Question 1

The vector reservoir for agents causing viral encephalitis in the United States is which of the following?

Accepted Answer

Mosquitoes and ticks are the primary vector reservoirs for the agents causing viral encephalitis in the United States, as they can carry and transmit viruses such as West Nile virus, St. Louis encephalitis virus, and tick-borne encephalitis virus to humans.

Question 2

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 can't believe the child has epilepsy. The nurse's best response is which of the following?

Accepted Answer

C) is the best response because epilepsy is diagnosed after a person has had at least two unprovoked seizures, not just one. This response acknowledges the father's concern without making assumptions about the child's condition or its recurrence.

Question 3

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 which of the following?

Accepted Answer

Raccoon bites can transmit rabies, a fatal disease if not treated promptly. The standard protocol after potential exposure to rabies is to start antirabies prophylaxis, which includes wound cleaning and administration of rabies vaccine and immunoglobulin, if necessary, to prevent the onset of symptoms.

Question 4

A toddler fell out of a second-story window. She had brief loss of consciousness and vomited 4 times. Since admission, she has been alert and oriented. Her mother asks why a CT scan is required when she "seems fine." The nurse should explain that she:

Accepted Answer

A CT scan is required to rule out any potential brain injury, as the toddler experienced a fall, loss of consciousness, and vomiting, which are concerning symptoms.

Question 5

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

Accepted Answer

Vaccination against Haemophilus influenzae type b (Hib) has significantly reduced the incidence of Hib meningitis, a common type of bacterial meningitis in children before the widespread use of the vaccine.

Question 6

Five-year-old José is being prepared for surgery to remove a brain tumor. Nursing actions should be based on which of the following?

Accepted Answer

The answer of Five-year-old José is being prepared for surgery...

Question 7

Which of the following best describes a neuroblastoma?

Accepted Answer

Neuroblastoma is a type of cancer that often presents with metastasis by the time of diagnosis, making it difficult to catch early. It is not typically diagnosed early due to obvious clinical manifestations, it is not a brain tumor but rather originates from neural crest cells, and it is not benign but rather a malignant tumor.

Question 8

Which of the following types of seizures may be difficult to detect?

Accepted Answer

Absence seizures can be difficult to detect because they often involve subtle symptoms like brief lapses in awareness or staring spells, which can easily go unnoticed.

Question 9

Which of the following types of seizures refers to seizures that involve both hemispheres of the brain?

Accepted Answer

Generalized seizures involve both hemispheres of the brain, affecting the entire brain from the start of the seizure.

Question 10

The most common clinical manifestation(s) of brain tumors in children is which of the following?

Accepted Answer

Headaches and vomiting are common clinical manifestations of brain tumors in children, often resulting from increased intracranial pressure.

Question 11

A child is unconscious after a motor vehicle accident. The watery discharge from the nose tests positive for glucose. The nurse should recognize that this suggests:

Accepted Answer

The presence of glucose in a watery discharge from the nose following a motor vehicle accident suggests leaking of cerebrospinal fluid (CSF), indicating a possible skull fracture or brain injury. CSF often contains glucose, which is not typically found in such high concentrations in nasal secretions from other causes.

Question 12

Which of the following may be beneficial in reducing the risk of Reye syndrome?

Accepted Answer

Reye syndrome is associated with the use of aspirin or aspirin-containing products in children and teenagers who have viral infections, such as influenza or chickenpox (varicella). Avoiding aspirin and similar medications (like ibuprofen in some recommendations) in these cases can help reduce the risk of developing Reye syndrome. Immunizations, attention to head injuries, and treatment of bacterial meningitis, while important for other reasons, do not directly impact the risk of Reye syndrome.

Question 13

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 would be which of the following?

Accepted Answer

Complications such as respiratory issues or neurological damage can occur after a near-drowning incident, so hospitalization is necessary for observation.

Question 14

An important nursing intervention when caring for a child who is experiencing a seizure would be which of the following?

Accepted Answer

Describing and recording the seizure activity observed is crucial for proper diagnosis and treatment. It helps healthcare professionals understand the type of seizure, its duration, and potential triggers. Restraint could cause injury, placing a tongue blade can cause oral injuries or choking, and suctioning during a seizure is not recommended due to the risk of injury.

Question 15

Which of the following is the initial clinical manifestation of generalized seizures?

Accepted Answer

Loss of consciousness is often the initial clinical manifestation of generalized seizures, as these types of seizures affect both sides of the brain and typically result in a loss of consciousness without any warning.

Question 16

A school-age child has sustained a head injury and multiple fractures after being thrown off 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 which of the following?

Accepted Answer

Given the child's variable level of consciousness and multiple injuries, it is crucial to manage their pain effectively while also considering the safety of analgesics due to the head injury. Discussing with a practitioner what analgesia can be safely administered ensures that the child's pain is addressed without compromising their condition.

Question 17

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

Accepted Answer

Reye syndrome is often associated with a recent viral infection, particularly varicella (chickenpox) or influenza, especially when aspirin has been used for treatment.

Question 18

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

Accepted Answer

The level of consciousness is the most sensitive and earliest indicator of neurological changes, making it crucial for detecting early signs of a worsening condition after a head injury.

Question 19

When caring for the child with Reye syndrome, the priority nursing intervention would be which of the following?

Accepted Answer

Monitoring intake and output is crucial in managing Reye syndrome due to the risk of cerebral edema and changes in intracranial pressure, which can affect fluid balance.

Question 20

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 of the following is considered a manifestation of postconcussion syndrome and does not necessitate medical attention?

Accepted Answer

Behavioral changes are considered a manifestation of postconcussion syndrome and do not necessarily require immediate medical attention unless they are severe or persist.

Quiz 28: The Child With Cerebral Dysfunction