N306_neurological

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? "I will watch my baby for irritability and difficulty feeding." "My baby's cerebrospinal fluid (CSF) is increasing intracranial pressure (ICP)." "The VP shunt will help drain fluid from my baby's brain." "This shunt is the only surgery my baby will need."

"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 will report any changes in behavior or signs of infection immediately." "We expect our child to continue engaging in normal activities, including sports." "The shunt will need to stay in place for the rest of our child's life." "The shunt may need to be repositioned as our child grows."

"We expect our child to continue engaging in normal activities, including sports." The nurse should intervene if the parents expect the child to engage in sports. The nurse will need to determine which type of sports the child will engage in. A child with a VP shunt should avoid contact sports such as football because of the risk of shunt damage. The parents should report any changes in behavior or signs of infection immediately so that treatment can begin promptly. VP shunts are typically needed for life and have the potential to become displaced as the child grows.

The nurse is collecting data from a child who may have a seizure disorder. Which nursing observations suggest an absence seizure? Sudden, momentary loss of muscle tone, with a brief loss of consciousness Muscle tone maintained and child frozen in position Brief, sudden contracture of a muscle or muscle group Minimal or no alteration in muscle tone, with a brief loss of responsiveness or attention

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

The parents of a toddler have just learned that their child has profound hearing loss. The parents are very upset and state to the nurse, "It just isn't fair. We did everything right during our pregnancy all the way to this point." How should the nurse respond? "I can't imagine how difficult this must be. When you're ready I would be happy to arrange a meeting with a support group of other parents with children who have hearing loss." "Even when we do the right thing, it doesn't always ensure that our child will be healthy. It's important to think positively." "There could be much worse things to happen to your child. At least your child is healthy in all other aspects." "Many children who have a profound hearing loss function very well. There are lots of treatments available."

"I can't imagine how difficult this must be. When you're ready I would be happy to arrange a meeting with a support group of other parents with children who have hearing loss."

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? "The next time he has a fever, I need to make sure I read the dosage on the acetaminophen bottle carefully." "I need to set an alarm to wake up and check his temperature during the night when he is sick." "I hate to think that I will need to be worried about my child having seizures for the rest of his life." "When he gets his next set of immunizations, I need to make sure I give him some ibuprofen so he doesn't spike a fever."

"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 reviewing discharge planning instructions with the parents of a child who had a ventriculoperitoneal (VP) shunt placed. Which statement by the parents requires further follow-up by the nurse? "Our child may have occasional lethargy." "We will watch for changes in behavior at home." "Our child should be monitored for poor feeding." "If our child has vomiting, something may be wrong with the shunt."

"Our child may have occasional lethargy."

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? "Your child will need high doses of antibiotics to treat the infection." "We will monitor your child closely and keep your child comfortable." "Until your child improves, we cannot give your child anything to eat." "We will need to move your child to the intensive care unit for care."

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

The nurse is caring for a toddler who was just diagnosed with a hearing impairment. What would the nurse expect to assess in the child? Inability to articulate the sounds of the letter 'R' and "S" when vocalizing A delay or lack of clear, understandable speech pattern Purulent draining from one or both ears associated with pain behaviors A history of supplemental oxygen use at birth or shortly after birth

A delay or lack of clear, understandable speech pattern

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? Take vital signs every 4 hours Monitor temperature every 4 hours Decrease environmental stimulation Encourage the parents to hold the child

Decrease environmental stimulation

The nurse is preparing hospital discharge instructions for a 7-year-old girl recovering from head trauma and receiving gastrostomy feedings. Which activity is most important before the child is discharged home? Determining the parents' ability to administer the enteral feedings. Assessing the parents' emotional status. Helping the family to access financial resources. Preparing a list of home equipment and supplies needed.

Determining the parents' ability to administer the enteral feedings.

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. Refer the child to an ophthalmologist for further evaluation. Assure the parent that the scleral hemorrhages will resolve. Administer acetaminophen if needed for pain.

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

A nurse is preparing a presentation on neurologic development in children. What information should the nurse include in the presentation? Teratogens have little effect on a child's neurologic development. Poverty and caregiver mental illness are shown to contribute to developmental delays in children. Only a small portion of the body's total blood supply is needed to support cerebral metabolism in children. The ratio of body surface area to body weight is much less in children than in adults.

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

The nurse is planning care for a toddler who is diagnosed with a profound hearing loss. Which nursing diagnosis should the nurse identify as the priority once the child is discharged? Risk for injury related to hearing loss Social isolation related to effects of hearing loss Impaired verbal communication related to congenital hearing deficit Risk for parental role strain related to responsibilities of caring for sensory impaired child

Risk for injury related to hearing loss

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 Renal failure Left-sided heart failure Cardiogenic shock

cerebral edema

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 reduction in heart rate increase in heart rate decline in respiratory rate

change in level of consciousness

The nurse is performing a neurologic assessment on a 7-month-old infant. Which task should the nurse perform last? Elicit the gag reflex. Shine a penlight in each eye. Move a toy through the field of vision. Palpate the anterior fontanelle.

elicit the gag reflex

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)? Select all that apply. Babinski Moro Gag Cough Swallow

gag cough swallow

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? Phenytoin Lorazepam Fosphenytoin Midazolam

lorazepam

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? Complete blood count Lumbar puncture Computed tomography Magnetic resonance imaging

lumbar puncture

The previous examination noted the child to be alert but answering questions inappropriately. In this exam, the child only responds to vigorous stimuli. Which action should the nurse take first? Notify the health care provider. Have another nurse verify the results. Document the findings on the hourly assessment tool. Reassess in 1 hour.

notify the healthcare provider

A nurse has received the above hand-off report for a client hospitalized with blunt head trauma following a motor vehicle accident. What is the nurse's priority in providing care for the client? Maintain hydration. Provide pain relief. Observe for behavioral changes. Ensure adequate rest.

observe for behavioral changes

A child with a seizure disorder is being admitted to the inpatient unit. When preparing the room for the child, what should be included? Select all that apply. oxygen gauge and tubing suction at bedside tongue blade padding for side rails smelling salts

oxygen gauge and tubing suction at bedside padding for side rails

A nurse is caring for a 4-year-old child who presents to the emergency department with suspected meningitis. The nurse suspects the child has septic meningitis. Which assessment finding supports this suspicion? recent influenza infection report of a stiff neck purple skin rash presence of photophobia

purple skin rash

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? Inspect the teeth for obvious caries. Reduce the pain related to nuchal rigidity. Provide an opportunity for therapeutic play. Increase stimulation opportunities to prevent coma.

reduce the pain related to nuchal rigidity

A child has recently been diagnosed with cataracts. The treatment for cataracts is: eye drops to lower the pressure. surgery. wearing a patch until the cloudiness clears. there is no treatment for childhood cataracts.

surgery

"Your infant should be evaluated in person, because a new helmet may be needed." "It is time for your infant to stop wearing the helmet." "This is a sign of infection." "This is a normal finding after surgery; it will resolve on its own."

your infant should be evaluated in person, because a new helmet may be needed

The nurse has finished teaching the mother of a 5-year-old male diagnosed with bacterial conjunctivitis how to manage her son's infection at home. Which statement by the mother would indicate a need for further education? "I will use a warm compress to help loosen crust that accumulated on his eyelid overnight." "I will wash my hands immediately after caring for him." "I will use Visine drops in his infected eye to help reduce redness." "I will encourage my son to not touch his eyes."

"I will use Visine drops in his infected eye to help reduce redness."

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 out. The resting position of the eye is turned in. One pupil is higher than the other. The same eye deviates constantly.

The resting position of the eye is turned in.

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? Administer lorazepam IV as prescribed. Perform a glucose finger stick to determine the child's blood sugar level. Administer carbamazepine as prescribed. Observe and document the length of time of the seizure and type of movement observed.

administer lorazepam IV as prescribed