Question 1

A 3-year-old has been diagnosed with bacterial meningitis.What should the nurse expect to find on the lab report for the most common cause of this bacterial meningitis?
A) Haemophilus influenzae
B) Neisseria meningitidis
C) Streptococcus pneumonia
D) Escherichia coli

Accepted Answer

The most common cause of bacterial meningitis in children under 4 is Neisseria meningitidis.Haemophilus influenzae formerly was the most common cause of bacterial meningitis, but vaccines have decreased this.Streptococcus pneumonia can cause meningitis and is the most common cause of bacterial meningitis in children under 23 months, while Escherichia coli is the most common cause of meningitis in the newborn.

Question 2

A child is diagnosed with cerebral palsy, characterized by extreme difficulty in fine motor coordination and purposeful movement.Which of the following types of cerebral palsy is the child experiencing?
A) Ataxic
B) Dystonic
C) Spastic
D) Mixed

Accepted Answer

Dystonic cerebral palsy is associated with extreme difficulty in fine motor coordination and purposeful movements.Ataxic cerebral palsy manifests with gait disturbances and instability.The infant with this form of cerebral palsy may have hypotonia at birth, but stiffness of the trunk muscles develops by late infancy.Spastic cerebral palsy is associated with increased muscle tone, persistent primitive reflexes, hyperactive deep tendon reflexes, clonus, rigidity of the extremities, scoliosis, and contractures.Mixed cerebral palsy may have symptoms of each of the disorders.

Question 3

Which of the following diseases does the nurse screen for in all newborns?
A) Epilepsy
B) Tay-Sachs disease
C) Pica
D) Phenylketonuria (PKU)

Accepted Answer

All newborns are screened for PKU.Not all newborns are screened for epilepsy, Tay-Sachs, or pica.

Question 4

An infant has an anterior midline defect of neural tube closure.What term will the nurse observe written on the chart?
A) Anencephaly
B) Myelodysplasia
C) Cyclopia
D) Hydrocephalus

Accepted Answer

Cyclopia is an example of an anterior midline defect that may cause brain and face abnormalities.In anencephaly, the soft, bony component of the skull and part of the brain are missing.Myelodysplasia is a posterior neural tube disorder.Hydrocephalus is associated with accelerated head growth.

Question 5

A baby is stillborn after 6 hours of labor.Autopsy reveals hydrocephalus caused by cystic dilation of the fourth ventricle and aqueductal compression.Which of the following is the most likely diagnosis?
A) Congenital hydrocephalus
B) Microcephaly
C) Dandy-Walker deformity
D) Macewen sign

Accepted Answer

The Dandy-Walker malformation is a congenital defect of the cerebellum characterized by a large posterior fossa cyst, which communicates with the fourth ventricle, and an atrophic upwardly rotated cerebellar vermis.Congenital hydrocephalus is characterized by enlargement of the cerebral ventricles.Microcephaly is lack of brain growth with retarded mental and motor development.Macewen sign is characterized by separation of the cranial sutures with a resonant sound when the skull is tapped.

Question 6

What nutrient should the nurse encourage a woman in the early stages of pregnancy to consume to prevent neural tube defects?
A) Protein
B) Iron
C) Vitamin D
D) Folic acid

Accepted Answer

Folic acid deficiency during early stages of pregnancy increases the risk for neural tube defects.Neural tube defects are not associated with deficiencies of protein, iron, or vitamin D.

Question 7

What term is used to describe a premature closure of one or more of the cranial sutures during the first 18 months of life?
A) Craniosynostosis
B) Congential hydrocephalus
C) Microcephaly
D) Acrania

Accepted Answer

Craniosynostosis is the premature closure of one or more of the cranial sutures.Congenital hydrocephalus is characterized by enlargement of the cerebral ventricles.Microcephaly is lack of brain growth with retarded mental and motor development.In acrania, the cranial vault is almost completely absent; an extensive defect of the vertebral column is often present.

Question 8

A nurse is preparing to teach about the most common defects of neural tube closure.Which one should the nurse discuss?
A) Anterior
B) Posterior
C) Lateral
D) Superior

Accepted Answer

Posterior neural tube defects are the most common.Neural tube defects associated with the other options are not as common.

Question 9

Which reflex of infancy will disappear first?
A) Stepping
B) Rooting
C) Palmar grasp
D) Moro reflex

Accepted Answer

The stepping reflex should no longer be obtainable at 6 weeks.The rooting reflex should no longer be obtainable at 4 months.The palmar grasp should no longer be obtainable at 6 months.The Moro reflex should no longer be obtainable at 3 months.

Question 10

An infant is diagnosed with congenital hydrocephalus.Which of the following characteristics would the nurse expect to find?
A) Enlarged ventricles
B) Decreased cerebrospinal fluid (CSF) production
C) Increased resorption of CSF
D) Smaller than average head circumference

Accepted Answer

Congenital hydrocephalus is characterized by enlargement of the cerebral ventricles.Increased, not decreased, CSF production would lead to hydrocephalus.Decreased resorption of CSF would lead to hydrocephalus, not increased CSF.An infant with congenital hydrocephalus would have increased head circumference.

Question 11

When should the nurse assess for the vomiting and headache that are the classic symptoms of childhood brain tumors?
A) Morning
B) Early afternoon
C) As the sun goes down and darkness begins
D) During the middle of the night

Accepted Answer

Headache and vomiting occur more commonly in the morning.

Question 12

During infancy, what is the fastest growing part of the human body?
A) Spinal cord
B) Limb bones
C) Head
D) Vertebral column

Accepted Answer

The head, not the spinal cord, limb bones, or vertebral column, is the fastest growing part of the body during infancy.

Question 13

What is the cause of true (primary)microcephaly?
A) Viral infection
B) An autosomal recessive gene
C) Fetal trauma
D) Hydrocephalus

Accepted Answer

True (primary)microcephaly is usually caused by an autosomal recessive genetic or chromosomal defect.Viral infections and fetal trauma can lead to microcephaly but are not the true cause.Hydrocephalus does not lead to microcephaly.

Question 14

What is the most common type of cerebral palsy?
A) Ataxic
B) Dystonic
C) Spastic
D) Mixed

Accepted Answer

Spastic cerebral palsy accounts for approximately 70-80% of cerebral palsy cases.Ataxic cerebral palsy accounts for 5-10% of cerebral palsy cases.Dystonic cerebral palsy accounts for 10-20% of cerebral palsy cases.Mixed cases account for 13% of cerebral palsy cases.

Question 15

Parents of a 3-month-old bring the infant to the emergency room (ER)after a seizure has caused muscle rigidity.Both parents are of Jewish ancestry.For what genetic disease should this infant be screened?
A) Juvenile myoclonic epilepsy
B) Congenital encephalopathy
C) Tay-Sachs disease
D) PKU

Accepted Answer

Perhaps the best known of the lysosomal storage disorders is Tay-Sachs disease, an autosomal recessive disorder related to a deficiency of the enzyme hexosaminidase A (HEX A).Approximately 80% of individuals diagnosed are of Jewish ancestry.Jewish ancestry is not necessarily associated with epilepsy, encephalopathy, or PKU.

Question 16

Which term is used to document a hernial protrusion of a saclike cyst through a defect in the posterior arch of a vertebra?
A) Craniosynostosis
B) Meningocele
C) Encephalocele
D) Myelomeningocele

Accepted Answer

A myelomeningocele is a hernial protrusion of a saclike cyst (containing meninges, spinal fluid, and a portion of the spinal cord with its nerves)through a defect in the posterior arch of a vertebra in the lower spine.Craniosynostosis is the premature closure of one or more of the cranial sutures (saggital, coronal, lambdoid, metopic)during the first 18-20 months of the infant's life.A meningocele, a saclike cyst of meninges filled with spinal fluid, is a mild form of posterior neural tube closure defect.These can occur throughout the cervical, thoracic, and lumbar spine areas.An encephalocele refers to a herniation or protrusion of brain and meninges through a defect in the occipital region of the skull, resulting in a saclike structure.

Question 17

It is true that viral meningitis:
A) is always sudden in onset.
B) often occurs with measles, mumps, or herpes.
C) is effectively treated with antibiotics.
D) causes increased sugar in the cerebral spinal fluid (CSF).

Accepted Answer

Viral meningitis may result from a direct infection of a virus, or it may be secondary to disease, such as measles, mumps, or herpes.Onset may be sudden or gradual.Treatment is symptomatic; antibiotics are not used.Glucose in the CSF is normal.

Question 18

A 10-month-old infant presents for a well-baby visit.Which of the following reflexes should be present at this age?
A) Stepping
B) Sucking
C) Landau
D) Palmar grasp

Accepted Answer

The Laundau reflex would be present up until 24 months.The stepping reflex should no longer be obtainable at 6 weeks.The sucking reflex should have disappeared by 10 months.The palmar grasp should no longer be obtainable at 6 months.

Question 19

What term is used to document a herniation of brain and meninges through a defect in the occipital area of the skull?
A) Encephalocele
B) Meningocele
C) Myelomeningocele
D) Craniosynostosis

Accepted Answer

An encephalocele refers to a herniation or protrusion of brain and meninges through a defect in the occipital region of the skull, resulting in a saclike structure.A meningocele is a saclike cyst of meninges filled with spinal fluid, a mild form of posterior neural tube closure defect.These can occur throughout the cervical, thoracic, and lumbar spine areas.A myelomeningocele is a hernial protrusion of a saclike cyst (containing meninges, spinal fluid, and a portion of the spinal cord with its nerves)through a defect in the posterior arch of a vertebra in the lower spine.Craniosynostosis is the premature closure of one or more of the cranial sutures (saggital, coronal, lambdoid, and metopic)during the first 18-20 months of the infant's life.

Question 20

A 3-year-old Black child with a history of sickle cell disease and is now diagnosed with meningitis.Which is the most likely microorganism the nurse will find on the lab report?
A) Virus
B) Haemophilus influenzae type B
C) Streptococcus pneumonia
D) Neisseria meningitidis

Accepted Answer

Children with sickle cell disease are at risk for developing bacterial meningitis.These children do not experience an increased risk for the development of a viral infection, Haemophilus influenzae, or Neisseria meningitidis.

Quiz 17: Alterations of Neurologic Function in Children

A 3-year-old has been diagnosed with bacterial meningitis.What should the nurse expect to find on the lab report for the most common cause of this bacterial meningitis?

A child is diagnosed with cerebral palsy, characterized by extreme difficulty in fine motor coordination and purposeful movement.Which of the following types of cerebral palsy is the child experiencing?

Which of the following diseases does the nurse screen for in all newborns?

An infant has an anterior midline defect of neural tube closure.What term will the nurse observe written on the chart?

A baby is stillborn after 6 hours of labor.Autopsy reveals hydrocephalus caused by cystic dilation of the fourth ventricle and aqueductal compression.Which of the following is the most likely diagnosis?

What nutrient should the nurse encourage a woman in the early stages of pregnancy to consume to prevent neural tube defects?

What term is used to describe a premature closure of one or more of the cranial sutures during the first 18 months of life?

A nurse is preparing to teach about the most common defects of neural tube closure.Which one should the nurse discuss?

Which reflex of infancy will disappear first?

An infant is diagnosed with congenital hydrocephalus.Which of the following characteristics would the nurse expect to find?

When should the nurse assess for the vomiting and headache that are the classic symptoms of childhood brain tumors?

During infancy, what is the fastest growing part of the human body?

What is the cause of true (primary) microcephaly?

What is the most common type of cerebral palsy?

Parents of a 3-month-old bring the infant to the emergency room (ER) after a seizure has caused muscle rigidity.Both parents are of Jewish ancestry.For what genetic disease should this infant be screened?

Which term is used to document a hernial protrusion of a saclike cyst through a defect in the posterior arch of a vertebra?

It is true that viral meningitis:

A 10-month-old infant presents for a well-baby visit.Which of the following reflexes should be present at this age?

What term is used to document a herniation of brain and meninges through a defect in the occipital area of the skull?

A 3-year-old Black child with a history of sickle cell disease and is now diagnosed with meningitis.Which is the most likely microorganism the nurse will find on the lab report?