PEDS neuro

Which order would the nurse question for a child just admitted with the diagnosis of bacterial meningitis? a) Maintain isolation precautions until 24 hours after receiving intravenous antibiotics. b) Intravenous fluids at 1 ½ times regular maintenance. c) Neurological checks every hour. d) Administer acetaminophen for temperatures higher than 38°C (100.4°F)

B

When talking with the parents of a Down syndrome child, which of the following goals would be most appropriate for the child and family? a. teaching the child one new thing every day b. encouraging self-care skills in the child c. establishing more lenient behavior standards d. achieving age-appropriate social skills

B. encouraging self-care skills in the child

An appropriate nursing action during a tonic-clonic seizure is: a. restraining flailing extremities b. placing padding between the teeth c. observing the type of movements and duration of the seizure d. placing the child in a supine or prone position

C. observing the type of movements and duration of seizure

2. Which medication should the nurse anticipate administering first to a child in status epilepticus? a) Establish an intravenous line, and administer intravenous lorazepam. b) Administer rectal diazepam. c) Administer an oral glucose gel to the side of the child's mouth. d) Administer oral diazepam.

b. admin rectal diazepam

The nurse is aware that cloudy cerebrospinal fluid (CSF) most likely indicates: a) Viral meningitis b) Bacterial meningitis c) No infection, as CSF is usually cloudy d) Sepsis

b. bacterial meningitis

Select the best room assignment for a newly admitted child with bacterial meningitis. a) Semiprivate room with a roommate who also has bacterial meningitis. b) Semiprivate room with a roommate who has bacterial meningitis but has received intravenous antibiotics for more than 24 hours. c) Private room that is dark and quiet with minimal stimulation. d) Private room that is bright and colorful and has developmentally appropriate activities available.

c. private room that is dark and quiet with minimal stimulation

a clinical manifestation of increased ICP in an infant is: a. slurred speech b. headache c. blurred vision d. bulging fontanel

d. bulging fontanel

Which nursing action should be a priority when the parents first meet their infant with an open spinal defect? a. have the parents feed the infant b. encourage discussion of fears and concerns c. provide written information reinforcing health care provider education d. emphasize the infants normal and positive features

d. emphasize the infants normal and postitive features

An expexted finding in an analysis of CSF in the child with bacterial meningitis is: a. low protein level b. cloudy appearance c. high glucose level d. increased red blood cells

B cloudy apperance

The health care provider has ordered mannitol (Osmitrol) for a child with a head injury. The best indicator that this medication has been effective is: a. increased urine output b. improved level of consciousness c. decreased facial swelling d. decreased intercranial pressure

B. improved level of consciousness

Which assessment detail is most important for the clinic nurse to make regarding a school-age child who has a sore throat, arm weakness, muscle tenderness, and generally feeling unwell? a. diet intake for last 24 hours b. exposure to illnesses c. difficulty urinating d. swallowing ability

D. swallowing ability

T/F: the appearance of the Cushing reflex is an early sign of increased ICP

f

What is not included in the Glasgow Coma Scale? a. eye opening b. motor response c. verbal response d. neurovascular status

D, neurovascular status

T/F: the progression from decerebrate to decorticate posturing indicates the deterioration of the child's condition

F

T/F: changes in a childs normal behavior are important indicators of increased ICP.

T

T/F: the pupils dilate as ICP increases

T

Which position initially is most beneficial for an infant who has just returned from having a ventriculoperitoneal (VP) shunt placed? a) Semi-Fowler in an infant seat b) Flat in the crib c) Trendelenburg d) In the crib with the head elevated to 90 degrees

b. flat in the crib

Which of the following findings would indicate to the nurse that spinal shock was resolving in an adolescent with a spinal cord injury? a. widening pulse pressure b. hyperactive reflexes c. atonic urinary bladder d. flaccid paralysis

B. hyperactive reflexes

Which change in vital signs is not associated with the Cushing reflex? a. increased systolic pressure b. decreased heart rate c. increased temperature d. irregular respiratory pattern

c. increased temperature

Before surgery, the priority for care of a newborn with a myelomeningocele is: a. preventing infection b. preserving urinary function c. promoting nutrition d. maximizing motor function

a. preventing infection

Congenital myelomeningocele is commonly associated with which of the following conditions? a. hydrocephalus b. microencephaly c. cranial suture overlap d. absence of the cranial vault

A. hydrocephalus

A newborn has a sac in the lumbosacral area containg CSF, meninges, nerve roots, and the spinal cord. This condition is referred to as: a. myelominingocele b. meningocele c. arnold chiari malformation d. spina bifida occulta

A. myelomeningocele

A child with a known seizure disorder is hospitalized for an unrelated procedure. Upon walking the child back from the restroom, the nurse notes tonic-clonic movements. Which action should the nurse take first? a. note the time b. ease the child to the floow c. clear the area of object and pad the head d. roll the child to side-lying position to protect the airway

A. note the time

If a child awakens easily but exhibits limited responsiveness, his level of consciousness is described as a. confused b. disoriented c. lethargic d. stuporous

C, Lethargic

A child fell off his bike and sustained a closed-head injury. The child is currently awake and alert, but his mother states that he "passed out" for approximately 2 minutes. The mother appears highly anxious and is very tearful. The child was not wearing a helmet. Which is a priority for the triage nurse to say at this time? a) "Was anyone else injured in the accident?" b) "Tell me more about the accident." c) "Did he vomit, have a seizure, or display any other behavior that was unusual when he woke up?" d) "Why was he not wearing a helmet?"

C. did he vomit, have a seizure, or display any other behavior that was unusual

Which signs best indicate increased intracranial pressure (ICP) in an infant? Select all that apply: a) Sunken anterior fontanel b) Complaints of blurred vision c) High-pitched cry d) Increased appetite e) Sleeping more than usual

C. high pitched cry e. sleeping more than usual

Which of the following is the best indicator of brain function in a child with a moderate brain injury? a. pupil response b. vital signs c. level of consciousness d. gross motor strength

C. level of consciousness

The nurse is caring for a child who has been in a motor vehicle accident (MVA). The child falls asleep unless her name is called or she is gently shaken. This state of consciousness is referred to as: a) Coma b) Delirium c) Obtunded d) Confusion

C. obtunded - child has a limited response to the environment and can be aroused by verbal or tactile stimulation

A 10-year-old child is admitted for suspected infratentorial brain tumor. During the child's admission, which action should the nurse anticipate doing first? a. implement seizure precautions b. introduce child to other children the same age c. prepare child and parents for diagnostic procedures d. eliminate the childs anxiety using distraction techniques

C. prepare child and parents for diagnostic procedures

The nurse is caring for a 1-year old who has just been diagnosed with viral encephalitis. The parents ask if their child will be admitted to the hospital. Select the nurse's best response. a) "Your child will likely be sent home because encephalitis is usually caused by a virus and not bacteria." b) "Your child will likely be admitted to the pediatric floor for intravenous antibiotics and observation." c) "Your child will likely be admitted to the PICU for close monitoring and observation." d) "Your child will likely be sent home because she is only 1 year old. We see fewer complications and a shorter disease process in the younger child."

C. your child will likely be admitted to the PICU for close monitoring and observation

A child with a verticuloperitoneal (VP) shunt complains of headache and blurry vision and now experiences irritability and sleeping more than usual. The parents ask the nurse what they should do. Select the nurse's best response. a) "Give her some acetaminophen, and see if her symptoms improve. If they do not improve, bring her to the pediatrician's office." b) "It is common for girls to have these symptoms, especially prior to beginning their menstrual cycle. Give her a few days, and see if she improves." c) "You are probably worried that she is having a problem with her shunt. This is very unlikely as it has been working well for 9 years." d) "You should immediately take her to the emergency room as these may be symptoms of a shunt malfunction."

D: you should immediately tae her to the ER as these may be symptoms of a shunt malfunction

What notable sign may indicate increased intercranial pressure in an infant? a. overflow voiding b. bulging fontanel when crying c. high-pitched cry d. minimal lower exremity movement

High-pitched cry

A child diagnosed with meningitis is having a generalized tonic-clonic seizure. Which should the nurse do first? a) Administer blow-by oxygen and call for additional help. b) Reassure the parents that seizures are common in children with meningitis. c) Call a code and ask the parents to leave the room. d) Assess the child's temperature and blood pressure.

a. admin blow-by o2 and call for additional help

5. The nurse is caring for an unconscious 6-year old who has had a severe closedhead injury and notes the following changes: hear rate has dropped from 120 to 55, blood pressure has increased from 110/44 to 195/62, and respirations are becoming more irregular. Which should the nurse do first after calling the physician? a) Call for additional help, and prepare to administer mannitol. b) Continue to monitor the patient's vital signs, and prepare to administer a bolus of isotonic fluids. c) Call for additional help, and prepare to administer an antihypertensive. d) Continue to monitor the patient, and administer supplemental oxygen.

a. call for additional help, and prepare to administer mannitol

The mother of an unconscious child has been calling her name repeatedly and gently shaking her shoulders in an attempt to wake her up. The nurse notes that the child is flexing her arms and wrists while bringing her arms closer to the midline of her body. The child's mother asks, "What is going on?" Select the nurse's best response. a) "I think your daughter hears you, and she is attempting to reach out to you." b) "Your child is responding to you; please continue trying to stimulate her." c) "It appears that your child is having a seizure." d) "Your child is demonstrating a reflex that indicates she is overwhelmed with the stimulation she is receiving."

d. your child is demonstrating a reflex that indicates she is overwhelmed with the stimulation she is receiving