Deck 51: Cerebral Dysfunction

Question 1

The nurse should recommend medical attention if a child with a slight head injury experiences:

A)Sleepiness.
B)Vomiting,even once.
C)Headache,even if slight.
D)Confusion or abnormal behavior.

Answer 1

Confusion or abnormal behavior.

Question 2

What is descriptive of a concussion?

A)Petechial hemorrhages cause amnesia.
B)Visible bruising and tearing of cerebral tissue occur.
C)It is a transient,reversible neuronal dysfunction.
D)A slight lesion develops remote from the site of trauma.

Answer 2

It is a transient,reversible neuronal dysfunction.

Question 3

Which drug would be used to treat a child who has increased intracranial pressure (ICP) resulting from cerebral edema?

A)Mannitol
B)Epinephrine hydrochloride
C)Atropine sulfate
D)Sodium bicarbonate

Answer 3

Mannitol

Question 4

An adolescent boy is brought to the emergency department after a motorcycle accident. His respirations are deep,periodic,and gasping. There are extreme fluctuations in blood pressure. Pupils are dilated and fixed. What type of head injury should the nurse suspect?

A)Brainstem
B)Skull fracture
C)Subdural hemorrhage
D)Epidural hemorrhage

Question 5

The nurse is closely monitoring a child who is unconscious after a fall and notices that the child suddenly has a fixed and dilated pupil. The nurse should interpret this as:

A)Eye trauma.
B)Neurosurgical emergency.
C)Severe brainstem damage.
D)Indication of brain death.

Question 6

A toddler fell out of a second-story window. She had brief loss of consciousness and vomited four times. Since admission she has been alert and oriented. Her mother asks why a computed tomography (CT) scan is required when she "seems fine." The nurse should explain that the toddler:

A)May have a brain injury.
B)Needs this because of her age.
C)May start having seizures.
D)Probably has a skull fracture.

Question 7

Which type of fracture describes traumatic separation of cranial sutures?

A)Basilar
B)Compound
C)Diastatic
D)Depressed

Question 8

The nurse is preparing a school-age child for a computed tomography (CT scan) to assess cerebral function. When preparing the child for the scan,which statement should the nurse include?

A)"Pain medication will be given."
B)"The scan will not hurt."
C)"You will be able to move once the equipment is in place."
D)"Unfortunately no one can remain in the room with you during the test."

Question 9

A school-age child has sustained a head injury and multiple fractures after being thrown from a horse. The child's level of consciousness is variable. The parents tell the nurse that they think their child is in pain because of periodic crying and restlessness. The most appropriate nursing action is to:

A)Discuss with parents the child's previous experiences with pain.
B)Discuss with practitioner what analgesia can be safely administered.
C)Explain that analgesia is contraindicated with a head injury.
D)Explain that analgesia is unnecessary when child is not fully awake and alert.

Question 10

Which neurologic diagnostic test gives a visualized horizontal and vertical cross section of the brain at any axis?

A)Nuclear brain scan
B)Echoencephalography
C)Computed tomography (CT) scan
D)Magnetic resonance imaging (MRI)

Question 11

The nurse is assessing a child who was just admitted to the hospital for observation after a head injury. The most essential part of the nursing assessment to detect early signs of a worsening condition is:

A)Posturing.
B)Vital signs.
C)Focal neurologic signs.
D)Level of consciousness.

Question 12

The Glasgow Coma Scale consists of an assessment of:

A)Pupil reactivity and motor response.
B)Eye opening and verbal and motor responses.
C)Level of consciousness and verbal response.
D)Intracranial pressure (ICP) and level of consciousness.

Question 13

Which test is never performed on a child who is awake?

A)Oculovestibular response
B)Doll's head maneuver
C)Funduscopic examination for papilledema
D)Assessment of pyramidal tract lesions

Question 14

The priority nursing intervention when a child is unconscious after a fall is to:

A)Establish adequate airway.
B)Perform neurologic assessment.
C)Monitor intracranial pressure.
D)Determine whether a neck injury is present.

Question 15

The most common clinical manifestation(s) of brain tumors in children is:

A)Irritability.
B)Seizures.
C)Headaches and vomiting.
D)Fever and poor fine motor control.

Question 16

Which term is used to describe a child's level of consciousness when the child can be aroused with stimulation?

A)Stupor
B)Confusion
C)Obtundation
D)Disorientation

Question 17

Which term is used when a patient remains in a deep sleep,responsive only to vigorous and repeated stimulation?

A)Coma
B)Stupor
C)Obtundation
D)Persistent vegetative state

Question 18

A 5-year-old girl sustained a concussion when she fell out of a tree. In preparation for discharge,the nurse is discussing home care with her mother. Which statement made by the mother indicates a correct understanding of the teaching?

A)"I should expect my child to have a few episodes of vomiting."
B)"If I notice sleep disturbances,I should contact the physician immediately."
C)"I should expect my child to have some behavioral changes after the accident."
D)"If I notice diplopia,I will have my child rest for 1 hour."

Question 19

Which statement best describes a subdural hematoma?

A)Bleeding occurs between the dura and the skull.
B)Bleeding occurs between the dura and the cerebrum.
C)Bleeding is generally arterial,and brain compression occurs rapidly.
D)The hematoma commonly occurs in the parietotemporal region.

Question 20

A 3-year-old child is hospitalized after a near-drowning accident. The child's mother complains to the nurse,"This seems unnecessary when he is perfectly fine." The nurse's best reply is:

A)"He still needs a little extra oxygen."
B)"I'm sure he is fine,but the doctor wants to make sure."
C)"The reason for this is that complications could still occur."
D)"It is important to observe for possible central nervous system problems."

Question 21

An infant with hydrocephalus is hospitalized for surgical placement of a ventriculoperitoneal shunt. Which interventions should be included in the child's postoperative care? Choose all that apply.

A)Observe closely for signs of infection.
B)Pump the shunt reservoir to maintain patency.
C)Administer sedation to decrease irritability.
D)Maintain Trendelenburg position to decrease pressure on the shunt.
E)Maintain an accurate record of intake and output.
F) Monitor for abdominal distention.

Question 22

What may be beneficial in reducing the risk of Reye's syndrome?

A)Immunization against the disease
B)Medical attention for all head injuries
C)Prompt treatment of bacterial meningitis
D)Avoidance of aspirin and ibuprofen for children with varicella or those suspected of having influenza

Question 23

An important nursing intervention when caring for a child who is experiencing a seizure is to:

A)Describe and record the seizure activity observed.
B)Restrain the child when seizure occurs to prevent bodily harm.
C)Place a tongue blade between the teeth if they become clenched.
D)Suction the child during a seizure to prevent aspiration.

Question 24

What best describes a neuroblastoma?

A)Diagnosis is usually made after metastasis occurs.
B)Early diagnosis is usually possible because of the obvious clinical manifestations.
C)It is the most common brain tumor in young children.
D)It is the most common benign tumor in young children.

Question 25

A young child's parents call the nurse after their child was bitten by a raccoon in the woods. The nurse's recommendation should be based on knowing that:

A)The child should be hospitalized for close observation.
B)No treatment is necessary if thorough wound cleaning is done.
C)Antirabies prophylaxis must be initiated.
D)Antirabies prophylaxis must be initiated if clinical manifestations appear.

Question 26

Which type of seizure involves both hemispheres of the brain?

A)Focal
B)Partial
C)Generalized
D)Acquired

Question 27

When taking the history of a child hospitalized with Reye's syndrome,the nurse should not be surprised that a week ago the child had recovered from:

A)Measles.
B)Varicella.
C)Meningitis.
D)Hepatitis.

Question 28

The vector reservoir for agents causing viral encephalitis in the United States is:

A)Tarantula spiders.
B)Mosquitoes and ticks.
C)Carnivorous wild animals.
D)Domestic and wild animals.

Question 29

What clinical manifestations would suggest hydrocephalus in a neonate?

A)Bulging fontanel and dilated scalp veins
B)Closed fontanel and high-pitched cry
C)Constant low-pitched cry and restlessness
D)Depressed fontanel and decreased blood pressure

Question 30

The treatment of brain tumors in children consists of which therapies? Choose all that apply.

A)Surgery
B)Bone marrow transplantation
C)Chemotherapy
D)Stem cell transplantation
E)Radiation
F) Myelography

Question 31

A child is brought to the emergency department after experiencing a seizure at school. There is no previous history of seizures. The father tells the nurse that he cannot believe the child has epilepsy. The nurse's best response is:

A)"Epilepsy is easily treated."
B)"Very few children have actual epilepsy."
C)"The seizure may or may not mean that your child has epilepsy."
D)"Your child has had only one convulsion;it probably won't happen again."

Question 32

When caring for the child with Reye's syndrome,the priority nursing intervention is to:

A)Monitor intake and output.
B)Prevent skin breakdown.
C)Observe for petechiae.
D)Do range-of-motion (ROM) exercises.

Question 33

Clinical manifestations of increased intracranial pressure in infants are (choose all that apply):

A)Low-pitched cry
B)Sunken fontanel
C)Diplopia and blurred vision
D)Irritability
E)Distended scalp veins
F) Increased blood pressure

Question 34

Which type of seizure may be difficult to detect?

A)Absence
B)Generalized
C)Simple partial
D)Complex partial

Question 35

The initial clinical manifestation of generalized seizures is:

A)Being confused.
B)Feeling frightened.
C)Losing consciousness.
D)Seeing flashing lights.

Question 36

The mother of a 1-month-old infant tells the nurse that she worries that her baby will get meningitis like her oldest son did when he was an infant. The nurse should base her response on knowing that:

A)Meningitis rarely occurs during infancy.
B)Often a genetic predisposition to meningitis is found.
C)Vaccination to prevent all types of meningitis is now available.
D)Vaccination to prevent Haemophilus influenzae type b meningitis has decreased the frequency of this disease in children.