Neuro practice questions

14). After striking his head on a tree while falling from a ladder, a young man age 18 is admitted to the emergency department. He is unconscious and his pupils are nonreactive. Which intervention would be the most dangerous for the client? A. Give him a barbiturate. B. Place him on mechanical ventilation. C. Perform a lumbar puncture. D. Elevate the head of his bed.

C. Perform a lumbar puncture.

19). The nurse teaches a pregnant client regarding the necessity for a folic acid supplement. Which neonatal disorder does folic acid taken during the first trimester prevent? A. phenylketonuria B. down syndrome C. neural tube defects D. erythroblastosis fetalis

C. neural tube defects

15). A 7-year-old male patient is being evaluated for seizures. While in the child's room talking with the child's parents, you notice that the child appears to be daydreaming. You time this event to be 10 seconds. After 10 seconds, the child appropriately responds and does not recall the event. This is known as what type of seizure? A. Focal Impaired Awareness (complex partial) B. Atonic C. Tonic-clonic D. Absence

D. Absence

24). The nurse is caring for a school-age child with Duchenne muscular dystrophy in elementary school. Which would be an appropriate nursing diagnosis? A. Anticipatory grieving. B. Anxiety reduction. C. Increased pain. D. Activity intolerance.

D. Activity intolerance.

3). Which of the following describes decerebrate posturing? A. Internal rotation and adduction of arms with flexion of elbows, wrists, and fingers. B. Back hunched over, rigid flexion of all four extremities with supination of arms and plantar flexion of the feet. C. Supination of arms, dorsiflexion of feet. D. Back arched; rigid extension of all four extremities.

D. Back arched; rigid extension of all four extremities.

25). The nurse observes as a child with Duchenne's muscular dystrophy attempts to rise from a sitting position on the floor. After attaining a kneeling position, the child "walks" his hands up his legs to stand. The nurse documents this as which of the following? A. Galeazzi's sign. B. Goodell's sign. C. Goodenough's sign. D. Gower's sign

D. Gower's sign

8). The nurse is assessing a child diagnosed with a brain tumor. Which of the following signs and symptoms would the nurse expect the child to demonstrate? Select all that apply. A. Increased appetite B. Vomiting C. Polydipsia D. Lethargy E. Increased pulse

B. vomiting D. lethargy

16). You are developing discharge instructions for the parents of a child who experiences atonic seizures. What information below is important to include in the teaching? A. "This type of seizure is hard to detect because the child may appear like he or she is daydreaming." B. "Be sure your child wears a helmet daily." C. "It is common for the child to feel extremely tired after experiencing this type of seizure." D. "Avoid high fat and low carbohydrate diets."

C. "It is common for the child to feel extremely tired after experiencing this type of seizure."

1). An 18-year-old client was hit in the head with a baseball during practice. When discharging him to the care of his mother, the nurse gives which of the following instructions? A. "Watch him for a keyhole pupil the next 24 hours." B. "Expect profuse vomiting for 24 hours after the injury." C. "Wake him every hour and assess his orientation to person, time, and place." D. "Notify the physician immediately if he has a headache."

C. "Wake him every hour and assess his orientation to person, time, and place."

17). An 8-year-old child, who is not responding to anti-seizure medications, is prescribed to start a ketogenic diet. This diet will include: A. High carbohydrates and high fat B. Low fat, high salt, and high carbohydrates C. High fat and low carbohydrates D. High glucose, high fat, and low carbohydrates

C. High fat and low carbohydrates

4). A client comes into the ER after hitting his head in an MVA. He is alert and oriented. Which of the following nursing interventions should be done first? A. Assess full ROM to determine the extent of injuries. B. Call for an immediate chest x-ray. C. Immobilize the client's head and neck. D. Open the airway with the head-tilt-chin-lift maneuver.

C. Immobilize the client's head and neck.

6). During the acute stage of meningitis, a 3-year-old child is restless and irritable. Which of the following would be most appropriate to institute? A. Limiting conversation with the child. B. Allowing the child to play in the bathtub. C. Keeping extraneous noise to a minimum. D. Performing treatments quickly.

C. Keeping extraneous noise to a minimum.

12). Which of the following assessment data indicated nuchal rigidity? A. Positive Kernig's sign B. Negative Brudzinski's sign C. Positive Homan's sign D. Negative Kernig's sign

A. Positive Kernig's sign

2). A client is at risk for increased ICP. Which of the following would be a priority for the nurse to monitor? A. Unequal pupil size B. Decreasing systolic blood pressure. C. Tachycardia D. Decreasing body temperature

A. Unequal pupil size

18). An infant with a diagnosis of hydrocephalus has just had a ventriculoperitoneal shunt inserted. In what position should the nurse place the infant? A. supine on the unaffected side B. side-lying on the affected side C. head elevated at 45 degrees on the affected side. D. head elevated at 90 degrees on the unaffected side.

A. supine on the unaffected side

10). A nurse is planning care for a child with acute bacterial meningitis. Based on the mode of transmission of this infection, which of the following would be included in the plan of care? A. No precautions are required as long as antibiotics have been started. B. Maintain enteric precautions. C. Maintain respiratory isolation precautions for at least 24 hours after the initiation of antibiotics. D. Maintain neutropenic precautions.

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

5). A 13-year-old client has been hit on the head with a baseball bat. The nurse notes clear fluid draining from his ears and nose. Which of the following nursing interventions should be done first? A. Position the client flat in bed. B. Check the fluid for dextrose with a dipstick. C. Suction the nose to maintain airway patency. D. Insert nasal and ear packing with sterile gauze.

B. Check the fluid for dextrose with a dipstick.

9). A lumbar puncture is performed on a child suspected of having bacterial meningitis. CSF is obtained for analysis. A nurse reviews the results of the CSF analysis and determines which of the following results would verify the diagnosis? A. Cloudy CSF, decreased protein, and decreased glucose. B. Cloudy CSF, elevated protein, and decreased glucose. C. Clear CSF, elevated protein, and decreased glucose. D. Clear CSF, decreased pressure, and elevated protein.

B. Cloudy CSF, elevated protein, and decreased glucose.

23). The nurse knows that teaching was successful when a parent states which of the following are early signs of muscular dystrophy? A. Increased muscle strength. B. Difficulty climbing stairs. C. High fevers and tiredness. D. Respiratory infections and obesity

B. Difficulty climbing stairs.

13). Meningitis occurs as an extension of a variety of bacterial infections due to which of the following conditions? A. Congenital anatomic abnormality of the meninges. B. Lack of acquired resistance to the various etiologic organisms. C. Occlusion or narrowing of the CSF pathway. D. Natural affinity of the CNS to certain pathogens.

B. Lack of acquired resistance to the various etiologic organisms.

7). When interviewing the parents of a 2-year-old child, a history of which of the following illnesses would lead the nurse to suspect pneumococcal meningitis? A. Bladder infection B. Middle ear infection C. Fractured clavicle D. Septic arthritis

B. Middle ear infection

22). A nurse is reviewing the record of a child with increased ICP and notes that the child has exhibited signs of decerebrate posturing. On the child's assessment, the nurse would expect to note which of the following if this type of posturing was present? A. Abnormal flexion of the upper extremities and extension of the lower extremities. B. Rigid extension and pronation of the arms and legs. C. Rigid pronation of all extremities. D. Flaccid paralysis of all extremities.

B. Rigid extension and pronation of the arms and legs.

11). What protrudes from the baby's back in myelomeningocele? A. There is usually no sign of a defect. B. The meninges C. A layer of fat D. The meninges and the spinal cord

B. The meninges

20). An infant has had surgery for repair of a myelomeningocele. For which early sign of impending hydrocephalus should the nurse monitor the infant? A. frequent crying B. bulging fontanels C. change in vital signs D. difficulty with feeding

B. bulging fontanels

21). Which is the most severe form of spina bifida? A. Spina bifida occulta B. Meningocele C. Myelomeningocele D. They are equally severe.

c. Myelomeningocele