Question 1

Which assessment finding in a child with meningitis should be reported immediately?
A) Irregular respirations
B) Tachycardia
C) Slight drop in blood pressure
D) Elevated temperature

Accepted Answer

Irregular respirations in conjunction with slowing heart rate and increasing blood pressure are reported immediately,because they could indicate increased intracranial pressure.

Question 2

A child diagnosed with epilepsy had a generalized tonic-clonic seizure that lasted 90 seconds.What would the nurse expect to assess after a generalized tonic-clonic seizure?
A) Restlessness
B) Sleepiness
C) Nausea
D) Anxiety

Accepted Answer

Following a generalized tonic-clonic seizure,the child may have some confusion and may sleep for a time (postictal lethargy)and then return to full consciousness.

Question 3

An adolescent has just had a generalized seizure and collapsed in the school nurse's office.When should the nurse should call 911?
A) The seizure lasts more than 5 minutes.
B) The child is sleepy and lethargic after the seizure.
C) The child vomited at the onset of the seizure.
D) The child is confused and has slurred speech after the seizure.

Accepted Answer

If there are multiple seizures or if seizures last more than 5 minutes,call 911 because these are indicators of possible status epilepticus,a medical emergency.

Question 4

A parent comments that her infant has had several ear infections in the past few months.Why are infants more susceptible to otitis media?
A) Infants are in a supine or prone position most of the time.
B) Sucking on a nipple creates middle ear pressure.
C) They have increased susceptibility to upper respiratory tract infections.
D) The Eustachian tube is short,straight,and wide.

Accepted Answer

An infant's Eustachian tubes are short,wide,and straight,allowing microorganisms easy access to the middle ear.

Question 5

What will the nurse teach parents when giving instructions for acute conjunctivitis?
A) Apply cool compresses to the affected eye several times a day.
B) Instill topical steroid eyedrops for 1 week.
C) Clear drainage from the inner to the outer aspect of the eye.
D) Keep the eye patched until the inflammation resolves.

Accepted Answer

Eye secretions are always cleared from the inner canthus downward and away from the opposite eye (inner to outer direction).

Question 6

The nurse is planning to teach parents about prevention of Reye's syndrome.What information would the nurse include in this teaching?
A) Use aspirin instead of acetaminophen for children with viral illness.
B) Advise parents to have their children immunized against Reye's syndrome.
C) Avoid giving salicylate-containing medications to a child who has viral symptoms.
D) Get the child tested for Reye's syndrome if the child exhibits fever,vomiting,and lethargy.

Accepted Answer

Prevention of Reye's syndrome includes educating parents not to give aspirin-containing medication to children with viral symptoms.

Question 7

The nurse observes a child's position is supine with his arms and legs rigidly extended and the hands pronated.How does the nurse identify this posture?
A) Correct anatomical position
B) Decorticate
C) Decerebrate
D) Opisthotonos

Accepted Answer

In decerebrate posturing,arms are extended along the side of the body and hands are pronated.This posture indicates brainstem function only.

Question 8

A parent reports that her child has begun to do poorly at school and experiences episodes where he appears to be staring into space.Of which type of seizure is this behavior a characteristic?
A) Absence
B) Akinetic
C) Myoclonic
D) Complex partial

Accepted Answer

Absence seizures are characterized by transient loss of consciousness where the child appears to stare blankly,and may last only a few seconds.

Question 9

What assessment does the school nurse recognize as the cardinal sign of a hyphema?
A) Opacity of the lens
B) A yellow-white reflex on the pupil
C) A dark-red spot in front of the iris
D) Inflamed mucous membranes of the eyelids

Accepted Answer

A dark red spot in front of the iris is blood that has drained into the anterior chamber as the result of an injury.

Question 10

Which situation would cause the nurse to suspect a hearing impairment?
A) 3-month-old infant with a positive Moro (startle reaction)reflex
B) 15-month-old toddler who is babbling
C) 18-month-old toddler who is speaking one-syllable words
D) 24-month-old toddler who communicates by pointing

Accepted Answer

The child who is not making verbal attempts by 18 months should undergo a complete physical examination.

Question 11

What symptom leads the nurse caring for a 5-month-old child with viral influenza to suspect the development of Reye's syndrome?
A) Respirations drop from 18 to 14 breaths/minute
B) Falling asleep after feeding
C) Sudden vomiting without effort
D) Development of a macular rash

Accepted Answer

A child with a viral infection is at risk for Reye's syndrome,the onset of which is effortless vomiting,lethargy,and a change in level of consciousness.A 5-month-old child who sleeps after eating is normal.

Question 12

What does the nurse explain to parents of a child with febrile seizures?
A) They occur when the body temperature exceeds 38.3° C (101° F).
B) They can be prevented by anticonvulsant medication.
C) They usually lead to the development of epilepsy.
D) They occur when the temperature rises quickly.

Accepted Answer

Febrile seizures occur in response to a rapid rise in temperature,often above 38.8° C (102° F).

Question 13

What is an appropriate nursing action when a child is experiencing a generalized tonic-clonic seizure?
A) Assist the child to bed and then go for help.
B) Move objects out of the child's immediate area.
C) Stick a padded tongue blade between the child's teeth.
D) Manually restrain the child.

Accepted Answer

During a generalized tonic-clonic seizure,the immediate area is cleared to protect the child from injury.

Question 14

The nurse observes that the legs of a child with cerebral palsy cross involuntarily,and the child exhibits jerky movements with his arms as he tries to eat.The nurse recognizes that he has which type of cerebral palsy?
A) Athetoid
B) Ataxic
C) Spastic
D) Mixed

Accepted Answer

Spasticity is characterized by tension in certain muscle groups,which makes voluntary movements of muscles jerky and uncoordinated.

Question 15

What assessment made by the school nurse would lead to the suspicion of strabismus?
A) Reddened sclera in one eye
B) Child covers one eye to read the chalkboard
C) Child complains of a headache
D) Copious tears while watching TV

Accepted Answer

Indicators of strabismus include covering one eye to see,tilting the head to see,and missing objects in attempts to pick them up.Although headaches may be associated with amblyopia,this symptom is too vague to point suspicion to any disorder.

Question 16

What would the nurse include when planning postoperative teaching for a child who has had a tympanostomy with insertion of tubes?
A) Keeping the infant flat after feeding
B) Giving over-the-counter decongestants
C) Avoiding getting water in the ears
D) Cleaning the ear canal with cotton-tipped applicators

Accepted Answer

After a tympanostomy,care should be taken to avoid getting water in the ears.

Question 17

What is the best way for the nurse to communicate with a 10-year-old child who has a hearing impairment?
A) Use gestures and signs as much as possible.
B) Let the child's parents communicate for her.
C) Face the child and speak clearly in short sentences.
D) Recognize that the child's ability to communicate will be on a 6-year-old child's level.

Accepted Answer

The nurse who faces the child and speaks clearly will help the hearing-impaired child in the hospital to develop a healthy personality.

Question 18

What statement by a patient's mother leads the nurse to determine she understands instructions about administering an oral antibiotic for otitis media?
A) "I will continue using the medication until symptoms are relieved."
B) "I will share the medicine with siblings if their symptoms are the same."
C) "I will give the medication with a glass of milk."
D) "I will administer prescribed doses until all the medication is used."

Accepted Answer

Antibiotic therapy for otitis media is continued until the prescribed amount has been completed,even if symptoms are alleviated.

Question 19

What would the nurse include when creating a teaching plan that includes the long-term administration of phenytoin (Dilantin)?
A) The medication should be given on an empty stomach.
B) Insomnia can be a significant side effect.
C) Gums should be massaged regularly to prevent hyperplasia.
D) Blood pressure should be closely monitored.

Accepted Answer

Dilantin can cause gum overgrowth,which can be minimized by regular massaging.Dilantin frequently causes drowsiness and should be given with meals at the same time each day.

Question 20

What might the nurse explain as a common treatment for amblyopia?
A) Patching the good eye to force the brain to use the affected eye
B) Patching the affected eye to allow the refractory muscles to rest
C) Using glasses that will slightly blur the image for the good eye
D) Using corticosteroids to treat inflammation of the optic nerve

Accepted Answer

Early detection and treatment are essential for the child with amblyopia.Treatment includes patching the good eye and using glasses to correct refractive errors.

Quiz 23: The Child With a Sensory or Neurological Condition

Which assessment finding in a child with meningitis should be reported immediately?

A child diagnosed with epilepsy had a generalized tonic-clonic seizure that lasted 90 seconds.What would the nurse expect to assess after a generalized tonic-clonic seizure?

An adolescent has just had a generalized seizure and collapsed in the school nurse's office.When should the nurse should call 911?

A parent comments that her infant has had several ear infections in the past few months.Why are infants more susceptible to otitis media?

What will the nurse teach parents when giving instructions for acute conjunctivitis?

The nurse is planning to teach parents about prevention of Reye's syndrome.What information would the nurse include in this teaching?

The nurse observes a child's position is supine with his arms and legs rigidly extended and the hands pronated.How does the nurse identify this posture?

A parent reports that her child has begun to do poorly at school and experiences episodes where he appears to be staring into space.Of which type of seizure is this behavior a characteristic?

What assessment does the school nurse recognize as the cardinal sign of a hyphema?

Which situation would cause the nurse to suspect a hearing impairment?

What symptom leads the nurse caring for a 5-month-old child with viral influenza to suspect the development of Reye's syndrome?

What does the nurse explain to parents of a child with febrile seizures?

What is an appropriate nursing action when a child is experiencing a generalized tonic-clonic seizure?

The nurse observes that the legs of a child with cerebral palsy cross involuntarily,and the child exhibits jerky movements with his arms as he tries to eat.The nurse recognizes that he has which type of cerebral palsy?

What assessment made by the school nurse would lead to the suspicion of strabismus?

What would the nurse include when planning postoperative teaching for a child who has had a tympanostomy with insertion of tubes?

What is the best way for the nurse to communicate with a 10-year-old child who has a hearing impairment?

What statement by a patient's mother leads the nurse to determine she understands instructions about administering an oral antibiotic for otitis media?

What would the nurse include when creating a teaching plan that includes the long-term administration of phenytoin (Dilantin) ?

What might the nurse explain as a common treatment for amblyopia?