Question 1

Nursing care of the infant who has had a myelomeningocele repair should include

Accepted Answer

Measurement of head circumference is important after a myelomeningocele repair to assess for signs of hydrocephalus, which is a common complication. Securely fastening the diaper is important to prevent contamination of the surgical site but is not a priority over measuring head circumference. Measurement of pupil size and administration of seizure medications are not directly related to the surgical repair of a myelomeningocele.

Question 2

How should the nurse explain positioning for a lumbar puncture to a 5-year-old child?

Accepted Answer

The child will lie on their side and bend their knees so that they touch their chin. This is the most accurate description of the positioning for a lumbar puncture.

Question 3

Which information should the nurse give to a child who is to have magnetic resonance imaging (MRI)of the brain?

Accepted Answer

To reduce fear and enhance cooperation during the MRI,the child should be made aware that the head will be restricted to obtain accurate information.Drinking fluids is usually done for neurologic procedures.A child should lie flat after a lumbar puncture,not after an MRI.Electrodes are attached to the head for an electroencephalogram.

Question 4

When a 2-week-old infant is seen for irritability,poor appetite,and rapid head growth with observable distended scalp veins,the nurse recognizes these signs as indicative of

Accepted Answer

The signs of irritability, poor appetite, and rapid head growth with observable distended scalp veins are consistent with hydrocephalus, which is an accumulation of cerebrospinal fluid within the brain causing increased intracranial pressure. Hydrocephalus is a medical emergency that requires prompt intervention to prevent brain damage and potential death. The other options (B, C, D) are less likely given the specific presenting symptoms provided.

Question 5

Latex allergy is suspected in a child with spina bifida.Appropriate nursing interventions include

Accepted Answer

The best intervention for a suspected latex allergy is avoidance of all latex products since even nonallergenic latex products can still trigger an allergic reaction.

Question 6

How much folic acid is recommended for women of childbearing age?

Accepted Answer

Women of childbearing age should consume 0.4 mg of folic acid daily to help prevent neural tube defects in a developing fetus.

Question 7

The nurse teaches parents to alert their health care provider about which adverse effect when a child receives valproic acid (Depakene)to control generalized seizures?

Accepted Answer

Bruising is a potential adverse effect of valproic acid, and should be reported to the healthcare provider. Weight loss, anorexia, and drowsiness are also possible adverse effects, but they are not the most important to report.

Question 8

What finding should cause the nurse to suspect a diagnosis of spastic cerebral palsy?

Accepted Answer

Spastic cerebral palsy,the most common type of cerebral palsy,will manifest with hypertonicity and increased deep tendon reflexes.The child's muscles are very tight,and any stimuli may cause a sudden jerking movement.Tremulous movements,slow writhing movements,and loss of kinesthetic sense are not manifestations of spastic cerebral palsy.

Question 9

Which finding in an analysis of cerebrospinal fluid (CSF)is consistent with a diagnosis of bacterial meningitis?

Accepted Answer

Cloudy appearance in the CSF is a classic finding in bacterial meningitis due to the presence of increased white blood cells and bacteria in the fluid. The other choices, decreased CSF pressure, few leukocytes, and increased glucose level compared with blood, are not consistent with bacterial meningitis.

Question 10

Which statement best describes a subdural hematoma?

Accepted Answer

A subdural hematoma is bleeding that occurs between the dura and the cerebrum as a result of a rupture of cortical veins that bridge the subdural space. An epidural hemorrhage occurs between the dura and the skull, is usually arterial with rapid brain concussion, and occurs most often in the parietotemporal region.

Question 11

What is the best response to a father who tells the nurse that his son "daydreams" at home and his teacher has observed this behavior at school?

Accepted Answer

This response invites the father to provide more information about the nature of his son's daydreams and when they occur, which can help the nurse better understand the situation and identify any potential concerns. The other responses do not address the father's concerns in a helpful or informative way.

Question 12

Which type of fractures describes traumatic separation of cranial sutures?

Accepted Answer

The answer of Which type of fractures describes traumatic separation...

Question 13

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

Accepted Answer

The term "stupor" is used when a patient remains in a deep sleep and is only responsive to vigorous and repeated stimulation. Coma is a state of unconsciousness in which the patient is unresponsive even to painful stimuli. Obtundation is a state of decreased alertness and responsiveness to stimuli. A persistent vegetative state is a state of wakefulness without awareness, usually due to severe brain damage.

Question 14

A recommendation to prevent neural tube defects is the supplementation of

Accepted Answer

Folic acid supplementation is recommended for all women of childbearing age to prevent neural tube defects, as these defects can occur very early in pregnancy, often before a woman knows she is pregnant.

Question 15

The most common problem of children born with a myelomeningocele is

Accepted Answer

Neurogenic bladder is the most common problem associated with children born with a myelomeningocele. This is because the spinal cord defect can disrupt the nerve signals that control the bladder, leading to issues with urinary retention, incontinence, and urinary tract infections. The other options listed (intellectual impairment, respiratory compromise, and cranioschisis) are possible complications of myelomeningocele but are less common than neurogenic bladder.

Question 16

A mother reports that her child has episodes where he appears to be staring into space.This behavior is characteristic of which type of seizure?

Accepted Answer

Staring into space is a common symptom of absence seizures, also known as petit mal seizures. The child may also experience brief lapses in awareness or consciousness during these episodes.

Question 17

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

Accepted Answer

The level of consciousness is the most essential part of nursing assessment to detect early signs of a worsening condition in a child with a head injury. It is important to monitor changes in the child's level of consciousness as this can indicate a progression in the injury and the need for immediate medical attention. Posturing, vital signs, and focal neurologic signs are also important to assess, but the level of consciousness is the most crucial in detecting a worsening condition.

Question 18

What is a sign of increased intracranial pressure (ICP)in a 10-year-old child?

Accepted Answer

Headache is a common sign of increased intracranial pressure in children, as they are able to express their discomfort through verbal communication. Bulging fontanels are seen in infants and young children but not typically in 10-year-olds. Tachypnea (rapid breathing) can be a sign of respiratory distress but is not specific to increased ICP. Increase in head circumference may be seen in infants with hydrocephalus but is unlikely to be seen in a 10-year-old child.

Question 19

A child with a head injury sleeps unless aroused,and when aroused responds briefly before falling back to sleep.What should the nurse chart for this child's level of consciousness?

Accepted Answer

The child's response of briefly waking up before falling back to sleep indicates that they are obtunded, meaning they only have a partial arousal to stimulation. They are not fully conscious or alert. The other answer choices (disoriented, lethargic, stuporous) describe different levels of consciousness that do not match the child's symptoms.

Question 20

The Glasgow Coma Scale consists of an assessment of

Accepted Answer

The Glasgow Coma Scale consists of an assessment of eye opening, verbal response, and motor response. It does not directly assess pupil reactivity or level of consciousness. It is also not used to measure intracranial pressure (ICP). Therefore, the best answer is B, which includes the correct components of the Glasgow Coma Scale assessment.

Quiz 52: The Child With a Neurologic Alteration