Neuro PrepU Practice

What is a clinical manifestation of Hydrocephalus? Select all that apply. a. Decrease head circumference b. Increase head circumference c. bulging fontanel d. tachycardia e. separated sutures f. Bradycardia

b,c,e

What is a clinical manifestation of increased intracranial pressure (ICP) in child? Select all that apply. a) Shrill, high-pitched cry b) Blurred vision c) Nausea/Vomiting d) Bulging Frontanel e) Seizures f) Slurred Speech

b,c,f

A nurse is caring for a child with spina bifida. The child's mother asks the nurse what she did to cause the birth defect. Which statement would be the nurse's best response?

"The cause is unknown and there are many environmental factors that may contribute to it."

A baby is preoperative for closure of a myelomeningocele. Which of the following is the baby's priority nursing diagnosis? 1. Risk for Infection 2. Impaired Physical Mobility 3. Risk for Latex Allergy 4. Bowel Incontinence

1. Risk for Infection Although babies born with meningomyelocele are at risk for latex allergy and have both impaired physical mobility of their lower extremities and bowel incontinence, their most significant problem is their risk for infection. The exposed sac is a direct portal for bacterial invasion. The sac must be protected with moist, sterile dressings until it is surgically closed.

he wife of the client diagnosed with septic meningitis asks the nurse, "I am soscared. What is meningitis?" Which statement would be the most appropriateresponse by the nurse? 1. "There is bleeding into his brain causing irritation of the meninges." 2. "A virus has infected the brain and meninges, causing inflammation." 3. "This is a bacterial infection of the tissues that cover the brain and spinal cord." 4. "This is an inflammation of the brain parenchyma caused by a mosquito bite."

3. "This is a bacterial infection of the tissues that cover the brain and spinal cord."

A child who is experiencing high fever and nuchal rigidity is diagnosed with viral meningitis. Which of the following should the nurse include in the discharge teaching? 1. Keep the child isolated until the temperature returns to normal. 2. Pad the child's bed headboard. 3. Rent a commode for the child to use at home. 4. Administer over-the-counter analgesics as needed.

4. Administer over-the-counter analgesics as needed. Children with meningitis often have headaches. Over-the-counter analgesics are administered for the pain

Which type of precautions should the nurse implement for the client diagnosed withseptic meningitis? 1. Standard Precautions. 2. Airborne Precautions. 3. Contact Precautions. 4. Droplet Precautions.

4. Droplet Precautions.

1.Administer an oral antibiotic. Medication to treat acute bacterial meningitis is administered intravenously, not orally. A culture and sensitivity is done to determine if the diagnosis is bacterial or viral. Until meningitis is ruled out, the child is placed in isolation on droplet precautions because the disease is spread by airborne means. Strict intake and output should be maintained.

A child is admitted to the hospital with a diagnosis of acute bacterial meningitis. In reviewing the health care provider's prescriptions, which would the nurse question as appropriate for a child with this diagnosis? 1.Administer an oral antibiotic. 2.Maintain strict intake and output. 3.Draw blood for a culture and sensitivity. 4.Place the child on droplet precautions in a private room.

4.Providing a quiet atmosphere with dimmed lighting Patient will show signs of lethargy, drowsiness, vomiting, liver dysfunction.

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? 1.Assessing hearing loss 2.Monitoring urine output 3.Changing body position every 2 hours 4.Providing a quiet atmosphere with dimmed lighting

Prior to surgery for a myelomeningocele, the nurse would place the baby in which of the following positions? A. Prone B. Right side C. Left side D. Dorsal

A. prone

A 9-year-old client who suffered a head injury has strabismus. The nurse assesses the client for intracranial pressure (ICP). Which additional intervention is most important for the nurse to perform? Assess the level of consciousness (LOC). Notify the primary health care provider. Place the child on fall precaution. Place a patch over the client's affected eye.

Assess the level of consciousness (LOC).

The nurse is caring for a 2-month-old with cerebral palsy. The infant is limp and flaccid with uncontrolled, slow, worm-like, writhing, and twisting movements. Which of the following would the nurse use when documenting these observations? A) Spastic B) Athetoid C) Ataxic D) Mixed

B) Athetoid

The most important nursing intervention when caring for an infant with myelomeningocele in the preoperative stage is which? A) Take vital signs every hour. B) Place the infant on the side to decrease pressure on the spinal sac. C) Watch for signs that might indicate developing hydrocephalus. D) Apply a heat lamp to facilitate drying and toughening of the sac.

B) Place the infant on the side to decrease pressure on the spinal sac. The spinal sac is protected from damage until surgery is performed. Early surgical closure is recommended to prevent local trauma and infection. Monitoring vital signs and watching for signs that might indicate developing hydrocephalus are important interventions, but preventing trauma to the sac is a priority. The sac is kept moist until surgical intervention is done.

What type of cerebral palsy (CP) is the most common type? A) Ataxic B) Spastic C) Dyskinetic D) Mixed type

B) Spastic

In working with parents who have a child diagnosed with cerebral palsy, which therapeutic management goals should be included in the plan of care? (Select all that apply.) A. Limit socialization to similar type affected children. B. Provide educational opportunities that are individualized to children's needs and abilities. C. To help support and maintain location, communication and self-help skills. D. To correct body image perception. E. To integrate motor function.

B,C,E

A 3-year-old has cerebral palsy (CP) and is hospitalized for orthopedic surgery. The child's mother states the child has difficulty swallowing and cannot hold a utensil to self-feed. The child is slightly underweight for height. What is the most appropriate nursing action related to feeding? A. Bottle-feed or tube-feed the child with a specialized formula until sufficient weight is gained. B. Stabilize the child's jaw with one hand (either from a front or side position) to facilitate swallowing. C. Place the child in a well-supported, semireclining position to make use of gravity flow. D. Place the child in a sitting position with the neck hyperextended to make use of gravity flow.

B. Stabilize the child's jaw with one hand (either from a front or side position) to facilitate swallowing.

A 4-year-old child is brought to the emergency department after being in a motor vehicle accident. The child experienced head trauma in the accident. When assessing the child, which will be the first change noted in the presence of increasing intercranial pressure? Change in level of consciousness Reduction in heart rate Increase in heart rate Decline in respiratory rate

Change in level of consciousness A change in the level of consciousness is the initial finding in the client who is experiencing an increase in intracranial pressure.

A child with cerebral palsy has undergone surgery for placement of a baclofen pump. Which of the following would the nurse include when teaching the parents about caring for their child? A) Waiting 48 hours before allowing the child to take a tub bath B) Not allowing the child to sleep on his side for about 4 weeks C) Calling the physician if the child's temperature is over 100.5°F D) Discouraging the child from stretching or bending forward for 4 weeks

D) Discouraging the child from stretching or bending forward for 4 weeks

What refers to a hernial protrusion of a saclike cyst of meninges, spinal fluid, and a portion of the spinal cord with its nerves through a defect in the vertebral column? A) Rachischisis B) Meningocele C) Encephalocele D) Myelomeningocele

D) Myelomeningocele A myelomeningocele has a visible defect with an external saclike protrusion, containing meninges, spinal fluid, and nerves. Rachischisis is a fissure in the spinal column that leaves the meninges and the spinal cord exposed. Meningocele is a hernial protrusion of a saclike cyst of meninges with spinal fluid but no neural elements. Encephalocele is a herniation of brain and meninges through a defect in the skull, producing a fluid-filled sac.

What is the most common cause of cerebral palsy (CP)? A) Central nervous system (CNS) diseases B) Birth asphyxia C) Cerebral trauma D) Neonatal encephalopathy

D) Neonatal encephalopathy

A newborn baby is diagnosed with a myelomeningocele. The nurse measures his head circumference daily to assess for the development of what complication? A. Hydrocele B. Hordeolum C. Hypsarrhythmia D. Hydrocephalus

D. Hydrocephalus (D) There is greater production than absorption of cerebrospinal fluid in the ventricular system, which is a complication associated with myelomeningocele.

A neural tube defect that is not visible externally in the lumbosacral area would be called A. meningocele. B. myelomeningocele. C. spina bifida cystica. D. spina bifida occulta.

D. spina bifida occulta.

During the physical assessment of a 2½-month-old infant, the nurse suspects the child may have hydrocephalus. Which sign or symptom was observed? Dramatic increase in head circumference Vertical nystagmus Posterior fontanel (fontanelle) is closed Pupil of one eye dilated and reactive

Dramatic increase in head circumference

A patient being treated for viral meningitis arrives at the hospital reporting a persistent severe headache. Which nursing intervention is most appropriate for the patient? 1 Telling the patient to use analgesics 2 Informing the patient that headaches can occur after recovery 3 Informing the patient that a headache is not a major complication 4 Informing the patient that a full recovery from viral meningitis is not possible

Informing the patient that headaches can occur after recovery The patient should be informed that headaches will occur postrecovery, even though they are a rare manifestation. The patient should be treated symptomatically, based on the reason for developing the headache. A complete recovery is expected. A severe headache might be a major complication.)

4.Severe headache, fever, and a change in the level of consciousness The classic signs/symptoms of meningitis include severe headache, fever, stiff neck, and a change in the level of consciousness. Photophobia also may be a prominent early manifestation and is thought to be related to meningeal irritation. Although nausea, confusion, delirium, and back pain may occur in meningitis, these are not the classic signs/symptoms.

The community health nurse is providing information to parents of children in a local school regarding the signs of meningitis. The nurse informs the parents that the classic signs/symptoms of meningitis include which findings? 1.Nausea, delirium, and fever 2.Severe headache and back pain 3.Photophobia, fever, and confusion 4.Severe headache, fever, and a change in the level of consciousness

4.A bulging anterior fontanel

The nurse caring for an infant with a diagnosis of hydrocephalus should monitor the infant for which sign of increased intracranial pressure? 1.Proteinuria 2.Bradycardia 3.A drop in blood pressure 4.A bulging anterior fontanel

4.Check the skin and eyes every day for a yellow discoloration Checking for jaundice will assist in identifying the presence of liver complications, which are characteristic of Reye's syndrome. Decreasing stimuli and providing rest decrease stress on the brain tissue. If vomiting occurs in Reye's syndrome, it is caused by cerebral edema and is a sign of intracranial pressure.

The nurse is providing home care instructions to the mother of a child who is recovering from Reye's syndrome. Which instruction should the nurse provide to the mother? 1.Increase stimuli in the home environment. 2.Avoid daytime naps so that the child will sleep at night. 3.Give the child frequent small meals, if vomiting occurs. 4.Check the skin and eyes every day for a yellow discoloration

1.Not easily arousable and limited interaction Obtunded indicates that the child sleeps unless aroused and once aroused has limited interaction with the environment. Confusion indicates that the ability to think clearly and rapidly is lost. Disorientation indicates that the ability to recognize place or person is lost. Full consciousness indicates that the child is alert, awake, oriented, and interacts with the environment.

The nurse is reviewing a chart for a child with a head injury. The nurse notes that the level of consciousness has been documented as obtunded. Which finding should the nurse expect to note on assessment of the child? 1.Not easily arousable and limited interaction 2.Loss of the ability to think clearly and rapidly 3.Loss of the ability to recognize place or person 4.Awake, alert, interacting with the environment

3.Airway and breathing

The nursing student is writing a plan of care for a child who presents with an acute head injury. The nursing instructor reviews the plan of care and praises the student for identifying which assessment as a priority? 1.Inspecting the scalp 2.Pupillary assessment 3.Airway and breathing 4.Palpating the child's head

A 3-year-old child is status is getting treatment for hydrocephaly. Part of the nursing care plan is discuss to the parents. Which Nursing plans did the nurse discuss? Select all that apply. a. Placement of VP shunt b. Have the child move the head side to side at least every 2 hours. c. Shunt will need revision as child grows d. Watch for shunt dysfunction due to infection, kinks, breakage. e. requiring prompt treatment with antibiotics

a,c,d

What is a clinical manifestation of Reyes syndrome? Select all that apply. a. lethargy b. apnea c. Vomiting d. poor cry e. drowniness f. liver dysfunction

a,c,e,f

What is a clinical manifestation of Meningitis in child? Select all that apply. a.Photophobia b. apnea c. diarrhea d. nuchal rigidity e. headache f. seizures

a,d,e

What is a clinical manifestation of increased intracranial pressure (ICP) in infants? Select all that apply. a) Shrill, high-pitched cry b) Photophobia c) Pulsating anterior fontanel d) Bulging Frontanel e) Seizures f) Vomiting and diarrhea

a,d,e

What is a clinical manifestation of Meningitis in infant? Select all that apply. a. Petecial rash b. bulging frontanel c. apnea d. poor cry e. nuchal rigidity f. poor feeding

b,c,d,f

The nurse will teach parents of children with myelomeningocele to maintain an environment free of what element?

latex

An important nursing intervention when caring for a child with myelomeningocele in the postoperative stage is to: o place child on his or her side to decrease pressure on the spinal cord. o apply a heat lamp to facilitate drying and toughening of the sac. o keep skin clean and dry to prevent irritation from diarrheal stools. o measure head circumference and examine fontanels for signs that might indicate developing hydrocephalus.

o measure head circumference and examine fontanels for signs that might indicate developing hydrocephalus.