Chapter 45 Neurological and Cognitive Disorders

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The nurse is assigned to care for an 8-year-old child with a diagnosis of a basilar skull fracture. The nurse reviews the health care provider's (HCPs) prescriptions and should contact the HCP to question which prescription? 1. Suction as needed. 2. Obtain daily weight. 3. Provide clear liquid intake. 4. Maintain a patent intravenous line.

1

The nurse is developing 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. 1. Time the seizure 2. Restrain the child 3. Stay with the child 4. Place the child in a prone position 5. Move furniture away from the child 6. Insert a padded tongue blade in the child's mouth

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An infant with a diagnosis of hydrocephalus is scheduled for surgery. Which is the PRIORITY nursing intervention in the preoperative period? 1. Test the urine for protein 2. Reposition the infant frequently 3. Provide a stimulating environment 4. Assess blood pressure every 15 minutes

2

A lumbar puncture is performed on a child suspected to have bacterial meningitis, and cerebrospinal fluid (CSF) is obtained for analysis. The nurse reviews the results of the CSF analysis and determines that which results would verify the diagnosis? 1. Clear CSF, decreased pressure, and elevated protein level. 2. Clear CSF, elevated protein, and decreased glucose levels. 3. Cloudy CSF, elevated protein, and decreased glucose levels. 4. Cloudy CSF, decreased protein, and decreased glucose levels.

3

The nurse is reviewing the record of a child with increased intracranial pressure and notes that the child has exhibited signs of decerebrate posturing. On assessment of the child, the nurse expects to note which characteristic of this type of posturing? 1. Flaccid paralysis of all extremities. 2. Adduction of the arms at the shoulders. 3. Rigid extension and pronation of the arms and legs. 4. Abnormal flexion of the upper extremities and extension and adduction of the lower extremities.

3

A child is diagnosed with Reye's syndrome. The nurse develops a nursing care plan for the child and should include which intervention in the plan? 1. Assessing hearing loss 2. Monitoring urine output 3. Changing body positions every 2 hours 4. Providing a quiet atmosphere with dimmed lighting

4

A mother arrives at an emergency department with her 5-year-old child and states that the child fell off a bunk bed. A head injury is suspected, and the nurse checks the child's airway status and assesses the child for early and late signs of increased intracranial pressure (ICP). Which is a LATE sign of increased ICP? 1. Nausea 2. Irritability 3. Headache 4. Bradycardia

4

The nurse develops a plan of care for a child at a risk for tonic-clonic seizures. In the plan of care, the nurse identifies seizure precautions and documents that which item(s) need to be placed at the child's bedside? 1. Emergency cart 2. Tracheotomy set 3. Padded tongue blade 4. Suctioning equipment and oxygen

4

The nurse is planning care for a child with acute bacterial meningitis. Based on the mode of transmission of this infection, which precautionary intervention should be included in the plan of care? 1. Maintain enteric precautions 2. Maintain neutropenic precautions 3. No precautions are required as long as antibiotics have been started. 4. Maintain respiratory isolation precautions for at least 24 hours after the initiation of antibiotics.

4

The nurse notes documentation that a child with meningitis is exhibiting a positive Kernig's sign. Which observation is characteristic of this sign? 1.The child complains of muscle and joint pain. 2. Petechial and purpuric rashes are noted on the child's trunk. 3. Neck flexion causes adduction and flexion movements of the lower extremities. 4. The child is not able to extend the leg when the thigh is flexed anteriorly at the hip.

4

The parents of a child recently diagnosed with cerebral palsy ask the nurse about the disorder. The nurse bases the response on the understanding that cerebral palsy is which type of condition? 1. An infectious disease of the central nervous system. 2. An inflammation of the brain as a result of a viral illness. 3. A congenital condition that results in moderate to severe retardation. 4. A chronic disability characterized by impaired muscle movement and posture.

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