NCLEX-PN PEDIATRIC NEUROLOGICAL
The nurse is evaluating the parent's understanding of discharge care regarding the functioning of the infant's ventricular peritoneal shunt. Which statement by a parent indicates an understanding of the shunt complications?
"If my baby has a high-pitched cry, I should call the primary health care provider."
A nursing student is caring for a child with increased intracranial pressure. On review of the chart, the student nurse notes that a transtentorial herniation has occurred. A nursing instructor asks the student about this type of herniation. Which statement by the student indicates a need for further research about this condition?
"It involves only the anterior portions of the client's brain."
The nurse in a newborn nursery is told that a newborn with spina bifida (myelomeningocele type) will be transported from the delivery room. The nurse is asked to prepare for the arrival of the newborn. The nurse places which priorityitem at the newborn's bedside?
A bottle of sterile normal saline
The parents of a child recently diagnosed with cerebral palsy ask the nurse about the disorder. The nurse bases the response on the understanding that cerebral palsy is which type of condition?
A chronic disability characterized by impaired muscle movement and posture
The nurse is initiating seizure precautions for a child being admitted to the nursing unit. Which items are essential for the nurse to place at the bedside?
A suction apparatus and oxygen
Which finding would indicate that a child had a tonic-clonic seizure during the night?
Blood on the pillow
The nurse is caring for a newborn with a diagnosis of spina bifida (myelomeningocele). Which should the nurse perform to monitor for a major symptom of this condition?
Check for responses to painful stimuli from the torso downward.
A child is admitted to the hospital, and a diagnosis of bacterial meningitis is suspected. A lumbar puncture is performed, and the results reveal cloudy cerebrospinal fluid (CSF) with high protein and low glucose levels. The nurse determines that these results are indicative of which finding?
Confirmation of the diagnosis
The nurse is monitoring a child with a head injury. On data collection, the nurse notes an abnormal flexion of the upper extremities and an extension of the lower extremities. The nurse documents that the child is experiencing which?
Decorticate posturing
The nurse assists in monitoring for early signs of meningitis in a child and assists with attempting to elicit Kernig's sign. Which is the appropriate procedure to elicit a Kernig's sign?
Extend the leg and knee and check for pain.
The nurse is caring for a 3-year-old child with suspected bacterial meningitis. Which signs and symptoms should the nurse expect to find during the initial data collection? Select all that apply
Fever Irritability Nuchal rigidity
When checking a child's trochlear nerve function, the nurse should perform which data collection technique?
Have the child look down and in.
To ensure a safe environment for a child admitted to the hospital for a craniotomy to remove a brain tumor, the nurse should include which in the plan of care?
Initiating seizure precautions
The nurse is caring for a newborn with spina bifida (myelomeningocele type) who is scheduled for the removal of the gibbus (sac on the back filled with cerebrospinal fluid, meninges, and some of the spinal cord). Which is the prioritynursing action in the preoperative period?
Maintain moisture of the normal saline dressing on the gibbus area.
A child is diagnosed with Reye's syndrome. The nurse assists with developing a nursing care plan for the child and should include which intervention in the plan?
Provide a quiet atmosphere with dimmed lighting.
The nurse assists with preparing a nursing care plan for a child who has Reye's syndrome. Which is the priority nursing intervention?
Providing a quiet atmosphere with dimmed lights
The nurse is reviewing the record of a child with increased intracranial pressure and notes that the child has exhibited signs of decerebrate posturing. During data collection about the child, the nurse expects to note which characteristic of this type of posturing?
Rigid extension and pronation of the arms and legs
The nurse is developing a plan of care for a child with autism. The nurse should identify which priority problem for this child?
Risk for injury
The nurse working in the day care center is told that a child with autism will be attending the center. The nurse collaborates with the staff of the day care center and assists in planning activities that will meet the child's needs. The nurse understands that the priority consideration in planning activities for the child is to ensure which need is met?
Safety with activities
The nurse reviews the plan of care for a child with Reye's syndrome. Which priority complication should the nurse plan to monitor?
Signs of increased intracranial pressure
A child has a basilar skull fracture. Which primary health care provider's prescription should the nurse question?
Suction via the nasotracheal route as needed.
The nurse should anticipate that which medication is the most likely to be prescribed prophylactically for a child with spina bifida (myelomeningocele) who has a neurogenic bladder?
Sulfasalazine
When checking a child's glossopharyngeal nerve function, the nurse should perform which data collection technique?
Test sense of sour or bitter taste on the posterior segment of the tongue.
The nurse should implement which actions in the care of a child who is having a seizure? Select all that apply.
Time the seizure. Stay with the child. Loosen clothing around the child's neck.
A 1-year-old child is admitted to the hospital for control of tonic-clonic seizures. The nurse should perform which actions in order to protect the child from injury? Select all that apply.
Turn the client to the side during a seizure. Keep side rails and other hard objects padded.
The nurse reinforces home care instructions to the mother of a child recovering from Reye's syndrome. Which statement by the mother indicates a need for further teaching?
"I need to give frequent, small, nutritious meals if my child starts to vomit."
A licensed practical nurse is providing care for a child with hydrocephalus who has had a ventriculoperitoneal shunt revision. Which data collection finding should be reported to the registered nurse immediately?
Temperature 100.9° F
The nurse is reinforcing instructions to the parents of an infant with a ventriculoperitoneal shunt. The nurse plans to include which instruction?
"Call the primary health care provider if the infant has a high-pitched cry."
A client has been prescribed valproic acid for the treatment of generalized seizures, and the nurse reinforces instructions to the child about the potential side effects of the medication. Which statement by the client would indicate a need for further teaching?
"I am so glad that I won't lose any of my hair. I was worried what my friends would think."
The nurse provides homecare instructions to the parent of a child with attention deficit hyperactivity disorder regarding behavioral therapy interventions. Which statement by the parent indicates a need for further teaching?
"I hear that the side effects of the medication that my child will be on can cause overeating."
The nurse instructs a mother of a child who has seizures regarding seizure precautions. Which statement by the mother indicates a need for further teaching?
"I will need to give antiseizure medications when my child has a seizure."
Which statement should the nurse include when providing safety instructions to the parents of an infant with a diagnosis of hydrocephalus?
"When picking up your infant, support the infant's neck and head with the open palm of your hand."
The nurse is caring for a hospitalized infant and is monitoring for increased intracranial pressure (ICP). The nurse notes that the anterior fontanel bulges when the infant cries. Based on this finding, which action should the nurse take?
Document the findings.
The nurse is preparing to care for a child with a head injury. On review of the records, the nurse notes that the primary health care provider has documented decorticate posturing. The nurse plans care, knowing that this type of posturing indicates which finding?
Dysfunction in the cerebral hemisphere
A child with a brain tumor returns from the recovery room following "debulking" of the tumor. The nurse assigned to care for the child monitors the child for brainstem involvement. Which sign would indicate that brainstem involvement occurred during the surgical procedure?
Elevated temperature
A diagnostic workup is performed on a 1-year-old child suspected of a diagnosis of neuroblastoma. Which finding specifically associated with this type of tumor would the nurse expect to find documented in the child's record?
Elevated vanillylmandelic acid (VMA) levels in the urine
The nurse is reviewing the postoperative prescriptions for an infant with hydrocephalus, who came back from surgery with a ventriculoperitoneal shunt. Which of the primary health care provider's prescriptions does the nurse question?
Keep the head of the bed elevated 45 degrees.
The nurse is assisting in preparing a plan of care for a child who is being admitted to the pediatric unit with a diagnosis of seizures. Which components should be included in the plan of care? Select all that apply.
Maintain the bed in a low position. Pad the side rails of the bed with blankets. Place the child in a side-lying lateral position if a seizure occurs. Protect the child's head, body, and extremities if a seizure occurs.
Which is the primary goal that should be included in the plan of care for a child who has cerebral palsy?
Maximize the child's assets and minimize the limitations.
The nurse is monitoring a 7-year-old child who sustained a head injury in a motor vehicle crash for signs of increased intracranial pressure (ICP). The nurse assesses the child frequently for which early sign of increased ICP?
Nausea
The nurse is caring for a child following surgical removal of a brain tumor. The nurse is monitoring the child and notes that the pulse rate has increased and the blood pressure has dropped significantly. Bloody drainage also is noted on the posterior dressing. Which is the best nursing action?
Notify the registered nurse (RN).
A licensed practical nurse (LPN) is bathing a neonate and notices small dark tufts of fine hair on the neonate's lower back. The LPN should take which best action?
Notify the registered nurse of the finding.
The nurse is monitoring an infant for signs of increased intracranial pressure (ICP) and notes that the anterior fontanel bulges when the infant is sleeping. Based on this finding, which is the priority nursing action?
Notify the registered nurse.
The nurse is reinforcing information to parents regarding the signs of meningitis. The nurse informs the parents that which are the primarysigns/symptoms of meningitis?
Severe headache and neck stiffness
The nurse is reviewing a chart of a child with a head injury. The nurse notices that the level of consciousness has been documented as obtunded. Which observation should the nurse expect to make during data collection of the child?
The child sleeps unless aroused and, once aroused, interacts poorly with the environment.
A school nurse is preparing a physical education plan for a child with Down syndrome. Before preparing the plan, the nurse obtains which copy of an x-ray report?
The child's cervical spine
The nurse is caring for a newborn diagnosed with Down syndrome. The parents are asking questions about the disorder. The nurse should provide which information when discussing Down syndrome?
The condition is congenital and results in moderate to severe retardation and has been linked to an extra chromosome 21 (group G).
The nurse assists with developing a plan of care for the child with meningitis. Which would be the priority client problem for a child with a meningitis diagnosis?
Neurological dysfunction
The nurse is assisting with collecting data on a child with seizures. The nurse is interviewing the child's parents to establish their adjustment to caring for their child with a chronic illness. Which statement by the parents indicates a need for further teaching?
"Our child sleeps in our bedroom at night."
The nurse is caring for a child who sustained a head injury in an automobile accident and is monitoring the child for signs of increased intracranial pressure (ICP). The nurse plans to monitor for an early sign of increased ICP by checking for which sign?
Changes in level of consciousness
The nurse is caring for a child recently diagnosed with cerebral palsy. The parents of the child ask the nurse about the disorder. The nurse bases the response to the parents on the understanding that cerebral palsy is best described by which statement?
Cerebral palsy is a chronic disability characterized by a difficulty in controlling the muscles.
