Neuro Qs

When developing a teaching plan for the parents of a child with Down syndrome, the nurse focuses on activities to increase which of the following for the parents? 1. Affection for their child. 2. Responsibility for their child's welfare. 3. Understanding of their child's disability. 4. Confidence in their ability to care for their child.

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Which of the following statements obtained from the nursing history of a toddler would alert the nurse to suspect that the child has had a febrile seizure? 1. The child has had a low-grade fever for several weeks. 2. The family history is negative for convulsions. 3. The seizure resulted in respiratory arrest. 4. The seizure occurred when the child had a respiratory infection.

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When developing the plan of care for an infant diagnosed with myelomeningocele and the parents who have just been informed of the infant's diagnosis, which of the following would the nurse include as the priority when the parents visit the infant for the first time? 1. Emphasizing the infant's normal and positive features. 2. Encouraging the parents to discuss their fears and concerns. 3. Reinforcing thedoctor's explanation of the defect. 4 . Having the parents feed their infant.

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Which of the following would lead the nurse to suspect that a child with meningitis has developed disseminated intravascular coagulation? 1. Hemorrhagic skin rash. 2. Edema. 3. Cyanosis. 4. Dyspnea on exertion.

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After placing an infant with myelomeningocele in an isolette shortly after birth, which of the following would thenurse use as the best indicator to determine the effectiveness of this intervention? 1. The arterial PO, remains between 94 and 100 mm Hg. 2. The axillary temperature remains between 97° and 98°F (36.1° and 36.7°C). 3. The bilirubin level remains stable. 4. Weight increases by about 1 ounce per day.

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After surgical repair of a myelomeningocele, which of the following would the nurse use to prevent musculoskeletal deformity in the infant? 1. Placing the feet in flexion. 2. Allowing the hips to be abducted. 3. Maintaining knees in the neutral position. 4. Placing the legs in adduction.

2

After teaching the parents of a child with febrile seizures about methods to lower temperature other than medication, which of the following statements indicates successful teaching? 1. "We'll add extra blankets when he complains of being cold." 2. "We'll wrap him in a blanket if he starts shivering." 3. "We'll make the bath water cold enough to make him shiver." 4. "We'll use a solution of half alcohol and half water when sponging him."

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A 4-year-old child with hydrocephalus is scheduled to have a ventroperitoneal shunt in the right side of the head. When developing the child's postoperative plan of care, the nurse would expect to place the preschooler in which of the following positions immediately after surgery? 1. On the right side, with the foot of the bed elevated. 2. On the left side, with the head of the bed elevated. 3. Prone, with the head of the bed elevated. 4. Supine, with the head of the bed flat.

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An adolescent girl with a seizure disorder controlled with phenytoin (Dilantin) and carbamazepine (Tegretol) asks the nurse about getting married and having children. Which of the following responses by the nurse would be most appropriate? 1. "You probably shouldn't consider having children until your seizures are cured." 2. "Your children won't necessarily have an increased risk of seizure disorder." 3. "When you decide to have children, talk to the doctor about changing your medication." 4. "Women who have seizure disorders commonly have a difficult time conceiving."

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A hospitalized preschooler with meningitis who is to be discharged becomes angry when the discharge is delayed. Which of the following play activities would be most appropriate at this time? 1. Reading the child a story. 2. Painting with watercolors. 3. Pounding on a pegboard. 4. Stacking a tower of blocks.

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A preschooler with a history of repaired lumbar myelomeningocele is in the emergency department with wheezing and skin rash. Which of the following questions would the nurse ask the mother first? 1. "Is your child taking any medications?" 2. "Who brought your child to the emergency department?" 3. "Is your child allergic to bananas or milk products?" 4. "What are you doing to treat your child's skin rash?"

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A preschooler with pneumococcal meningitis is receiving intravenous antibiotic therapy. When discontinuing the intravenous therapy, the nurse allows the child to apply a dressing to the area where the needle is removed. The nurse's rationale for doing so is based on the interpretation that a child in this age group has a need to accomplish which of the following? 1. Trust those caring for her. 2. Find diversional activities. 3. Protect the image of an intact body. 4. Relieve the anxiety of separation from home.

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After teaching a group of schoolteachers about seizures, the teachers role-play a scenario involving a child experiencing a generalized tonic-clonic seizure. Which of the following actions, when performed first, indicates that the nurse's teaching has been successful? 1. Asking the other children what happened before the seizure. 2. Moving the child to the nurse's office for privacy. 3. Removing any nearby objects that could harm the child. 4. Placing a padded tongue blade between the child's teeth.

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When developing a plan of care focusing on promoting growth and development for the parents of a 6-year-old girl diagnosed with a seizure disorder, which of the following would the nurse expect to include? 1. Need for activity limitation and inability to perform as others do in the child's class. 2. Existence of a learning disability and need for tutoring to help the child reach her grade level. 3. Most often, demonstration of normal intelligence and ability to attend regular school. 4. Problems associated with social stigma and inability to attend public school.

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When positioning the neonate with an unrepaired myelomeningocele, which of the following positions would be most appropriate? 1. Supine with the hips at 90-degree flexion. 2. Right side-lying position with the knees flexed. 3. Prone with hips in abduction. 4. Semi-Fowler's position with chest and abdomen elevated.

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Which of the following statements by the mother of an infant with a repaired upper lumbar myelomeningocele indicates that she understands the nurse's teaching at the time of discharge? 1. "I can apply a heating pad to his lower back." 2. "I'll be sure to keep him away from other infants." 3. "I will call the doctor if his urine has a funny smell." 4. "I will prop him with pillows to prevent him from rolling over."

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Which of the following would alert the nurse initially to suspect hydrocephalus in an infant who has undergone surgical repair of a myelomeningocele? 1. Seizures and vomiting. 2. Frontal bossing and sunset eyes. 3. Increased head circumference and bulging fontanel. 4. Irritability and shrill cry.

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Which of the following would alert the nurse to suspect a physical problem commonly associated with Down syndrome? 1. Weight loss. 2. Irregular heart rate. 3. Rapid respirations. 4. Increased blood pressure.

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Which of the following would the nurse do when providing postoperative nursing care to a child after insertion of a ventriculoperitoneal shunt? 1. Administer narcotics for pain control. 2. Check the urine for glucose and protein. 3. Monitoring for increased temperature. 4. Test cerebrospinal fluid leakage for protein.

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The nurse discusses with the parents how best to raise the IQ of their child with Down syndrome. Which of the following would be most appropriate? 1. Serving hearty, nutritious meals. 2. Giving vasodilator medications as prescribed. 3. Letting the child play with more able children. 4. Providing stimulating, nonthreatening life experiences.

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The nurse evaluates the discharge teaching as successful when the parents of a school-aged child with a ventriculoperitoneal shunt insertion identify which of the following as signaling a blocked shunt? 1. Decreased urine output with stable intake. 2. Tense fontanel and increased head circumference. 3. Elevated temperature and reddened incisional site. 4. Irritability and increasing difficulty with eating.

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After talking with the parents of a child with Down syndrome, which of the following would the nurse identify as appropriate? 1. Encouraging self-care skills in the child. 2. Teaching the child something new each day. 3. Encouraging more lenient behavior limits for the child. 4. Achieving age-appropriate social skills.

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The mother of a newborn with myelomeningocele asks ifh e rbabyis likelyt o have any other defects. The nurse responds based on the understanding that myelomeningocele is frequently associated with which of the following? 1. Excessive cerebrospinal fluid within the cranial cavity. 2. Abnormally small head. 3. Congenitalabsence of the cranial vault. 4 . Overriding ofthe cranial sutures.

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The parents of a child with occasional generalized seizures want to send the child to summer camp. The parents contact the nurse for advice on planning for the camping experience. Which of the following activities would the nurse and family decide is most important for the child to avoid? 1. Rock climbing. 2. Hiking. 3. Swimming. 4. Tennis.

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The parents of an infant with myelomeningocele ask the nurse about their child's future mental ability. 1. "About one-third are mentally retarded, but it's too early to tell about your child." 2. "About two-thirds are significantly retarded, and you'll know soon if this will occur." 3. "Your child will probably be of normal intelligence since he demonstrates signs of it now." 4. "You'll need to talk with the doctor about that, but you can ask later."

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When assessing a newborn admitted to the pediatric unit with upper lumbar myelomeningocele, which of the following would the nurse anticipate finding? 1. Minimal movement of the lower extremities. 2 . Upper extremity paralysis. 3. Urinary bladder prolapse. 4. Respiratory problems.

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When assessing a toddler with near-drowning, which of the following acid-base imbalances would the nurse expect to find? 1. Respiratory acidosis and metabolic acidosis. 2. Respiratory acidosis and metabolic alkalosis. 3. Respiratory alkalosis and metabolic acidosis. 4. Respiratory alkalosis and metabolic alkalosis.

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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 of the following actions would be most appropriate? 1. Feeding the infant just before doing any procedures. 2. Giving the infant small, frequent feedings. 3. Feeding the infant in a horizontal position. 4. Scheduling the feedings for every 6 hours.

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During the acute stage of meningitis, a 3-year-old child is restless and irritable. Which of the following would be most appropriate to institute? 1. Limiting conversation with the child. 2. Keeping extraneous noise to a minimum. 3. Allowing the child to play in the bathtub. 4. Performing treatments quickly.

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The nurse caring for a toddler just admitted with the diagnosis of near-drowning in a neighbor's swimming pool is most concerned about which of the following? 1. Hypothermia. 2. Hypoxia. 3. Fluid aspiration. 4. Cutaneous capillary paralysis.

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The parents of a child tell the nurse that they feel guilty because their child almost drowned. Which of the following remarks by the nurse would be most appropriate? 1. "I can understand why you feel guilty, but these things happen." 2. "Tell me a little bit more about your feelings of guilt." 3. "You should not have taken your eyes off of your child." 4. "You really shouldn't feel guilty; you're lucky because your child will be all right."

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When interviewing the parents of a 2-year-old child, a history of which of the following illnesses would lead the nurse to suspect pneumococcal meningitis? 1. Bladder infection. 2. Middle ear infection. 3. Fractured clavicle. 4. Septic arthritis.

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When developing the discharge plan for the parents of an infant who has undergone a myelomeningocele repair, which of the following would the nurse include as most important? 1. A list of available hospital services. 2. Schedule for daily home health care. 3. Chaplain referral for psychological support. 4. Daily care required by the infant.

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