Deck 51: Cerebral Dysfunction

Question 1

Which one of the following sentences describes a concussion?

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

Answer 1

A transient, reversible neuronal dysfunction

Question 2

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." What is the nurse's best reply?

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."

Answer 2

"The reason for this is that complications could still occur."

Question 3

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

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

Answer 3

Oculovestibular response

Question 4

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 indicates that woman correctly understands 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 behavioural changes after the accident."
D) "If I notice diplopia, I will have my child rest for 1 hour."

Question 5

What is the most common clinical manifestation(s)of brain tumours in children?

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

Question 6

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

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

Question 7

What is the priority nursing intervention when a child is unconscious after a fall?

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

Question 8

Which drug is 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

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 they think their child is in pain because of periodic crying and restlessness.What is the most appropriate action for the nurse to take?

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

Question 10

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 his blood pressure.Pupils are dilated and fixed.What type of head injury should the nurse suspect?

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

Question 11

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 make?

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 12

Which neurological 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 13

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

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

Question 14

What type of fracture involves the traumatic separation of cranial sutures?

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

Question 15

The nurse should recommend medical attention if a child with a slight head injury experiences which of the following?

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

Question 16

The Glasgow Coma Scale assesses which of the following?

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

Question 17

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

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

Question 18

What 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 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 toddler fell out of a second-story window.She briefly lost 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." What knowledge should the nurse base her response on?

A) She may have a brain injury.
B) She needs this because of her age.
C) She may start having seizures.
D) She probably has a skull fracture.

Question 21

What agents are implicated for causing viral encephalitis?

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

Question 22

What is the initial clinical manifestation of generalized seizures?

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

Question 23

What type of seizure may be difficult to detect?

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

Question 24

An infant with hydrocephalus is hospitalized for surgical placement of a ventriculoperitoneal shunt.What intervention should be included in the child's postoperative care?

A) Monitor for abdominal distension.
B) Pump the shunt reservoir to maintain patency.
C) Administer sedation to decrease irritability.
D) Maintain Trendelenburg position to decrease pressure on the shunt.

Question 25

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.What is the nurse's best response?

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 26

When taking the history of a child hospitalized with Reye's syndrome,the nurse should not be surprised when the child indicates that a week ago she recovered from which of the following?

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

Question 27

What is the priority nursing intervention when caring for a child with Reye's syndrome?

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

Question 28

What is one important nursing intervention when caring for a child who is experiencing a seizure?

A) Describe and record the seizure activity observed.
B) Restrain the child when the 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 29

A young child's parents call the nurse after their child is bitten by a raccoon in the woods.What knowledge should the nurse base her recommendation for treatment on?

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

Question 30

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 31

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 32

What is a clinical manifestation of increased intracranial pressure in an infant?

A) Low-pitched cry
B) Sunken fontanel
C) Increased blood pressure
D) Irritability

Question 33

Which of the following statements best describes a neuroblastoma?

A) The 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 tumour in young children.
D) It is the most common benign tumour in young children.

Question 34

The treatment of brain tumours in children consists of which one of the following therapies?

A) Radiation
B) Bone marrow transplantation
C) Myelography
D) Stem cell transplantation

Question 35

The mother of a 2-month-old infant tells the nurse that she worries her baby will get meningitis like her oldest son did when he was an infant.What knowledge should the nurse base her response on?

A) Meningitis rarely occurs during infancy.
B) Often there is a genetic predisposition to meningitis.
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.

Question 36

Which type of seizure involves both hemispheres of the brain?

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