PEDS neuro
A preschool-age child is diagnosed with type 1 neurofibromatosis. What should the nurse expect to assess in this client? 1.Rash 2.Café au lait spots 3.Edematous lower extremities 4.Tiny red veins that appear in the corners of the eyes
2
A school-age client is experiencing bilateral lower extremity weakness that is spreading to the hands and arms. Which diagnostic test should the nurse expect to prepare this client? 1.MRI of the spine 2.Lumbar puncture 3.CT scan of the head 4.Electroencephalogram
2
The nurse is giving medications to an adolescent with cerebral palsy (CP). What symptom(s) do a majority of the CP medications target? 1.Decreased cardiac output 2.Muscle spasm and spasticity 3.Respiratory compromise 4.Muscle atrophy
2
The school nurse is being consulted by a teacher with concerns about a student who is doing poorly in class. The student stares off into space regularly and is unable to recall information that was just discussed. What disorder should the nurse suspect? 1.Myoclonic seizures 2.Absence seizures 3.Febrile seizures 4.Tonic-clonic seizures
2
A 5-year-old client is being tested for muscular dystrophy. Which type of this disorder should the nurse expect the client to perform Gowers' sign? 1.Becker muscular dystrophy 2.Acquired muscular dystrophy 3.Duchenne muscular dystrophy 4.Facioscapulohumeral muscular dystrophy
3
A mother is talking to the nurse and is concerned that her infant will get meningitis and die like her cousin's child did many years ago. The mother asks the nurse, "What is the best way I can protect my child?" How should the nurse respond? 1."There is no way to prevent it, unfortunately, but you must be quick to respond to any symptoms." 2."You should avoid taking your baby anywhere." 3."Many strains are vaccine-preventable, so getting all your vaccinations is a good start." 4."Keep your baby away from anyone who is sick."
3
A preadolescent client experiences severe migraine headaches. Which medication should the nurse expect to be prescribed to treat this client's health problem? 1.Valproate 2.Propranolol 3.Sumatriptan 4.Nortriptyline
3
A school-age client who has been on bed rest for several days becomes dizzy when moving to a sitting position. What type of hypotension should the nurse document in this client's medical record? 1.Cardiac 2.Vasovagal 3.Orthostatic 4.Psychogenic
3
The nurse in the clinic is assessing a school-age child brought in by his parent with reports of prolonged muscle weakness and fatigue. The nurse notes ptosis of the eyelids and an inability to smile. What condition should the nurse investigate further? 1.Cerebral palsy 2.Muscular dystrophy 3.Myasthenia gravis 4.Guillain-Barré
3
The nurse in the emergency department (ED) is assessing a school-age child with a new ventriculoperitoneal (VP) shunt. The child is being seen for lethargy, irritability, vomiting, severe headache, and a fever of 102.4°. What initial action should the nurse expect would be taken? 1.An admission to the hospital for IV fluids and monitoring 2.Give mannitol for increased intracranial pressure. 3.Obtain a CT scan of the brain with X-rays of the chest and abdomen. 4.A surgical intervention for hydrocephalus
3
The nurse is caring for a newborn after delivery and recognizes that the child was with born with a myelomeningocele. What action should the nurse take? 1.Clean the area and leave it open to air. 2.Clean the defect and cover with impregnated gauze. 3.Cover the defect with a sterile dressing moistened with warm and sterile normal saline. 4.Cover the defect with a simple dressing until the infant can go directly into surgery.
3
The nurse is caring for an adolescent client with myasthenia gravis. What issues should the nurse be vigilant and monitor for due to the complications it causes? 1.Blood clots 2.Heart failure 3.Aspiration 4.Hemorrhage
3
The nurse is doing health promotion education with a group of young women. Because of the risk of neural tube defects, the nurse should stress the importance of taking which supplement daily while of childbearing age? 1.Calcium 2.Magnesium 3.Folic acid 4.Iron
3
The nurse is preparing an education program on the Zika virus for a community health fair. Which information should the nurse include? 1.Sleep in a room that is not air-conditioned. 2.Apply insect repellant to the skin of all children. 3.Avoid travelling to areas with outbreaks if pregnant. 4.Spray porches and lawn areas with water at nightfall.
3
A toddler is scheduled for a routine wellness examination. What should the nurse do before beginning the assessment? 1.Encourage the parent to hold the child. 2.Ask the child to state his or her name and age. 3.Allow the child to manipulate the stethoscope. 4.Watch the child play with an age-appropriate toy.
4
The parent reports that a 3-year-old child receiving Lamotrigine for partial seizures has developed a rash. Which response should the nurse make to the parent? 1."Stop the medication immediately." 2."This means the dose needs to be doubled." 3."Take the client to the nearest medical facility." 4."This is something that occurs within the first 6 weeks of treatment."
4
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
ABCE
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
ABCE
A 3-year-old child is status postshunt revision for hydrocephaly. Part of the discharge teaching plan for the parents is signs of shunt malformation. Which signs are of shunt malformation? (Select all that apply.) A. Personality change B. Bulging anterior fontanel C. Vomiting D. Dizziness E. Fever
ACE
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.
ADE
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 child's blood pressure. c. Stabilize the child's neck and spine. d. Check the child's scalp and back for bleeding.
C
What is a priority of care when a child has an external ventricular drain (EVD)? a. Irrigation of drain to maintain flow b. As-needed dressing changes if dressing becomes wet c. Frequent assessment of amount and color of drainage d. Maintaining the EVD below the level of the child's head
C
What is the initial clinical manifestation of generalized seizures? a. Confusion b. Feeling frightened c. Loss of consciousness d. Seeing flashing lights
C
The nurse is collecting data from the caregivers of a child admitted with seizures. Which of the following statements indicates the child most likely had an atonic seizure? 1."He fell down and his whole body started shaking." 2."His arms had rapid jerking movements." 3."He was just staring into space and was totally unaware." 4."He usually is very coordinated, but he couldn't even walk without falling."
4
The nurse is providing education to a parent whose toddler is diagnosed with Duchenne muscular dystrophy. Which statement by the parent indicates the teaching was understood? 1."I am glad that my child's disability will not progress beyond where it is now." 2."It is acquired related to a maternal infection." 3."This disorder is characterized by muscle spasticity and mental deficits." 4."Life expectancy is in the twenties and death is usually caused by respiratory or cardiac failure."
4
The nurse, caring for a school-age client recovering from a ventriculoperitoneal (VP) shunt implant, completes an assessment and immediately notifies the healthcare provider. Which assessment finding caused the nurse to be concerned? 1.Poor appetite 2.Blood pressure 110/70 mm Hg 3.Pain level 4 on a scale from 1 to 10 4.Blood tinged spot on the pillowcase encircled by a lighter ring
4
The parent of a 3-month-old client is concerned because the child's eyes are deviating downward. What additional assessment should the nurse complete with this client? 1.Oral intake 2.Urine output 3.Status of reflexes 4.Integrity of the fontanelles
4
The nurse is preparing a school-age child for magnetic resonance imaging (MRI). What considerations should the nurse identify as important when preparing a pediatric client for an MRI? Select all that apply. 1.The child is often given age-appropriate sedation for the MRI. 2.Children should be encouraged to eat and drink prior to going into the MRI due to the long length of time they may be in the test. 3.Nursing care is aimed at alleviating anxiety and complications. 4.Any metallic piercings or jewelry must be removed from the child prior to the procedure. 5.Intake and output must be monitored.
1345
The nurse is asked to prepare a teaching tool about acquired hydrocephalus in pediatric clients. Which type should the nurse include? Select all that apply. 1.Ex-vacuo 2.Incomplete 3.Communicating 4.Normal pressure 5.Non-communicating
135
An infant is born with an open spinal cord defect. Which action should the nurse take when caring for this client? Select all that apply. 1.Position the client prone. 2.Position the client supine. 3.Keep the defect open to air. 4.Place the client on an open diaper. 5.Cover the defect with a moist, sterile dressing.
145
A preschool-age child requires an MRI of the brain and spinal cord. Which action should the nurse take when caring for this client? Select all that apply. 1.Remove earrings from both ears. 2.Provide age-appropriate sedation. 3.Restrict oral fluids after the study. 4.Monitor level of responsiveness after the study. 5.Report crying after the study to the health care provider.
124
The nurse is reviewing the plan of care for an adolescent child with cerebral palsy. Which treatment modalities would the nurse expect? Select all that apply. 1.Speech therapy 2.Physical therapy 3.Respiratory therapy 4.Occupational therapy 5.Educational therapy
1245
The nurse is assessing an infant for hydrocephalus. What signs and symptoms should the nurse identify to support this potential diagnosis? Select all that apply. 1.Rapid increase in head circumference or an unusually large head size 2.Bulging fontanel with crying 3.Vomiting 4.A high-pitched, shrill cry 5.Sunsetting eyes
1345
The nurse is admitting a toddler with suspected meningitis. In what order should the nurse perform these tasks?1234 1. Start antibiotics. 2. Obtain the lumbar puncture. 3. Begin IV fluids as ordered. 4. Start an IV.
4231
The nurse is preparing an educational poster on reflexes present in a newborn. In what order should the nurse identify that the reflexes disappear?1234 1. Moro reflex 2. Babinski sign 3. Placing reflex 4. Rooting reflex
4312
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 develops syndrome of inappropriate antidiuretic hormone secretion (SIADH) as a complication to meningitis. What action should be verified before implementing? a. Forcing fluids b. Daily weights with strict input and output (I and O) c. Strict monitoring of urine volume and specific gravity d. Close observation for signs of increasing cerebral edema
A
A child has been admitted with status epilepticus. An emergency medication has been ordered. What medication should the nurse expect to be prescribed? a. Lorazepam (Ativan) b. Phenytoin (Dilantin) c. Topiramate (Topamax) d. Ethosuximide (Zarontin)
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
A
A young child's parents call the nurse after their child is bitten by a raccoon in the woods. The nurse's recommendation should be based on what knowledge? a. Antirabies prophylaxis must be initiated immediately. b. The child should be hospitalized for close observation. c. No treatment is necessary if thorough wound cleaning is done. d. Antirabies prophylaxis must be initiated as soon as clinical manifestations appear.
A
An 18-month-old child is brought to the emergency department after being found unconscious in the family pool. What does the nurse identify as the primary problem in drowning incidents? a. Hypoxia b. Aspiration c. Hypothermia d. Electrolyte imbalance
A
An injury to which part of the brain will cause a coma? a. Brainstem b. Cerebrum c. Cerebellum d. Occipital lobe
A
If an intramuscular (IM) injection is administered to a child who has Reye syndrome, the nurse should monitor for what? a. Bleeding b. Infection c. Poor absorption d. Itching at the injection site
A
The nurse is caring for a 10-year-old child who has an acute head injury, has a pediatric Glasgow Coma Scale score of 9, and is unconscious. What intervention should the nurse include in the child's care plan? a. Elevate the head of the bed 15 to 30 degrees with the head maintained in midline. b. Maintain an active, stimulating environment. c. Perform chest percussion and suctioning every 1 to 2 hours. d. Perform active range of motion and nontherapeutic touch every 8 hours.
A
The nurse is caring for a toddler who has had surgery for a brain tumor. During an assessment, the nurse notes that the child is becoming irritable and pupils are unequal and sluggish. The MOST appropriate nursing action is to: A. notify the health care provider immediately. B. document level of consciousness. C. observe closely for signs of increased intracranial pressure (ICP). D. administer pain medication and assess for response.
A
The nurse is doing a neurologic assessment on a 2-month-old infant after a car accident. Moro, tonic neck, and withdrawal reflexes are present. How should the nurse interpret these findings? a. Neurologic health b. Severe brain damage c. Decorticate posturing d. Decerebrate posturing
A
The nurse is doing a neurologic assessment on a 2-month-old infant following a car accident. Moro, tonic neck, and withdrawal reflexes are present. The nurse should recognize that these reflexes suggest: A. neurologic health. B. severe brain damage. C. decorticate posturing. D. decerebrate posturing.
A
The nurse is doing a neurologic assessment on a child whose level of consciousness has been variable since sustaining a cervical neck injury 12 hours ago. The MOST appropriate nursing assessment in this case is: A: reactivity of pupils. B: doll's head maneuver. C: oculovestibular response. D: funduscopic examination to identify papilledema.
A
The nurse is planning care for a school-age child with bacterial meningitis. The plan should include: A. keeping environmental stimuli at a minimum. B. avoiding giving pain medications that could dull sensorium. C. measuring head circumference to assess developing complications. D. having child move head side to side at least every 2 hours.
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.
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
The nurse who is concerned about increased intracranial pressure in an infant should assess for: A: irritability B: photophobia. C: pulsating anterior fontanel. D: vomiting and diarrhea.
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.
A
What type of seizure may be difficult to detect? a. Absence b. Generalized c. Simple partial d. Complex partial
A
The nurse is preparing to admit a 5-year-old with an epidural hemorrhage. What clinical manifestations should the nurse expect to observe? (Select all that apply.) a. Headache b. Vomiting c. Irritability d. Cephalhematoma e. Pallor with anemia
ABC
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
ABCE
A 2-year-old child starts to have a tonic-clonic seizure. The child's jaws are clamped. What is the most important nursing action at this time? a. Place a padded tongue blade between the child's jaws. b. Stay with the child and observe his respiratory status. c. Prepare the suction equipment. d. Restrain the child to prevent injury.
B
A child is on phenytoin (Dilantin). What should the nurse encourage? a. Fluid restriction b. Good dental hygiene c. A decrease in vitamin D intake d. Taking the medication with milk
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 child's fluid and electrolyte balance is stabilized d. As soon as the practitioner is notified of the culture results
B
The postoperative care of a preschool child who has had a brain tumor removed should include which information? A. Colorless drainage is to be expected. B. Close supervision is needed while the child is regaining consciousness. C. Positioning is on the side in the Trendelenburg position. D. Analgesics are contraindicated because of altered consciousness.
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
What statement best describes a subdural hematoma? a. Bleeding occurs between the dura and the skull. b. Bleeding occurs between the dura and the cerebrum. c. Bleeding is generally arterial, and brain compression occurs rapidly. d. The hematoma commonly occurs in the parietotemporal region.
B
What term is used when a patient remains in a deep sleep, responsive only to vigorous and repeated stimulation? a. Coma b. Stupor c. Obtundation d. Persistent vegetative state
B
What test is never performed on a child who is awake? a. Doll's head maneuver b. Oculovestibular response c. Assessment of pyramidal tract lesions d. Funduscopic examination for papilledema
B
When taking the history of a child hospitalized with Reye syndrome, the nurse should not be surprised if a week ago the child had recovered from what? a. Measles b. Influenza c. Meningitis d. Hepatitis
B
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
C
A child has been seizure free for 2 years. A father asks the nurse how much longer the child will need to take the antiseizure medications. How should the nurse respond? a. Medications can be discontinued at this time. b. The child will need to take the drugs for 5 years after the last seizure. c. A step-wise approach will be used to reduce the dosage gradually. d. Seizure disorders are a lifelong problem. Medications cannot be discontinued.
C
A pregnant woman asks about prenatal diagnosis of hydrocephalus. The nurse's response should be based on which knowledge? a. It can be diagnosed only after birth. b. It can be diagnosed by chromosome studies. c. It can be diagnosed with fetal ultrasonography. d. It can be diagnosed by measuring the lecithin-to-sphingomyelin ratio.
C
A school-age child has sustained a head injury and multiple fractures after being thrown from a horse. The child's 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 child's 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.
C
A young child is having a seizure that has lasted 35 minutes. There is a loss of consciousness. The nurse should recognize that this is: A. absence seizure. B. generalized seizure. C. status epilepticus. D. simple partial seizure.
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
The nurse is admitting a young child to the hospital because bacterial meningitis is suspected. The PRIORITY of nursing care is to: A. initiate isolation precautions as soon as the diagnosis is confirmed. B. initiate isolation precautions as soon as the causative agent is identified. C. administer antibiotic therapy as soon as it is ordered. D. administer sedatives/analgesics on a preventive schedule to manage pain.
C
The nurse is caring for a 2-year-old girl who is unconscious but stable following a car accident. Her parents are staying at the bedside most of the time. An appropriate nursing intervention is to: A. suggest that the parents go home until she is alert enough to know that they are present. B. use ointment on her lips but do not attempt to cleanse her teeth until swallowing returns. C. encourage the parents to hold, talk, and sing to her as they usually would. D. position her with proper body alignment and head of bed lowered 15 degrees.
C
The nurse is caring for a child with multiple injuries who is comatose. The nurse should recognize that pain: 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 nurse is discussing long-term care with the parents of a child who has a ventriculoperitoneal shunt to correct hydrocephalus. In the discussion the nurse should include that: A. parental protection is essential until the child reaches adulthood. B. cognitive impairment is to be expected with hydrocephalus. C. shunt malfunction or infection requires immediate treatment. D. most usual childhood activities must be restricted.
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 child's head during a seizure." d. "My child will need to be taken to the emergency department [ED] after each seizure."
C
The temperature of an adolescent who is unconscious is 105° F. The PRIORITY nursing action is to: A. continue to monitor temperature. B. initiate a pain assessment. C. apply a hypothermia blanket. D. administer acetaminophen or ibuprofen.
C
What are quick, jerky, grossly uncoordinated, irregular movements that may disappear on relaxation called? a. Twitching b. Spasticity c. Choreiform movements d. Associated movements
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
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 child's 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.
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.
C
What term is used to describe a child's level of consciousness when the child is arousable with stimulation? a. Stupor b. Confusion c. Obtundation d. Disorientation
C
What term refers to seizures that involve both hemispheres of the brain? a. Absence b. Acquired c. Generalized d. Complex partial
C
The MOST appropriate nursing interventions when caring for a child experiencing a seizure include: (Select all that apply.) A. restraining the child when a seizure occurs to prevent bodily harm. B. placing a padded tongue between the teeth if they become clenched. C. avoid suctioning the child during the seizure. D. describing and documenting the seizure activity observed. E. applying supplemental oxygen after inserting an artificial oral airway.
CD
The nurse is caring for a child with a subdural hematoma. The nurse should assess for what signs that can indicate brainstem compression? (Select all that apply.) a. Coma b. Lethargy c. Hemiplegia d. Hemiparesis e. Unequal pupils
CDE
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.
D
The nurse is closely monitoring a child who is unconscious after a fall and notices that the child suddenly has a fixed and dilated pupil. How should the nurse interpret this? a. Eye trauma b. Brain death c. Severe brainstem damage d. Neurosurgical emergency
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 nurse's care plan include? a. Observing the child's 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
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
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
D
A young adolescent experiences infrequent migraine episodes. What pharmacologic intervention is most likely to be prescribed? a. Opioid b. Lorazepam c. Ergotamine d. Sumatriptan
D
The mother of a 1-month-old infant tells the nurse she worries that her baby will get meningitis like the child's younger brother had when he was an infant. The nurse should base a response on which information? a. Meningitis rarely occurs during infancy. b. Often a genetic predisposition to meningitis is found. c. Vaccination to prevent all types of meningitis is now available. d. Vaccinations to prevent pneumococcal and Haemophilus influenzae type B meningitis are available.
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
D
The nurse is caring for a child with severe head trauma after a car accident. What is an ominous sign that often precedes death? a. Delirium b. Papilledema c. Flexion posturing d. Periodic or irregular breathing
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
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 child's head side to side every hour. c. Provide environmental stimulation. d. Avoid activities that cause pain or crying.
D
What is the antiepileptic medication that requires monitoring of vitamin D and folic acid? a. Topiramate (Topamax) b. Valproic acid (Depakene) c. Gabapentin (Neurontin) d. Phenobarbital (Luminal)
D
What nursing intervention is used to prevent increased intracranial pressure (ICP) in an unconscious child? A. Suctioning child frequently B. Providing environmental stimulation C. Turning head side to side every hour D. Avoiding activities that cause pain or crying
D
Why are infants particularly vulnerable to acceleration-deceleration head injuries? A. The anterior fontanel is not yet closed. B. The nervous tissue is not well developed. C. The scalp of the head has extensive vascularity. D. Musculoskeletal support of head is insufficient.
D
