Deck 13: Neurological and Sensory Disorders

Question 1

Identify one or more choices that best complete the statement or answer the question.
The nurse in a pediatric unit is providing care for a 2-month-old infant just diagnosed with spinal muscle atrophy. Which characteristics of the condition does the nurse expect to find during physical assessment? Select all that apply.

A)Hyperreflexia in deep tendons
B)Few spontaneous movements
C)Deep, rapid respirations
D)Fasciculations of the tongue
E)Proximal muscle atrophy

Answer 1

Few spontaneous movements
Fasciculations of the tongue

Question 2

The pediatric nurse is examining the skin of a young child and notices eight café-au-lait spots between 1.5 and 3 inches in diameter on the body, along with axillary freckling. Which recommendation does the nurse make to the parent?

A)Refrain from having additional children without counseling.
B)Make an appointment with a physician for testing and evaluation.
C)Agree to blood testing of the child to identify a defect in the NF1 gene.
D)Arrange for psychological therapy to address self-esteem problems.

Answer 2

Make an appointment with a physician for testing and evaluation.

Question 3

A third-grade teacher discusses behavioral problems with a student. The teacher states, "He walks around class making horrible sucking noises. He does not respond to me." Which information does the nurse seek from the student's parents?

A)Ask if the student has been tested by a physician for seizure disorder.
B)Inquire if the student is either diagnosed or medicated for ADHD.
C)Ascertain if the student has experienced recent illness or a fever.
D)Suggest the student be screened for possible developmental delays.

Answer 3

Ask if the student has been tested by a physician for seizure disorder.

Question 4

The school nurse is present at a school assembly when a student falls to the floor with a seizure. Which intervention does the nurse initiate when providing care to the student during the seizure?

A)Protect the student from injury related to seizure movement.
B)Remove or loosen any tight clothing around the neck or waist.
C)Provide comfort and promote resting in a quiet environment.
D)If incontinent, cover the student with a blanket or sheet.

Question 5

The nurse is assessing a 4-month-old infant during a routine well-baby visit. During the neurological assessment, which finding is a reason for concern?

A)When the cheek is brushed, the head is turned toward the stimuli.
B)Toes fan out when the sole of the food is stroked upward.
C)Placing a small object in the palm inconsistently elicits a grasp.
D)A light puff of air in the face causes the eyes to close.

Question 6

The nurse is collecting information about a school-age patient brought to a pediatric clinic by a parent. The parent reports several incidences of syncope. Which assessment question helps the nurse to identify a possible diagnosis of vasovagal syncope?

A)"Has your daughter been diagnosed with diabetes mellitus?"
B)"Did your child feel strange and faint after standing up?"
C)"Was your child in a stressful situation before fainting?"
D)"Does your daughter have any cardiac conditions?"

Question 7

Identify one or more choices that best complete the statement or answer the question.
A parent brings an adolescent who is 16 years of age to the pediatric clinic, because the patient is experiencing unusual sensations in the feet. The nurse learns the patient was diagnosed with type 1 diabetes mellitus as a toddler; glucose levels have always been erratic and difficult to control. Which assessment findings does the nurse expect based on the health history? Select all that apply.

A)Inability to identify a sharp or blunt sensation on the sole of the foot
B)Feet warm to the touch and capillary refill within normal limits
C)Problems with balance when standing without support
D)Toe nails smooth in appearance and nail beds pink in color
E)Signs of weakness during neuromuscular checks to the lower legs

Question 8

The nurse is performing well-baby checks in a pediatric clinic. During physical examination of a 1-month-old infant, the nurse notices a dimple with a tuft of hair in the lumbar sacral area indicative of spina bifida. Which developmental delays does the nurse expect for this infant?

A)There may be issues related to bowel and bladder control.
B)Some degree of paralysis of the lower limbs is expected.
C)The infant is not expected to experience physical delays.
D)Muscles of the legs will be flaccid with some sensory loss.

Question 9

The nurse is providing care for a pediatric patient who received a concussion while playing football. The patient had brief loss of consciousness and now reports a headache with a pain level of 6 on a 0 to 10 scale. The patient states, "My team plays again in five days and I should be better." Which information is vital for the patient and parents to understand?

A)A realistic timeframe regarding complete recovery
B)Type of equipment to prevent a second head injury
C)The risk of acquiring second impact syndrome
D)The potential for long-term headaches

Question 10

The nurse is assessing a 7-year-old child at a pediatric clinic. The nurse notices that several developmental milestones have been missed or are late during previous visits. The parent states, "I know she is a little slow, but she will catch up quickly." Which action by the nurse is warranted?

A)Explain to the parent that rapid development takes place in infancy and early childhood.
B)Suggest activities in the home that may improve mental and physical development.
C)Recommend that the child be placed in special classes aimed at promoting development.
D)Ask the parent detailed questions about the pregnancy, birth, and early childhood health.

Question 11

Identify one or more choices that best complete the statement or answer the question.
The NICU nurse is providing care for a neonate exhibiting manifestations of congenital Zika syndrome. Which distinct features does the nurse associate with the syndrome? Select all that apply.

A)Partially collapsed skull
B)Decreased brain tissue
C)Damage to the back of the eyes
D)Multiple joint contractures
E)Agitated body movement
F)None of above

Question 12

The nurse is presenting a class to high school females about decreasing the developmental risks related to pregnancy. Which information does the nurse consider to be most important?

A)Young women should begin taking 600 mg of calcium twice a day.
B)All females of child-bearing age should take 0.4 mg of folic acid daily.
C)Early prenatal care is essential for a healthy pregnancy and baby.
D)Important fetal development occurs before pregnancy is suspected.

Question 13

A parent brings a child who is 8 years of age to the pediatric clinic and tells the nurse, “I think he has Tourette’s syndrome. He recently began some eye-blinking and grimacing actions.” Which information does the nurse provide to help the parent distinguish between transient tic of childhood and Tourette’s syndrome?

A)Vocal tics frequently become chronic in children with transient tic of childhood diagnosis.
B)Transient tic of childhood begins with a high level of tic activity and usually disappears completely by age 12.
C)Tourette’s syndrome is a disorder of complex motor and vocal tics that have been present for more than 1 year.
D)Tourette’s syndrome is a disorder of complex motor and vocal tics that develop between the ages of 3 to 8 years.

Question 14

The pediatric nurse in an acute care facility is providing care for a patient who is 12 years of age with a history of sickle cell anemia. During this hospitalization, it is determined that the patient has experienced a stroke. Which teaching is most important for the nurse to provide to the patient and parents?

A)A need for intensive physical and speech therapies
B)Reasons to have a designated social worker
C)The necessity for an individualized education plan
D)Manifestations of increased intracranial pressure

Question 15

The nurse in the emergency department of a pediatric hospital is providing care for a toddler with a sudden high fever. The parent states, "She has been grumpy all day and I thought she just needed a nap." Which finding does the nurse recognize as an indication of an immediate medical emergency?

A)The toddler keeps eyes closed or covered at all times.
B)The nurse elicits a positive Brudzinski's sign.
C)A rash of scattered red bumps is found on the skin.
D)The toddler cries when head and neck are moved.

Question 16

Identify one or more choices that best complete the statement or answer the question.
A parent brings an infant to the pediatric clinic and expresses concern about irritability and poor feeding, along with recent symptoms of flu lasting a few days. The nurse notices multiple raised mosquito bites on the infant. Which additional knowledge causes the nurse to suspect encephalitis? Select all that apply.

A)A recent local outbreak of West Nile fever
B)Bulging fontanels when in a quiet state
C)Signs of facial and eyelid weakness
D)Loss of deep tendon reflexes
E)Drooling instead of swallowing saliva

Question 17

The nurse is gathering health information on a child who is 8 years of age. The parent reports the child is extremely difficult to wake in the morning. Which other information will prompt the nurse to recommend screening for a sleep disorder?

A)The bedroom is shared with a sibling.
B)The nurse validates the child is obese.
C)There is a TV in the child's bedroom.
D)It is difficult to get the child to bed.

Question 18

The nurse is providing care for an infant at 3 months of age. The parent reports sudden flexor or extensor movements of the neck, trunk, and extremities occurring multiple times a day. The infant is diagnosed with infant spasms and is prescribed corticotropin (Acthar jell) therapy. Which instruction is most important for the nurse to provide for the parent?

A)Reason for weekly laboratory visits
B)Expected medication side effects
C)Signs and symptoms of infections
D)How to administer IM medication

Question 19

The nurse is performing a developmental assessment on a toddler at age 3 years. The nurse notices a variety of mixed developmental milestones that have been missed during the visit. Which delay does the nurse expect to be of greatest concern to the parent?

A)Difficulty putting small objects into a bottle
B)An inability to kick a ball back to the nurse
C)Difficulty with and reluctance to self-dress
D)An inability to express needs with language

Question 20

The nurse in the newborn nursery is providing care for a neonate with an open spinal cord defect. The neonate will be transported to a pediatric surgery hospital as soon as possible. Which description of the nurse's care of the neonate is correct?

A)Using aseptic technique, place a sterile plastic bag around the defect and loosely tie it closed.
B)Place the newborn prone on a loose diaper and cover the defect with a second saline-moistened diaper.
C)Position the newborn on the side with a moistened dressing on the defect; wrap the defect and newborn in a blanket.
D)Cover the defect with a sterile dressing moistened with warm sterile normal saline, using aseptic technique.