Question 1

A child has been examined by a pediatric ophthalmologist,and findings indicate a dulled red reflex and cloudy lens.Which treatment plan does the nurse educate the parents on based on these findings?

Accepted Answer

These manifestations are characteristic of cataracts,which can be congenital or acquired.Typical treatment includes surgical removal of the cataract and lens implant.The other options are not part of the treatment for cataracts.

Question 2

A nurse assesses a 1-month old's Glasgow Coma Scale (GCS)and finds the following: opens eyes to pain,irritable cry,localizes pain.Your calculation indicates that this child's GCS is ____________________.

Accepted Answer

The answer of A nurse assesses a 1-month old's Glasgow...

Question 3

A child is brought to the pediatric clinic by her mother,who reports redness,swelling,and pain around the child's right eye.Which information does the nurse give the mother?

Accepted Answer

This child has the manifestations of periorbital cellulitis,which is treated with a week of IV antibiotics.Steroid injections may be used for a chalazion.An ophthalmologist needs to assess the child with keratitis to assess for corneal damage.Warm moist soaks are used in conjunctivitis.

Question 4

The pediatric nurse is caring for a child with increased intracranial pressure (ICP).The nurse places priority on completing which interventions?

Accepted Answer

Hyperthermia is to be avoided because brain metabolic needs will be greatly increased.The nurse may use a hypothermic blanket if the child's temperature is over 102°F (39°C).The head of the bed can be elevated 15 to 30° to promote venous blood return,but a side effect of elevating the head is that the pressure of blood being delivered to the brain decreases,resulting in inadequate blood supply and perfusion.A priority nursing intervention is maintenance of a patent airway.Inadequate oxygenation or excess carbon dioxide causes cerebral blood vessels to dilate,resulting in increased intracranial pressure (ICP).The nurse may administer medications to decrease cerebral edema.A drug frequently prescribed is mannitol (Osmitrol).The patient should be suctioned if needed,but suctioning can increased ICP and should be done gently and only when necessary.

Question 5

A camp nurse reads on a medical history form that a camper has "drop attacks." What does the nurse understand about this condition?

Accepted Answer

"Drop attack" is an old term for atonic seizure activity.

Question 6

A child's chart indicates he has leukocoria and a hyphema in the right eye.Which teaching does the nurse implement for the child and parents?

Accepted Answer

Leukocoria (cat's eye reflex)and hyphema (blood in the anterior chamber of the eye)are manifestations of retinoblastoma,a rare and aggressive tumor of the retina.Treatment is vigorous and may include surgery (including enucleation),radiation,chemotherapy,laser,or cryotherapy.

Question 7

A nurse is preparing discharge teaching for an adolescent with a new diagnosis of epilepsy.What information should the nurse provide?

Accepted Answer

Once drug levels are therapeutic and the child has been seizure-free for several months (usually at least 6 months),he or she can return to participating in sports.School nurses should be aware of a child's diagnosis of a seizure disorder and treatment plan; the parents should check on the school's seizure action plan so they are aware of actions that will be taken if their child has a seizure on campus.Driving is allowed (depending on state law)with therapeutic drug levels and a certain period of seizure-free time.Monotherapy is the optimal treatment plan,but if a single drug does not work to control seizures,other drugs may be added to the regimen.Anyone with epilepsy or a seizure disorder should wear a Medic-Alert bracelet or necklace.

Question 8

A nurse is caring for a child and notes Battle's sign during the assessment.Which action by the nurse is the most appropriate?

Accepted Answer

Battle's sign is indicative of a basilar skull fracture.The child will need a head CT or an MRI.The other actions are not needed as a result of this finding.

Question 9

A nurse assesses an infant for signs of increased intracranial pressure.Which signs would lead the nurse to notify the rapid response team?

Accepted Answer

Bulging fontanels,irregular respirations,and posturing are among the late signs of increased intracranial pressure and would lead the nurse to intervene quickly by notifying the health-care provider or by activating the rapid response team.The other signs are early indicators of increased intracranial pressure.

Question 10

The pediatric nurse prepares a care plan for a patient admitted to the intensive care unit for meningitis.Which nursing interventions does the nurse include in the care plan for this patient? (Select all answers that apply.)

Accepted Answer

The nurse should initiate transmission-based precautions to help prevent transmission of infection.The nurse should initiate and maintain intravenous access (specify fluids and rate)as ordered.The nurse should monitor vital signs every 1 to 4 hours (depending on severity of symptoms)and place the patient on a cardiac monitor as indicated.The nurse should monitor neurological status and symptoms closely,comparing with baseline values for the child.Patients with meningitis often have pain,especially headaches,and the nurse should be prepared to assess and treat.

Question 11

A pediatric nurse caring for patients in an emergency room performs an assessment of a child who survived a drowning incident.Which does the nurse assess when using the Orlowski scale on this child?

Accepted Answer

According to the Orlowski scale,each item is assigned one point: 3 years of age or older,submersion time greater than 5 minutes,no resuscitation efforts for > 10 minutes after rescue,comatose on admission to the emergency room,and arterial pH < 7.10.If a child has a score of 2 or less,there is a 90% likelihood of a complete recovery.If a child has a score of 3 or more,there is a 5% rate of survival.

Question 12

An adolescent has frequent headaches accompanied by nausea and vomiting.What item is most appropriate for the nurse to include in the teaching plan for this adolescent patient?

Accepted Answer

These symptoms are characteristic of a migraine.Migraines can be treated with a variety of medications,including injectable sumatriptan (Imitrex).The nurse would determine if this medication was included in the treatment plan and offer related education.The child might also take Tylenol,in which case he or she needs to know the maximal daily dose,but that is not as specific for migraines as sumatriptan is.Ptosis and rhinorrhea are characteristic of cluster headache.Headaches are not generally accompanied by seizures.

Question 13

A pediatric nurse reads the diagnosis "SCIWORA" on a child's chart.Which assessment finding does the nurse anticipate to correlate with this condition?

Accepted Answer

SCIWORA stands for "spinal cord injury without radiographic abnormality." Common manifestations of spinal cord injury include increased muscle tone,loss of normal bowel and bladder function,numbness,sensory changes,pain,and weakness or paralysis of muscles.

Question 14

The nurse is admitting an adolescent with known myasthenia gravis to the intensive care unit with respiratory failure.Which questions would be most important for the nurse to ask to attempt to find the cause of the problem?

Accepted Answer

This child appears to be in a myasthenic crisis,which is usually caused by underdosing or skipping medication and illness,infection,or fatigue.The other questions will not help identify the cause of the crisis.

Question 15

A nurse is working with a teen who has epilepsy treated with carbamazepine (Tegretol).Laboratory results indicate a serum drug level of 2 µg/mL.Which action by the nurse is the most appropriate?

Accepted Answer

The therapeutic level of carbamazepine is 5-12 µg/mL.The nurse should assess the teen for noncompliance because this level is too low.It is also possible that the teen has grown since the last drug level was obtained and that he or she simply now needs a higher dose.The results should be documented,but the nurse should take other action.Because the level was too low,it is not appropriate to continue the drug regimen or to cut the dose in half.

Question 16

The nurse is preparing discharge teaching for the parents of a 7-year-old boy with hydrocephalus and a ventriculoperitoneal shunt.Which information does the nurse include in the discharge teaching?

Accepted Answer

Parents are taught how to care for their child after shunt placement.They need to know common signs of infection (fever,nausea,vomiting,change in behavior),how to take a temperature,and that contact sports are not permitted.Because hydrocephalus is a lifelong condition,monitoring for infection is ongoing and the shunt stays in place permanently.

Question 17

The pediatric nurse caring for a 3-year-old child with cerebral palsy (CP)prepares a home care teaching plan for the caregivers on discharge.Which items will the nurse include in the teaching plan?

Accepted Answer

The child with CP has some degree of muscular dysfunction.The nurse encourages the child to perform self-care tasks.The child may exhibit muscular hypotonia (low tension)or hypertonia (high tension).Splints and braces may be necessary to facilitate muscle control and to improve body functioning.Clothing should be easy to manipulate.Skeletal muscle relaxants may be used for short-term control with older children and adolescents.

Question 18

The nurse is providing care for a child in the intensive care unit who requires intracranial monitoring.The child's blood pressure is 100/42 mm Hg and his ICP is 10 mm Hg.Your calculation indicates that the child's cerebral perfusion pressure (CPP)is ____________________.

Accepted Answer

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

Question 19

A nurse is caring for a 1-year-old child who was admitted for seizures.The parents ask what could have caused the child's seizure.The nurse explains that seizures can be caused by which problems?

Accepted Answer

Seizures can be caused by many things,including traumatic brain injury,infection in the central nervous system,ingestion of toxins,endocrine dysfunction,atrial-venous malformation,or anoxia.The etiology may also be unknown.

Question 20

The clinic nurse is providing community education to a parent group.The topic is over-the-counter medications containing aspirin or aspirin compounds.Which products does the nurse advise the parents to avoid?

Accepted Answer

Common over-the-counter products containing aspirin include Kaopectate and Pepto-Bismol.Lamictal is not an over-the-counter drug.The other three medications do not contain aspirin compounds.

Quiz 28: Caring for the Child With a Neurological or Sensory Condition