Chapter 13 peds sensory and neurological disorders

The nurse is collecting information about a school-age patient brought to a pediatric clinic by a parent. The parent reports several incidences of syncope. Which assessment question helps the nurse to identify a possible diagnosis of vasovagal syncope? 1. "Has your daughter been diagnosed with diabetes mellitus?" 2. "Did your child feel strange and faint after standing up?" 3. "Was your child in a stressful situation before fainting?" 4. "Does your daughter have any cardiac conditions?"

2

What should the nurse anticipate when reviewing laboratory results of a patient with Guillain-Barre syndrome? 1. Elevated CBC 2. High protein in a cerebral spinal fluid tap 3. Creatinine phosphokinase elevated 4. Sensory nerve conduction time increased

2

Night terrors can occur in adolescents because of: 1. Emotional stress. 2. Alcohol use. 3. Bullying. 4. All of the above can trigger night terrors in adolescents.

4

A parent reports that her child experiences episodes where he appears to be staring into space. This behavior is characteristic of which type of seizure? 1 absence 2 akinetic 3 myoclonic 4 complex partial

1

A third-grade teacher discusses behavioral problems with a student. The teacher states, "He walks around class making horrible sucking noises. He does not respond to me." Which information does the nurse seek from the student's parents? 1. Ask if the student has been tested by a physician for seizure disorder. 2. Inquire if the student is either diagnosed or medicated for ADHD. 3. Ascertain if the student has experienced recent illness or a fever. 4. Suggest the student be screened for possible developmental delays.

1

An 18 month old is having a seizure when the nurse is assessing him. The nurse notes that the child is fluttering his eyes and smacking his lips. The nurse should document this seizure as: 1. An absence seizure. 2. A tonic-clonic seizure. 3. A myoclonic seizure. 4. A febrile seizure.

1

The assessment finding that should be reported immediately if observed in a child with meningitis is: 1 irregular respirations 2 tachycardia 3 slight drop in bp 4 elevated temp

1

The nurse, caring for a 3-year-old child with meningitis, should be alert for which signs and symptoms of increased intracranial pressure? Select all that apply. 1) Vomiting 2)Headache 3)Irritability 4)tachypnea 5) Hypotension

1) Vomiting 2)Headache 3)Irritability

A parent brings an infant to the pediatric clinic and expresses concern about irritability and poor feeding, along with recent symptoms of flu lasting a few days. The nurse notices multiple raised mosquito bites on the infant. Which additional knowledge causes the nurse to suspect encephalitis? Select all that apply. 1. A recent local outbreak of West Nile fever 2. Bulging fontanels when in a quiet state 3. Signs of facial and eyelid weakness 4. Loss of deep tendon reflexes 5. Drooling instead of swallowing saliva

12

The nurse assesses the hydrocephalic child for increasing ICP, which would be manifested by: SATA 1 high-pitched cry 2 inequality of pupils 3 bulging fontanelles 4 diarrhea 5 strabismus

123

A neonate was born to a 28-year-old mother with an uneventful pregnancy two hours ago. The baby was delivered via cesarean section and taken directly to the neonatal intensive care unit because of an encephalocele. The mother is coming to see the baby. The nurse should: 1. Be prepared to answer questions about the babys care and condition. 2. Leave the room and give the family time with the neonate. 3. Prepare the mother prior to entering the room about the dysmorphic features and discuss the supportive care being provided. 4. Not let the mother see the child at this point.

3

A newborn was just admitted to the NICU with a meningomyelocele. The priority for the preoperative nursing care of this newborn is to protect the sac by: 1 keeping the sac dry 2 diapering snugly 3 positioning prone in an incubator 4 moving from side to side every hour

3

The nurse is performing a developmental assessment on a toddler at age 3 years. The nurse notices a variety of mixed developmental milestones that have been missed during the visit. Which delay does the nurse expect to be of greatest concern to the parent? 1. Difficulty putting small objects into a bottle 2. An inability to kick a ball back to the nurse 3. Difficulty with and reluctance to self-dress 4. An inability to express needs with language

4

The staff development trainer is preparing orientation materials for a new staff hired to care for patients with seizure disorders. Which type of seizure can occur in any age group? SATA 1 absence 2 myoclonic 3 tonic-clonic 4 simple partial 5 complex partial

234

The nurse in a pediatric unit is providing care for a 2-month-old infant just diagnosed with spinal muscle atrophy. Which characteristics of the condition does the nurse expect to find during physical assessment? Select all that apply. 1. Hyperreflexia in deep tendons 2. Few spontaneous movements 3. Deep, rapid respirations 4. Fasciculations of the tongue 5. Proximal muscle atrophy

24

A child is admitted to the hospital because she had a seizure. Her parents report that for the past few weeks she has had headaches that are worse in the morning with vomiting. The nurse would suspect: 1 meningitis 2 ryes syndrome 3 brain tumor 4 encephalitis

3

A neonate is born with anencephaly. The prognosis for a neonate with this condition is: 1. A normal outcome. 2. A high risk for hydrocephaly. 3. Can be death. 4. Mental handicap.

3

The nurse is planning care for a patient with meningitis. What teaching material should be prepared to explain the prescribed treatment for this disorder? 1 fluid restriction 2 low-fat, low-calorie diet 3 OTC analgesics 4 long-term ABX therapy

4

A parent brings a child who is 8 years of age to the pediatric clinic and tells the nurse, "I think he has Tourette's syndrome. He recently began some eye-blinking and grimacing actions." Which information does the nurse provide to help the parent distinguish between transient tic of childhood and Tourette's syndrome? 1. Vocal tics frequently become chronic in children with transient tic of childhood diagnosis. 2. Transient tic of childhood begins with a high level of tic activity and usually disappears completely by age 12. 3. Tourette's syndrome is a disorder of complex motor and vocal tics that have been present for more than 1 year. 4. Tourette's syndrome is a disorder of complex motor and vocal tics that develop between the ages of 3 to 8 years

3

A patient with meningitis is prescribed a cooling blanket. What should the nurse explain as being the purpose of this device? 1 relieves pain 2 increases cerebral venous outflow 3 decreases oxygen demand in the brain 4 reduces the transmission of the infection

3

After feeding a baby with hydrocephalus, the nurse will take special care to: 1 sit the baby upright in an infant seat 2 place the baby over the shoulder to burp 3 leave the baby in a side-lying position 4 stimulate the baby by rubbing its feet

3

Identify a therapeutic management technique for a child with a tic disorder. 1. Behavioral modification to suppress the tics 2. Administer anti-psychotic medications to reduce the tics 3. Education and support for the child and the family 4. Genetic counseling for the family

3

Identify the false statement about bacterial meningitis. 1. Bacterial meningitis can be fatal if not treated. 2. Bacterial meningitis can spread quickly. 3. Bacterial meningitis cannot be effectively treated with antibiotics. 4. Bacterial meningitis can cause hearing loss in children.

3

Results from cerebrospinal fluid that was tested for meningitis have been received by the nurse. The results indicate bacterial meningitis. The nurse knows this because the results show: 1. A low protein count and a low glucose count. 2. A low red blood cell count. 3. An elevated protein count and a low glucose level. 4. A normal protein count and a high glucose count.

3

The nurse caring for a child with Duchennes muscular dystrophy notes a characteristic manifestation, which is that the child: 1 ambulates by holding onto furniture 2 exhibits atrophy of the calf muscles 3 falls frequently and is clumsy 4 has delayed fine-motor development

3

When speaking with a family about their 9-year-old daughters nightmares, it is important to ask: 1. If the child has a history of daytime napping. 2. What medications the child takes during the day. 3. How often the child consumes caffeine. 4. All of the above should be part of the assessment.

4

A quality of a partial seizure is: 1. Status epilepticus. 2. Tonic movements. 3. Fluttering eyelids. 4. Clonic movements.

4

Identify a true statement about Tourettes Syndrome (TS) is that: 1. Manifestations rarely change once developed. 2. Children with TS do not have obsessive compulsive disorders. 3. The tics of TS can lead to mental deterioration. 4. The tics are involuntary, and the person cannot control the behavior.

4

In the neural tube defect spina bifida, which of the following problems can the nurse expect the child to exhibit? 1. Problems walking 2. Partial or complete paralysis of the legs 3. Problems with bowel or bladder control 4. All of the above

4

A child that had a shunt placed four years ago for hydrocephalus is in the emergency room complaining of a rapid onset of vomiting and increased lethargy. The nurse knows that the child will need: 1. Nothing, as this is a normal complication and not an emergency. 2. To be placed on IV fluids to help maintain an electrolyte balance. 3. Small amounts of fluids until the vomiting has subsided. 4. To consider this a neurological medical emergency and check the childs head circumference.

4

A patient with guillain-barre syndrome asks how the illness develops. What should the nurse respond about the pathophysiology of the disorder? 1 an infection eats away at the nerve endings 2 an infection enters the spinal cord and erodes the nerves at the roots 3 the nerves are killed by infiltration of your body's WBC used to fight an infection 4 after an infection your immune system created antibodies that affect the covering of the nerves

4

An adolescent has just had a generalized seizure and collapsed in the school nurse's office. When should the nurse should call 911? a. The seizure lasts more than 5 minutes. b. The child is sleepy and lethargic after the seizure. c. The child fell at the onset of the seizure. d. The child is confused and has slurred speech after the seizure.

A If there are multiple seizures or if seizures last more than 5 minutes, call 911 because these are indicators of possible status epilepticus, a medical emergency.

What will the nurse include then documenting a grand mal seizure? (Select all that apply.) a. Presence of incontinence b. Current dose of antispasmodic medication c. Activity level prior to and following seizure d. Level of consciousness following seizure e. Length of seizure

A, C, D, E Documentation on a seizure should include LOC following episode, activity prior to and following seizure, change in color, respiration, muscle tone, and length of seizure. Reporting of medication regimen is not necessary.

A 13-month-old child is undergoing lumbar puncture for confirmation of a diagnosis of bacterial meningitis. During the procedure the nurse notes that the spinal fluid is cloudy. What does this finding indicate?

Increased white blood cell (WBC) count

A child that has rhythmic, repetitive, involuntary movements is exhibiting: 1. Tremors. 2. Dystonia. 3. Contractures. 4. Tics.

ANS: 2 Feedback1. Tremors are involuntary and have random movements.2. Twisting and repetitive, involuntary movements are common with dystonia.3. Contractures can be a permanent placement of the body because of muscle and ligament rigidity.4. Tics are not rhythmic in nature.

A parent reports that her child has begun to do poorly at school and experiences episodes where he appears to be staring into space. Of which type of seizure is this behavior a characteristic? a. Absence b. Akinetic c. Myoclonic d. Complex partial

ANS: A Absence seizures are characterized by transient loss of consciousness where the child appears to stare blankly, and may last only a few seconds.

Which type of seizure occurs during childhood and adolescence and rarely continues after adolescence?

Absence

Somatic nervous system has two nerves. What are they and what do they do?

Afferent nerves-carry info from receptors in the body to the brain Efferent nerves-carry info from brain to the body

An infant is found to have cerebral palsy (CP) several months after birth. When the infant is 10 months old the mother comes to the pediatric clinic because the child has begun to exhibit slow writhing movements. The nurse explains that these movements are characteristically associated with what type of CP?

Athetoid

PNS contains which two systems?

Autonomic nervous system-involuntary Somatic nervous system-voluntary

What is an appropriate nursing action when a child is experiencing a generalized tonic-clonic seizure? a. Guide the child to the floor if the child is standing, and then go for help. b. Move objects out of the child's immediate area. c. Stick a padded tongue blade between the child's teeth. d. Manually restrain the child.

B During a generalized tonic-clonic seizure, the immediate area is cleared to protect the child from injury.

The nurse is observing an infant who may have acute bacterial meningitis. Which finding might the nurse look for?

Irritability, fever, and vomiting

A child is admitted to the hospital. The parents stated that the child has been complaining of headaches, malaise, muscle aches, and nausea/vomiting. They also notice the child is uncomfortable around bright lights and has trouble twisting their head to look around. The parents are very concerned because they said these symptoms came from nowhere because their child was fine before these symptoms appeared. What type of meningitis do you suspect this child has?

Bacterial Meningitis

An infant is admitted to the hospital. The parents stated that the infant has been irritable, vomiting and eating poorly in the last day. They also say the infant has been crying strangely. Upon assessment you notice that the soft spot on the infant's head is abnormally swollen. What type of meningitis do you suspect this infant has?

Bacterial Meningitis

The nurse urges the mother of a 6-month-old to get her child inoculated with Haemophilus influenzae type B. What does this immunization protect against? a. Encephalitis b. Influenza c. Bacterial meningitis d. Otitis media

C H. influenzae type B and conjugated pneumococcal vaccines have decreased the incidence of bacterial meningitis.

A child becomes cyanotic during a generalized tonic-clonic seizure. What is the most appropriate action by the nurse while the patient is seizing?

Continuing to observe the seizure

For how long should a nurse maintain isolation of a child with bacterial meningitis?

For 48 hours after antibiotic therapy begins

The child with duchennes muscular dystrophy must push on his legs and walk up the leg in order to rise to a standing position. The nurse recognizes this characteristic behavior as _________ maneuver.

Gowers

Which signs/symptoms are characteristics of brain tumors in children? (Select all that apply.) Headache upon awakening Projectile vomiting Seizure activity Decreased blood pressure

Headache upon awakening Projectile vomiting Seizure activity

A 2-year-old toddler is admitted to the pediatric unit with a diagnosis of bacterial meningitis. What is the most important safety measure for the nurse to institute immediately after the child has a seizure?

Place the child in a side-lying position

A child sitting on a chair in a playroom starts to have a tonic-clonic seizure with a clenched jaw. What is the best initial action by the nurse?

Placing the child on the floor

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

Positive Kernig sign

The nurse notes that a 3-year-old child in a crib has a clamped jaw and is having a tonic-clonic seizure. What is the priority nursing responsibility at this time?

Protecting the child from self-injury

A nurse is caring for a 2-year-old child with meningitis. For which clinical manifestations of increasing intracranial pressure should the nurse assess the child? Select all that apply. Seizures Vomiting Bulging fontanels Subnormal temp Decreased RR

Seizures Vomiting Decreased RR

A nurse is caring for a school-aged child who has had a tonic-clonic seizure. How should the nurse describe the clonic phase?

Spasmodic body jerking

The nurse is interviewing the caregivers of a child brought to the emergency unit. The caregiver states, "She has a history of seizures but this time it lasted more than 30 minutes and she just keeps having them." The most accurate description of this child's condition would be

The child is in status epilepticus.

Neurofibromatosis Type 1 is the most common neurofibromatosis in children. True or False

True

A child is admitted to the hospital. The parents stated that their son has been complaining of headaches, with nausea and vomiting. They said their son was just getting over an upper respiratory infection when these new symptoms occurred. What type of meningitis do you suspect this child has?

Viral Meningitis

A new nurse is caring for a child who had a ventriculoperitoneal shunt placed 2 days ago for hydrocephalus. Which action by the new nurse causes the experienced nurse to intervene? A. Administers IV antibiotics B. Asks for medication to treat nausea C. Palpates the shunt tract with assessments D. Raises the head of the bed to 30°

b

A nurse is caring for an 8-year-old with Guillain-Barré Syndrome (GBS). On hourly rounds, the nurse assesses that the child's lung sounds are diminished, respiratory rate is 8 breaths/min and shallow, and pulse oximeter is 88%. What action by the nurse takes priority? A. Administer high-flow oxygen by mask. B. Call the rapid response team; prepare for intubation. C. Encourage the patient to take slow, deep breaths. D. Have the patient use the incentive spirometer.

b

What is the cause of athetoid cerebral palsy in infants?

birth asphyxia

A nurse in a well-child clinic notes that a 5-month-old is not able to hold her head up. Which action by the nurse is the most appropriate? A. Ask about other developmental milestones . B. Document the finding in the child's chart. C. Measure the child's head circumference. D. Obtain the child's length and weight.

c

Obstruction within the ventricles of the brain or inadequate reabsorption of CSF may be responsible for the occurrence of: 1 meningitis 2 meningocele 3 spina bifida occulta 4 hydrocephalus

4

The nurse instructs the parents of a child with Guillain-Barré syndrome on care that will be needed once the child is discharged home. Which statement made by the parents indicates that teaching has been effective?

"Our child might experience weakness even after recovering from the illness."

The nurse explains that febrile seizures: 1 Occur when the body temp exceeds 103 2 can be prevented by anticonvulsant medication 3 usually lead to the development of epilepsy 4 occur when the temp rises quickly

4

During an assessment the nurse suspects that patient should be evaluated for myasthenia gravis. What did the nurse assess to make this clinical determination? SATA 1 Ptosis 2 diplopia 3 abdominal pain 4 left leg weakness 5 epigastric burning

12

The NICU nurse is providing care for a neonate exhibiting manifestations of congenital Zika syndrome. Which distinct features does the nurse associate with the syndrome? Select all that apply. 1. Partially collapsed skull 2. Decreased brain tissue 3. Damage to the back of the eyes 4. Multiple joint contractures 5. Agitated body movement

12345

The nurse caring for a child with infectious meningitis, would include in the care: SATA 1 isolation precautions 2 provision of dimly lit room 3 observation for increasing intercranial pressure 4 preparation for spinal tap 5 seizure precautions

12345

A 9 month old is admitted to the pediatric unit for seizures of unknown origin. The child has an EEG performed for several hours. The EEG notes several seizures occurring at different intervals. The nurse knows this child: 1. Will develop at the same rate as his peers. 2. May have severe mental and physical challenges due to the frequent seizure activity. 3. May exhibit a slight cognitive delay as he grows. 4. Will grow out of having seizures

2

A child had a generalized tonic-clonic seizure that lasted 90 seconds. After a generalized tonic-clonic seizure, the nurse would expect that the child might be: 1 restless 2 sleepy 3 nauseated 4 anxious

2

A client is diagnosed with myasthenia gravis. What should the nurse explain about this disease process? 1 your nerve endings are worn out 2 your body does not recognize the neurotransmitter needed for movement 3 your body does not make enough of the neurotransmitter needed for movement 4 your nerves have lost their protective covering and impulses cannot reach body areas

2

The nurse caring for an infant with hydrocephalus would take special precaution to: 1 align the limbs 2 support the head 3 keep the head lower than the hips 4 check intake and output

2

When assessing a 10-year-old child with myasthenia gravis, the nurse notes ptosis and drooping facial expressions. The nurse knows this disease will require all of the following except: 1. Supportive care, as there is no cure for the disease. 2. Administering beta blockers to improve the muscle tone. 3. Check the child for a depressive state due to body image issues. 4. Explain procedures to the child as needed and provide emotional support.

2

Which is the following is not a characteristic of Tourettes Syndrome? 1. Complex motor tics 2. The child is unaware of his/her behavior 3. Present for more than one year 4. Present before the 18th birthday

2

The nurse in the emergency department of a pediatric hospital is providing care for a toddler with a sudden high fever. The parent states, "She has been grumpy all day and I thought she just needed a nap." Which finding does the nurse recognize as an indication of an immediate medical emergency? 1. The toddler keeps eyes closed or covered at all times. 2. The nurse elicits a positive Brudzinski's sign. 3. A rash of scattered red bumps is found on the skin. 4. The toddler cries when head and neck are moved.

3

The nurse is identifying the difference between primary headaches to secondary headaches. Secondary headaches can occur: 1. Because of stress. 2. In relation to low blood pressure. 3. Because of concussions. 4. Because of migraines.

3

The nurse is performing well-baby checks in a pediatric clinic. During physical examination of a 1-month-old infant, the nurse notices a dimple with a tuft of hair in the lumbar sacral area indicative of spina bifida. Which developmental delays does the nurse expect for this infant? 1. There may be issues related to bowel and bladder control. 2. Some degree of paralysis of the lower limbs is expected. 3. The infant is not expected to experience physical delays. 4. Muscles of the legs will be flaccid with some sensory loss.

3

The nurse observes that the legs of a child with cerebral palsy cross involuntarily, and the child exhibits jerky movements with his arms as he tries to eat. The nurse recognizes that he has which type of cerebral palsy? 1 athetoid 2 ataxic 3 spastic 4 mixed

3

The nurse uses a diagram to show that when the CSF is obstructed in the subarachnoid space rather than in the ventricles, the resulting hydrocephalus is diagnosed at ___________ hydrocephalus.

communicating

During assessment of a 6-year-old child with meningitis, the nurse places the child supine and attempts to put the child's chin on her chest. The child cries out in pain and flexes her knees. How does the nurse document this assessment finding in the medical record? A. Absent Moro reflex B. Exaggerated Grey-Turner sign C. Negative Kernig sign D. Positive Brudzinski sign

d

A 2-year-old toddler is admitted with a fever of 103 F (39.4 C), stiffness of the neck, and general malaise and diagnosed with acute bacterial meningitis. What is the priority nursing intervention for this child?

initiating droplet precautions

The parents of a school-aged child with fever, headache, and a stiff neck ask that the child be tested for meningitis. Which test should the nurse tell the parents is used to confirm the diagnosis of meningitis?

lumbar puncture

The nurse clarifies to the parents of a child with spina bifida that their child has a portion of the spinal cord in the sac, in addition to the meninges, which makes this defect a _________.

meningomyelocele

What are the symptoms of increased intracranial pressure in infants and children? 1. Vomiting, sunsetting eyes, lethargy 2. Vomiting, irritability, decline in academic performance 3. Headache, diarrhea, insomnia 4. Excitability, anorexia, regression in language skills

1

Which is true about microcephaly? 1. Microcephaly is defined as the condition when the circumference of the head is more than two standard deviations below normal. 2. Microcephaly is defined as the condition when the circumference of the head is more than three standard deviations below normal. 3. Microcephaly is defined as the condition when the circumference of the head is more than one standard deviation below normal. 4. Microcephaly is defined as the condition when the circumference of the head is more than two standard deviations above normal.

1

Which of the following is a symptom of tension headaches? 1. A feeling of tightness or pressure around the head 2. Unilateral throbbing or pounding head pain 3. Nausea, vomiting, anorexia 4. Sensitivity to light and/or noise

1

Which of the following is not true about sleepwalking? 1. Sleepwalking occurs in REM sleep. 2. Sleepwalking tends to run in families. 3. When sleepwalking, a child looks awake and his/her eyes are open. 4. Sleepwalking is most common between the ages of 4 and 8.

1

A multidisciplinary meeting is being conducted for a 4-year-old boy with cerebral palsy. A goal for managing this childs condition would be: 1. Assistance with motor control of voluntary muscles. 2. Maximizing the childs capabilities. 3. Surgically correcting deformities. 4. Waiting to place the child in school.

2

A patient has been experiencing a tonic-clonic seizure for 5 min. What should the nurse do first? 1 assess carotid pulse 2 prepare to insert an airway 3 provide rescue breathing 4 insert an IV access line

2

The nurse has developed a nursing plan for the care of a 6-year-old girl with congenital hydrocephalus whose shunt has become infected. The most important discharge teaching point for this family is

ensuring the parents know how to properly give antibiotics.

An adolescent has just had a generalized seizure lasting 1 min. Following the seizure, the nurse should: 1 help the patient to sit upright 2 turn on the side 3 offer ice chips 4 assist to ambulate

2

Brian, a 4-year-old boy, is demonstrating the Gowers sign, and his mother is wondering why her child is making this movement. The child is doing this because: 1. The weakness of his arms requires his legs to do more work. 2. The weakness in his hips and thighs requires help from his arms to stand. 3. Weakening trunk and back muscles require the legs and arms to help keep an upright position. 4. Weakening of the trunk requires this movement to help breath.

2

During morning care a patient with a seizure disorder asks why the room has suddenly turned green. What should the nurse do? 1 ask the patient to explain 2 prepare for a seizure to begin 3 turn on the overhead room lights 4 document visual hallucinations present

2

Hydrocephalus occurs when cerebrospinal fluid collects in an abnormal pattern in the brain, causing an enlargement in the ventricles. What feature of young infants helps to compensate for the increased pressure caused by the collection of the cerebrospinal fluid? 1. They are too young to perceive pain. 2. They have open fontanels and sutures in the skull to allow for the expansion of the fluid. 3. Infants grow quickly, so the ventricles accommodate for the fluid. 4. All of the above

2

Migraine headaches in children can be debilitating and can be triggered by all of the following except: 1. Too much or too little sleep. 2. Overhydration. 3. Skipping meals. 4. Unusual stress or the childs inability to cope with stressors.

2

Questions about neurological function are raised when a child: 1. Snores. 2. Shows aggression when previously none was shown. 3. Wants attention from a parent. 4. Refuses to follow adult instruction.

2

The assessment a nurse performed on a 12-year-old boy demonstrated a positive Kernigs sign and a Brudzinskis sign. Identify the priority for the nurses next action. 1. Document the findings and note as normal. 2. Further assess the neurological function of the child and call the doctor with a report. 3. Explain to the patient that the assessment was abnormal and there is no a cause for concern. 4. Prepare the child for a lumbar puncture.

2

The nurse is gathering health information on a child who is 8 years of age. The parent reports the child is extremely difficult to wake in the morning. Which other information will prompt the nurse to recommend screening for a sleep disorder? 1. The bedroom is shared with a sibling. 2. The nurse validates the child is obese. 3. There is a TV in the child's bedroom. 4. It is difficult to get the child to bed.

2

The pediatric nurse is examining the skin of a young child and notices eight café-au-lait spots between 1.5 and 3 inches in diameter on the body, along with axillary freckling. Which recommendation does the nurse make to the parent? 1. Refrain from having additional children without counseling. 2. Make an appointment with a physician for testing and evaluation. 3. Agree to blood testing of the child to identify a defect in the NF1 gene. 4. Arrange for psychological therapy to address self-esteem problems.

2

When a child is experiencing a generalized tonic-clonic seizure, an appropriate nursing action would be to: 1 guide the child to the floor if the child is standing, and then go for help 2 move objects out of the childs immediate area 3 stick a padded tongue blade between the childs teeth 4 manually restrain the child

2