's skin appears red on the both temples. How should the nurse respond?

"Your infant should be evaluated in person, because a new helmet may be needed."

A nurse is administering carbamazepine to a 4-year-old child diagnosed with epilepsy. The health care provider has prescribed 10 mg/kg/day by mouth. The child weighs 32 lb (14.52 kg). How many milligrams should the nurse administer? Record your answer rounded to the whole number.

145

The nurse is caring for a school-age child who has been having a continuous seizure for the last 40 minutes. What is the priority action by the nurse? Observe and document the length of time of the seizure and type of movement observed. Perform a glucose finger stick to determine the child's blood sugar level. Administer carbamazepine as prescribed. Administer lorazepam IV as prescribed.

Administer lorazepam IV as prescribed.

During the trial period to determine the efficacy of an anticonvulsant drug, which caution should be explained to the parents?

The child shouldn't participate in activities that could be hazardous if a seizure occurs

The nurse is caring for a 10-year-old child with bacterial conjunctivitis of the right eye. The eye is inflamed and drains a thick, yellow discharge. What should the nurse teach the patient about the care of the eye?

Clean the discharge away from the inner to outer canthus.

The nurse is assessing a child following a head injury sustained in a bicycle accident. The child falls asleep frequently unless the parents are talking to the child or the nurse is asking the child questions. How should the nurse document the child's level of consciousness?

obtunded

The parents of a 2-week-old neonate bring the neonate to the office for an evaluation. While reviewing the neonate's history, the nurse determines that the neonate is at risk for deformational plagiocephaly and institutes a teaching plan for the parents about prevention. Which factor(s) in the neonate's history would lead the nurse to this action? Select all that apply.

-Neonate was in the breech position in utero. -Neonate was born at 34 weeks' gestation. -Mother's length of labor was 22 hours.

A nurse is administering ear drops to a 7-year-old girl. What should the nurse do?

Pull the pinna of the ear up and back to straighten the external ear canal.

The nurse is planning care for a preschool-age child diagnosed with meningitis. What should the nurse identify as a priority goal for this patient's care?

Reduce the pain related to nuchal rigidity.