CGF Unit 7 Practice Questions- Neurological Disorders

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

A child recently diagnosed with epilepsy is being evaluated for anticonvulsant medication therapy. The child will likely be placed on which type of regimen? A. Two to three oral anticonvulsant medications so that dosing can be low and side effects minimized. B. One oral anticonvulsant medication to observe effectiveness and minimize side effects. C. One rectal gel to be administered in the event of a seizure. D. A combination of oral and intravenous anticonvulsant medications to ensure compliance

B

A child with Reye syndrome is described in the nurse's notes as follows: 1200—comatose with sluggish pupils; when stimulated, demonstrates decerebrate posturing. 1400—unchanged except that now demonstrates decorticate posturing when stimulated. The nurse concludes that the child's condition is: A. Worsening and progressing to a more advanced stage of Reye syndrome. B. Worsening, and the child may likely experience cardiac and respiratory failure. C. Improving and progressing to a less advanced stage of Reye syndrome. D. Improving as the child's posturing reflexes are similar.

C

The parents of a child with cerebral palsy (CP) are learning how to feed their child and avoid aspiration. The nurse would question which of the following when reviewing the teaching plan? A. Place the food on the tip of the tongue. B. Place the child in an upright position during feedings. C. Feed the child soft and blended foods. D. Feed the child slowly

A

The nurse knows that young infants are at risk for injury from shaken baby syndrome(SBS) because: A. The anterior fontanel is open. B. They have insufficient musculoskeletal support and a disproportionate head-to-body ratio. C. They have an immature vascular system with veins and arteries that are more superficial. D. The nurse knows there is immature myelination of the nervous system in a young infant.

B

Which is the best action for the nurse to take during a child's seizure? A. Administer the child's rescue dose of oral Valium (diazepam). B. Loosen the child's clothing, and call for help. C. Place a tongue blade in the child's mouth to prevent aspiration. D. Carry the child to the infirmary to call 911 and start an intravenous line.

B

The parent of an infant asks the nurse what to watch for to determine if the infant has CP. Which is the nurse's best response? A. "If the infant cannot sit up without support before 8 months." B. "If the infant demonstrates tongue thrust before 4 months." C. "If the infant has poor head control after 2 months." D. "If the infant has clenched fists after 3 months."

D

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

A child with a seizure disorder has been having episodes during which she drops her pencil and simply appears to be daydreaming. This is most likely a/an: A. Absence seizure. B. Akinetic seizure. C. Non-epileptic seizure. D. Simple spasm seizure

A

A 2-month-old infant is brought to the emergency room after experiencing a seizure.The infant appears lethargic with very irregular respirations and periods of apnea. The parents report the baby is no longer interested in feeding and before the seizure, rolled off the couch. What additional testing should the nurse immediately prepare for? A. Computed tomography (CT) scan of the head and dilation of the eyes. B. Computed tomography (CT) scan of the head and electroencephalogram (EEG). C. X-rays of the head. D. X-rays of all long bones

A

The nurse tells a family of a child with cerebral palsy (CP) that since the 1960s the incidence of CP has: A. Increased. B. Decreased. C. Remained the same. D. Has decreased due to early misdiagnosis.

A

The parent of a toddler newly diagnosed with cerebral palsy (CP) asks the nurse what caused it. The nurse should answer with which of the following? A. Most cases are caused by unknown prenatal factors. B. It is commonly caused by perinatal factors. C. The exact cause is not known. D. The exact cause is known in every instance.

A

A preschooler has been having periods during which he suddenly falls and appears to be weak for a short time after the event. The preschool teacher asks what she should do. Select the nurse's best response. A. "Have the parents follow up with his pediatrician as this is likely an atonic seizure." B. "Find out if there have been any new stressors in his life, as it could be attention-seeking behavior." C. "Have the parents follow up with his pediatrician as this is likely an absence seizure." D. "The preschool years are a time of rapid growth, and many children appear clumsy. It would be best to watch him, and see if it continues."

A

The mother of a newborn relates that this is her first child, the baby seems to sleep a lot, and does not cry much. Which question would the nurse ask the mother? A. "How many ounces of formula does your baby take at each feeding?" B. "How many bowel movements does your baby have in a day?" C. "How much sleep do you get every night?" D. "How long does the baby stay awake at each feeding?

A

The nurse is caring for a 6-month-old infant diagnosed with meningitis. When the child is placed in the supine position and flexes his neck, the nurse notes he flexes his knees and hips. This is referred to as: A: Brudzinski sign. B. Cushing triad. C. Kernig sign. D. Nuchal rigidity.

A

The nurse is caring for a child with a skull fracture who is unconscious and has severely increased intracranial pressure (ICP). The nurse notes the child's temperature to be 104°F (40°C). Which should the nurse do first? A. Place a cooling blanket on the child. B. Administer Tylenol (acetaminophen) via nasogastric tube. C. Administer Tylenol (acetaminophen) rectally. D. Place ice packs in the child's axillary areas.

A

A child with spastic CP had an intrathecal dose of baclofen in the early afternoon.What is the expected result 31/2 hours post dose that suggests the child would benefit from a baclofen pump? A. The ability to self-feed. B. The ability to walk with little assistance. C. Decreased spasticity. D. Increased spasticity

C

To treat a common manifestation of Reye syndrome, which medication would the nurse expect to have readily available? A. Lasix. B. Insulin. C. Glucose. D. Morphine

C

A child is admitted to the pediatric unit with spastic CP. Which would the nurse expect a child with spastic CP to demonstrate? Select all that apply. A. Increased deep tendon reflexes. B. Decreased muscle tone. C. Scoliosis. D. Contractures. E. Scissoring. F. Good control of posture. G. Good fine motor skills.

A, C, D, E

The parents of a 12-month-old with cerebral palsy (CP) ask the nurse if they should teach their child sign language because he has not begun to vocalize. The nurse bases the response on the knowledge that sign language: A. May be a very beneficial way to help children with CP communicate. B. May cause confusion and further delay vocalization. C. Is difficult to learn for most children with CP. D. Is beneficial to learn, but it would be best to wait until the child is older

A

Which developmental milestone should the nurse be concerned about if a 10-month-old could not do it? A. Crawl. B. Cruise. C. Walk. D. Have a pincer grasp

A

A child with cerebral palsy (CP) has been fitted for braces and is beginning physical therapy to assist with ambulation. The parents ask why he needs the braces when he was crawling without any assistive devices. Select the nurse's best response. A. "The CP has progressed, and he now needs more assistance to ambulate." B. "As your child grows, different muscle groups may need more assistance." C. "Most children with CP need braces to help with ambulation." D. "We have found that when children with CP use braces, they are less likely to fall."

B

An infant is born with a sac protruding through the spine, containing cerebrospinal fluid(CSF), a portion of the meninges, and nerve roots. This condition is referred to as: A. Meningocele. B. Myelomeningocele. C. Spina bifida occulta. D. Anencephaly.

B

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

The nurse is doing a follow-up assessment of a 9-month-old. The infant rolls both ways, sits with some support, pushes food out of the mouth, and pushes away when held. The parent asks about the infant's development. The nurse responds by saying which of the following? A. "Your child is developing normally." B. "Your child needs to see the primary care provider." C. "You need to help your child learn to sit unassisted." D. "Push the food back when your child pushes food out."

B

The nurse is providing discharge teaching to the parents of a toddler who experienced a febrile seizure. The nurse knows clarification is needed when the mother says: A. "My child will likely have another seizure." B. "My child's 7-year-old brother is also at high risk for a febrile seizure." C. "I'll give my child acetaminophen when ill to prevent the fever from rising too high too rapidly." D. "Most children with febrile seizures do not require seizure medicine.

B

Which activity should an adolescent just diagnosed with epilepsy avoid? A. Swimming, even with a friend. B. Being in a car at night. C. Participating in any strenuous activities. D. Returning to school right away.

B

Which child is at increased risk for cerebral palsy (CP)? A. Infant born at 34 weeks with an Apgar score of 6 at 5 minutes. B. 17-day-old infant with group B streptococcus meningitis. C. 24-month-old child who has experienced a febrile seizure. D. 5-year-old with a closed-head injury after falling off a bike

B

Which child requires continued follow-up because of behaviors suspicious of cerebral palsy (CP)? A. 1-month-old who demonstrates the startle reflex when a loud noise is heard. B. 6-month-old who always reaches for toys with the right hand. C. 14-month-old who has not begun to walk. D. 2-year-old who has not yet achieved bladder control during waking hours

B

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 11/2 times regular maintenance. C. Neurological checks every hour. D. Administer acetaminophen for temperatures higher than 38°C (100.4°F).

B

Which of the following would be included in the plan of care for a hospitalized newborn following surgical repair of a myelomeningocele. Select all that apply. A. Skull x-rays. B. Daily head circumference measurements. C. MRI scan. D. Vital signs every 6 hours. E. Holding to breastfeed

B, C

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

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

The nurse is caring for a 2-month-old infant who is at risk for cerebral palsy (CP)due to extreme low birth weight and prematurity. His parents ask why a speech therapist is involved in his care. Select the nurse's best response. A. "Your child is likely to have speech problems because of his early birth. Involving the speech therapist now will ensure vocalization at a developmentally appropriate age." B. "The speech therapist will help with tongue and jaw movements to assist with babbling." C. "The speech therapist will help with tongue and jaw movements to assist with feeding." D. "Many members of the health-care team are involved in your child's care so that we will know if there are any unmet needs.

C

The nurse knows further education is needed about Reye syndrome when a mother states: A. "I will have my children immunized against varicella and influenza. B. "I will make sure not to give my child any products containing aspirin." C. "I will give aspirin to my child to treat a headache." D. "Children with Reye syndrome are admitted to the hospital."

C

The nurse prepares to administer baclofen to a child with cerebral palsy (CP) who just had her hamstrings surgically released. The child's parents ask what the medication is for. Select the nurse's best response. A. "It is a medication that will help decrease the pain from her surgery." B. "It is a medication that will prevent her from having seizures." C. "It is a medication that will help control her spasms." D. "It is a medication that will help with bladder control."

C

The parent of a young child with CP brings the child to the clinic for a checkup.Which parent's statement indicates an understanding of the child's long-term needs? A. "My child will need all my attention for the next 10 years." B. "Once in school, my child will catch up and be like the other children." C. "My child will grow up and need to learn to do things independently." D. "I'm the one who knows the most about my child and can do the most for my child."

C

The parent of an infant with CP asks the nurse if the infant will be mentally retarded.Which is the nurse's best response? A. "Children with CP have some amount of mental retardation." B. "Approximately 20% of children with CP have normal intelligence." C. "Many children with CP have normal intelligence." D. "Mental retardation is expected if motor and sensory deficits are severe."

C

The parents of a child with meningitis and multiple seizures ask if the child will likely develop cerebral palsy (CP). Select the nurse's best response. A. "When your child is stable, she'll undergo computed tomography (CT) and magnetic resolution imaging (MRI). The physicians will be able to let you know if she has CP." B. "Most children do not develop CP at this late age." C. "Your child will be closely monitored after discharge, and a developmental specialist will be able to make the diagnosis." D. "Most children who have had complications following meningitis develop some amount of CP."

C

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, E

A child is being admitted with the diagnosis of meningitis. Select the procedure the nurse should do first: A. Administration of intravenous antibiotics. B. Administration of maintenance intravenous fluids. C. Placement of a Foley catheter. D. Send the spinal fluid and blood samples to the laboratory for cultures.

D

The nurse evaluates teaching of parents of a child newly diagnosed with cerebral palsy (CP) as successful when the parents state that CP is which of the following? A. Inability to speak and uncontrolled drooling. B. Involuntary movements of lower extremities only. C. Involuntary movements of upper extremities only. D. An increase in muscle tone and deep tendon reflexes

D

The nurse is caring for a child with cerebral palsy (CP) whose weight is in the fifth percentile and who has been hospitalized for aspiration pneumonia. His parents are anxious and state that they do not want a G-tube placed. Which would be the nurse's best response? A. "A G-tube will help your son gain weight and reduce his risk for future hospitalizations due to pneumonia." B. "G-tubes are very easy to care for and will make feeding time easier for your family." C. "Are you concerned that you will not be able to care for his G-tube?" D. "Tell me your thoughts about G-tubes."

D

The nurse is developing a plan of care for a child recently diagnosed with cerebral palsy (CP). Which should be the nurse's priority goal? A. Ensure the ingestion of sufficient calories for growth. B. Decrease intracranial pressure. C. Teach appropriate parenting strategies for a special-needs child. D. Ensure that the child reaches full potential.

D