Question 1

When care is provided to an infant,which clinical manifestation supports the diagnosis of meningitis?&#10;A) Hypothermia&#10;B) Soft,flat fontanel&#10;C) Poor feeding habits&#10;D) Cries that are consoled with holding&#10;

Accepted Answer

Poor feeding habits may indicate meningitis in an infant because the infant may have a decreased appetite and lethargy due to the infection. Other symptoms of meningitis in infants may include fever, irritability, vomiting, a high-pitched cry, and seizures. Hypothermia is not a common symptom of meningitis, and a soft, flat fontanel and cries that are consoled with holding are normal for infants.

Question 2

Which information should the nurse elicit when collecting assessment data related to a child's most recent seizure event? (Select all that apply.)&#10;A) Precipitating events&#10;B) Current medications&#10;C) Any aura experienced&#10;D) Description of movements&#10;E) Family history of neurological disorders&#10;

Accepted Answer

Precipitating events&#10;Current medications&#10;Any aura experienced&#10;Description of movements

Question 3

Which nursing action is appropriate when assisting with the rapid assessment of a patient diagnosed with a neurological condition?&#10;A) Assessing apical pulse&#10;B) Monitoring blood pressure&#10;C) Obtaining an oral temperature&#10;D) Determining level of consciousness&#10;

Accepted Answer

When assisting with the rapid assessment of a patient diagnosed with a neurological condition, it is important to determine the patient's level of consciousness as quickly as possible. This helps to establish a baseline for the patient's neurological status and guides further assessment and interventions. Monitoring blood pressure and obtaining an oral temperature may be important in certain situations, but they are not the most important actions to take when assessing a patient with a neurological condition. Assessing the apical pulse is also not as crucial as determining the patient's level of consciousness.

Question 4

Which teaching point should be included in the plan of care for a toddler-aged patient to decrease the risk of traumatic brain injury (TBI)?&#10;A) Using an appropriate rear-facing car seat&#10;B) Using head support devices when placed in a car seat&#10;C) Wearing a helmet when riding a tricycle&#10;D) Teaching appropriate technique for diving&#10;

Accepted Answer

The answer of Which teaching point should be included in...

Question 5

A pediatric patient is admitted to the ED with a traumatic brain injury (TBI)that caused a loss of consciousness.The last set of vital signs showed a heart rate of 48 bpm,a BP of 148/74 mm Hg,and a respiratory rate of 12 breaths per minute and irregular.Which does the nurse suspect?

A) Improvement
B) Typical for sleep
C) Spinal cord injury
D) Increased intracranial pressure

Accepted Answer

A heart rate of 48 bpm and an irregular respiratory rate in a pediatric patient with TBI may indicate increased intracranial pressure, which is a serious and potentially life-threatening condition. The elevated blood pressure may occur as a compensatory mechanism to maintain cerebral perfusion. Immediate intervention is necessary to prevent further neurologic deterioration.

Question 6

Which statement reflects appropriate understanding of the anatomy and physiology of the nervous system?&#10;A) The brain is a network of nerve cells called axons.&#10;B) The central nervous system consists of the brain only.&#10;C) The peripheral nervous system consists of the cranial nerves and the spinal nerves.&#10;D) Gray matter consists of axons that are coated with myelin,which allows nerve impulses to travel rapidly.&#10;

Accepted Answer

The peripheral nervous system consists of the cranial nerves and the spinal nerves. This is the only statement that accurately reflects the anatomy and physiology of the nervous system. The brain is not made up entirely of axons (A), the central nervous system includes the spinal cord in addition to the brain (B), and gray matter consists of nerve cell bodies, dendrites, and unmyelinated axons (not axons coated with myelin) (D).

Question 7

The nurse is planning a teaching session for the parents of a child who has been diagnosed with simple partial seizures.Which characteristics of this type of seizure should the nurse include in the session? (Select all that apply.)

A) Lasts less than 30 seconds
B) Pain or numbness may occur.
C) Sudden stiffening followed by jerking
D) Chewing and lip smacking are common.
E) Remains conscious with no postictal period

Accepted Answer

Simple partial seizures typically last less than 30 seconds, may involve sensory symptoms like pain or numbness, and the person remains conscious without a postictal period.

Question 8

Which assessment finding should the licensed practical nurse (LPN)report to the charge nurse when providing care to an infant with a ventral-peritoneal (VP)shunt?&#10;A) Pupils equal and reactive to light&#10;B) Apical pulse 110 beats per minute&#10;C) Respiratory rate 32 breaths per minute&#10;D) Tympanic temperature 102&#176;F (38.8&#176;C)&#10;

Accepted Answer

A tympanic temperature of 102°F (38.8°C) is an abnormal finding and may indicate an infection, which is a potential complication in an infant with a VP shunt. The other assessment findings are within normal range for an infant.

Question 9

Which action by the nurse is most appropriate for a child who presents with a history of migraine headaches?&#10;A) Administering a prescribed opioid analgesic by intramuscular injection&#10;B) Determining when the child's last eye examination was conducted&#10;C) Conducting a weight assessment and documenting the information in the medical record&#10;D) Asking the parent if the child is experiencing night terrors&#10;

Accepted Answer

Determining when the child's last eye examination was conducted is important because migraines can be triggered by certain visual stimuli such as flickering lights or reading for extended periods of time. An eye examination may be necessary to identify any visual problems or to rule out any underlying conditions that may be contributing to the migraines. Administering an opioid analgesic by injection is not appropriate as the first line of treatment for migraines in children. Conducting a weight assessment is not necessary in this situation as it does not provide information relevant to the management of migraines. Asking about night terrors is not relevant to the management of migraines.

Question 10

A child with a history of seizures arrives in the emergency department (ED)in status epilepticus.Which is the priority nursing action?&#10;A) Taking vital signs&#10;B) Maintaining a patent airway&#10;C) Establishing an IV line&#10;D) Performing rapid neurological assessment&#10;

Accepted Answer

Maintaining a patent airway is the priority nursing action in a patient with status epilepticus to ensure adequate oxygenation and prevent hypoxia. Depending on the severity of the patient's condition, other interventions such as establishing an IV line or performing a rapid neurological assessment may be done concurrently or after ensuring a patent airway. Taking vital signs can also be done after airway management.

Question 11

For which pediatric patient should the nurse provide focused teaching regarding near drowning?&#10;A) Toddler&#10;B) Preschooler&#10;C) School-aged&#10;D) Early adolescent&#10;

Accepted Answer

The answer of For which pediatric patient should the nurse...

Question 12

The nurse is providing care to a school-aged child who was treated with aspirin during a viral infection.Which data should the LPN report to the charge nurse?&#10;A) Eupnea&#10;B) Lethargy&#10;C) Urine output 30 mL/hr&#10;D) Pupils equal and reactive to light&#10;

Accepted Answer

The answer of The nurse is providing care to a...

Question 13

Which information should the nurse collect during the health history portion of the comprehensive neurological assessment for a pediatric patient? (Select all that apply.)&#10;A) Accidents&#10;B) Vital signs&#10;C) Family history of seizures&#10;D) Exposure to perinatal infection&#10;E) Glasgow coma scale assessment&#10;

Accepted Answer

The answer of Which information should the nurse collect during...

Question 14

Which nursing action is appropriate when providing care to a toddler-aged patient whose lead level is 8 mcg/dL?&#10;A) Conducting a survey of the environment&#10;B) Following up as needed during future appointments&#10;C) Administering prescribed edetate calcium-disodium (EDTA)&#10;D) Preparing the patient for hospital admission for a full medical work-up&#10;

Accepted Answer

The answer of Which nursing action is appropriate when providing...

Question 15

Which preventive strategies should the nurse include in a teaching session for a mother whose infant is at risk for febrile seizures?&#10;A) Decreasing oral fluid intake&#10;B) Patting the child dry after a tepid bath&#10;C) Administering dose-appropriate aspirin&#10;D) Providing a sponge bath with cold water&#10;

Accepted Answer

The answer of Which preventive strategies should the nurse include...

Question 16

The parents of an infant visit the ED with complaints that their son is experiencing a high fever and lack of interest in breastfeeding.Upon examination,the nurse records the following symptoms of meningitis: nuchal rigidity,a bulging fontanel,and photophobia.Which tests does the nurse explain to the parents are necessary to confirm a diagnosis of meningitis? (Select all that apply.)

A) Kernig's sign
B) Blood cultures
C) Rooting reflex
D) Lumbar puncture
E) Computed tomography scan

Accepted Answer

The answer of The parents of an infant visit the...

Question 17

Which nursing actions are appropriate to assist in the assessment of CN V? (Select all that apply.)&#10;A) Asking the patient to smile&#10;B) Asking the patient to identify different tastes&#10;C) Asking the patient to follow finger commands with the eyes&#10;D) Testing the patient's response to cotton ball sensations on the face&#10;E) Asking the patient to perform chewing movements on command&#10;

Accepted Answer

The answer of Which nursing actions are appropriate to assist...

Question 18

A 9-month-old who is not sitting independently has been diagnosed with ataxic cerebral palsy (CP).Which clinical manifestation does the nurse expect to see in the baby?&#10;A) Hypertonicity&#10;B) Muscle dystrophy&#10;C) Poor muscle coordination&#10;D) Involuntary wormlike movements&#10;

Accepted Answer

The answer of A 9-month-old who is not sitting independently...

Question 19

Which item regulates emotions and behavior?&#10;A) Thalamus&#10;B) Brainstem&#10;C) Spinal cord&#10;D) Hypothalamus&#10;

Accepted Answer

The answer of Which item regulates emotions and behavior?&#10;A) Thalamus&#10;B)...

Question 20

A teacher states to the school nurse,&#34;I have a student who often just stares at me for 15 seconds after being asked a question; then the student blinks and asks me to repeat the question.Should I be concerned?&#34; Which statement should the nurse include in the response to the teacher?&#10;A) The child may have Reye's syndrome.&#10;B) The child may have had a head injury.&#10;C) The child is experiencing absence seizures.&#10;D) The child has increased ICP.&#10;

Accepted Answer

The answer of A teacher states to the school nurse,&#34;I...

Deck 29: Child With a Neurological Condition