Peds: Neuro

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A nurse notes that a child is exhibiting signs of cerebral palsy. At what age are these signs usually first noticeable? 3 months 2 years 12 months 3 years

12 months

The nurse is performing a Glasgow Coma Scale on a school-age child with a head injury. The child opens eyes spontaneously, obeys commands, and is oriented to person, time, and place. Which is the score the nurse should record? 8 11 13 15

15

The nurse is creating a plan of care for a newborn infant with spina bifida (myelomeningocele type). The nurse includes assessment measures in the plan to monitor for increased intracranial pressure. Which assessment technique should be performed that will best detect the presence of an increase in intracranial pressure? Assess anterior fontanel for bulging. Check urine for specific gravity. Assess blood pressure for signs of hypotension. Monitor for signs of dehydration

Assess anterior fontanel for bulging

The hypertonicity of the muscles in an infant with cerebral palsy causes scissoring of the legs. The nurse teaches the mother that the preferred way to carry the infant is in a sitting position in what way? Wrapped tightly in a blanket Under the arm in a football hold Astride one of her hips Strapped in an infant seat

Astride one of her hips

A mother arrives at the emergency department with her 5-year-old child and states that the child fell off a bunk bed. A head injury is suspected. 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? Nausea Bradycardia Irritability Headache

Bradycardia

A school-age child with Down syndrome is brought to the ambulatory care center by the mother. The child has bruising all over the body. To work most effectively with this child, the nurse first addresses which complication associated with Down syndrome? Your text book identifies congenital heart defects among the conditions a Down syndrome child may present with. There is an important one that the text does not discuss. Do a little research outside of your text to answer this question. Children with Down syndrome fall down easily as a result of hyperflexibility and muscle weakness Children with Down syndrome are at risk for physical abuse because of their low intellectual functioning Children with Down syndrome are more likely to develop acute leukemia than the average child. Children with Down syndrome scratch themselves a lot because of dry, cracked, and frequently fissuring skin

Children with Down syndrome are more likely to develop acute leukemia than the average child.

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? Clear CSF, decreased pressure, and elevated protein level Cloudy CSF, elevated protein, and decreased glucose levels Cloudy CSF, decreased protein, and decreased glucose levels Clear CSF, elevated protein, and decreased glucose levels

Cloudy CSF, elevated protein, and decreased glucose levels

The body's thermostat, also known as the [a] is an autonomic center that regulates temperature control, appetite, blood pressure, breathing, sleep patterns, and peripheral nerve discharges.

Hypothalamus

The nurse is caring for a newborn infant with spina bifida (myelomeningocele) who is scheduled for surgical closure of the sac. In the preoperative period, which is the priority problem? Choking Inability to tolerate stimulation Delayed growth and development Infection

Infection

The nurse assists a health care provider in performing a lumbar puncture on a 3-year-old child with leukemia in whom central nervous system disease is suspected. In which position will the nurse place the child during this procedure? (See page 223.) Modified Sims' position Lateral recumbent position with the knees flexed and chin resting on the chest Lithotomy position Prone with knees flexed to the abdomen and head bent with chin resting on the chest

Lateral recumbent position with the knees flexed and chin resting on the chest

The nurse enters a child's room and discovers that the child is having a seizure. Which actions should the nurse take? Select all that apply. Loosen any restrictive clothing. Run to get the crash cart. Place an airway into the child's mouth. Turn the child on her side. Call a code. Check the child's respiratory status.

Loosen any restrictive clothing. Turn the child on her side. Check the child's respiratory status.

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? Maintain enteric precautions. Maintain neutropenic precautions. No precautions are required as long as antibiotics have been started. Maintain respiratory isolation precautions for at least 24 hours after the initiation of antibiotics.

Maintain respiratory isolation precautions for at least 24 hours after the initiation of antibiotics.

The nurse creates a plan of care for a child with Reye's syndrome. Which priority intervention should the nurse include in the plan of care? Immediately check the presence of protein in the urine. Teach the parents signs and symptoms of a bacterial infection. Reassure the parents hyperglycemia is a common symptom. Monitor for signs of increased intracranial pressure.

Monitor for signs of increased intracranial pressure.

The nurse is caring for a client who underwent surgery for a brain tumor. On assessment, the nurse suspects meningitis in the client. Which finding would help confirm the nurse's suspicion? Positive Brudzinski sign Negative Brudzinski sign Glasgow coma score:12 Absence of nuchal rigidity

Positive Brudzinski sign

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

Providing a quiet atmosphere with dimmed lighting

A nurse is caring for a child with meningococcal meningitis. What clinical finding does the nurse expect to encounter during a physical assessment? Low-grade fever Purpuric skin rash Tremors of the extremities Severe glossitis

Purpuric skin rash

The nurse is assessing for Kernig's sign in a child with a suspected diagnosis of meningitis. Which action should the nurse perform for this test? Compress the child's upper arm and assess for tetany. Raise the child's leg with the knee flexed and then extend the leg at the knee and assess for pain Bend the child's head toward the knees and hips and assess for pain. Tap the child's facial nerve and assess for spasm.

Raise the child's leg with the knee flexed and then extend the leg at the knee and assess for pain

The nurse develops a plan of care for a child at 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? Padded tongue blade Suctioning equipment and oxygen Emergency cart Tracheotomy set

Suctioning equipment and oxygen

The nurse is creating 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. Place the child in a prone position. Insert a padded tongue blade in the child's mouth. Restrain the child. Move furniture away from the child. Stay with the child. Time the seizure.

Time the seizure. Move furniture away from the child. Stay with the child.

A nurse in the pediatric clinic should be most observant for signs of cerebral palsy in a 6-month-old infant in which instance? Has a 40-year-old mother Was born during the 32nd week of gestation Was delivered by cesarean birth Was born with the Moro reflex

Was born during the 32nd week of gestation

Cerebral palsy is or is not progressively degenerative? is is not

is not

The nurse notes documentation that a child is exhibiting an inability to flex the leg when the thigh is flexed anteriorly at the hip. Which condition does the nurse suspect? Meningitis Decreased cerebral blood flow Spinal cord injury Intracranial bleeding

meningitis


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