Question 1

What is a priority of care when a child has an external ventricular drain (EVD)?

Accepted Answer

A)  Irrigation of drain to maintain flow 
B)  As-needed dressing changes if dressing becomes wet 
C)  Frequent assessment of amount and color of drainage 
D)  Maintaining the EVD below the level of the child's head 
A)  Irrigation of drain to maintain flow 
B)  As-needed dressing changes if dressing becomes wet 
C)  Frequent assessment of amount and color of drainage 
D)  Maintaining the EVD below the level of the child's head

Question 2

The nurse is teaching the parents of a 3-year-old child who has been diagnosed with tonic-clonic seizures. What statement by the parent should indicate a correct understanding of the teaching?

Accepted Answer

A)  "I should attempt to restrain my child during a seizure." 
B)  "My child will need to avoid contact sports until adulthood." 
C)  "I should place a pillow under my child's head during a seizure." 
D)  "My child will need to be taken to the emergency department [ED] after each seizure." 
A)  "I should attempt to restrain my child during a seizure." 
B)  "My child will need to avoid contact sports until adulthood." 
C)  "I should place a pillow under my child's head during a seizure." 
D)  "My child will need to be taken to the emergency department [ED] after each seizure."

Question 3

What is the antiepileptic medication that requires monitoring of vitamin D and folic acid?

Accepted Answer

A)  Topiramate (Topamax) 
B)  Valproic acid (Depakene) 
C)  Gabapentin (Neurontin) 
D)  Phenobarbital (Luminal) 
A)  Topiramate (Topamax) 
B)  Valproic acid (Depakene) 
C)  Gabapentin (Neurontin) 
D)  Phenobarbital (Luminal)

Question 4

What cerebrospinal fluid (CSF) analysis should the nurse expect with viral meningitis? (Select all that apply.)

Accepted Answer

A)  Color is turbid. 
B)  Protein count is normal. 
C)  Glucose is decreased. 
D)  Gram stain findings are negative. 
E)  White blood cell (WB
C)  count is slightly elevated. 
A)  Color is turbid. 
B)  Protein count is normal. 
C)  Glucose is decreased. 
D)  Gram stain findings are negative. 
E)  White blood cell (WB
C)  count is slightly elevated.

Question 5

The mother of a 1-month-old infant tells the nurse she worries that her baby will get meningitis like the child's younger brother had when he was an infant. The nurse should base a response on which information?

Accepted Answer

A)  Meningitis rarely occurs during infancy. 
B)  Often a genetic predisposition to meningitis is found. 
C)  Vaccination to prevent all types of meningitis is now available. 
D)  Vaccinations to prevent pneumococcal and Haemophilus influenzae type B meningitis are available. 
A)  Meningitis rarely occurs during infancy. 
B)  Often a genetic predisposition to meningitis is found. 
C)  Vaccination to prevent all types of meningitis is now available. 
D)  Vaccinations to prevent pneumococcal and Haemophilus influenzae type B meningitis are available.

Question 6

A child is admitted for revision of a ventriculoperitoneal shunt for noncommunicating hydrocephalus. What is a common reason for elective revision of this shunt?

Accepted Answer

A)  Meningitis 
B)  Gastrointestinal upset 
C)  Hydrocephalus resolution 
D)  Growth of the child since the initial shunting 
A)  Meningitis 
B)  Gastrointestinal upset 
C)  Hydrocephalus resolution 
D)  Growth of the child since the initial shunting

Question 7

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

Accepted Answer

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

Question 8

A 6-year-old child is admitted for revision of a ventriculoperitoneal shunt for noncommunicating hydrocephalus. What sign or symptom does the child have that indicates a revision is necessary?

Accepted Answer

A)  Tachycardia 
B)  Gastrointestinal upset 
C)  Hypotension 
D)  Alteration in level of consciousness 
A)  Tachycardia 
B)  Gastrointestinal upset 
C)  Hypotension 
D)  Alteration in level of consciousness

Question 9

What type of seizure may be difficult to detect?

Accepted Answer

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

Question 10

The nurse is preparing to admit a 5-year-old with an epidural hemorrhage. What clinical manifestations should the nurse expect to observe? (Select all that apply.)

Accepted Answer

A)  Headache 
B)  Vomiting 
C)  Irritability 
D)  Cephalhematoma 
E)  Pallor with anemia 
A)  Headache 
B)  Vomiting 
C)  Irritability 
D)  Cephalhematoma 
E)  Pallor with anemia

Question 11

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 that they think their child is in pain because of periodic crying and restlessness. What is the most appropriate nursing action?

Accepted Answer

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

Question 12

What is a nursing intervention to reduce the risk of increasing intracranial pressure (ICP) in an unconscious child?

Accepted Answer

A)  Suction the child frequently. 
B)  Turn the child's head side to side every hour. 
C)  Provide environmental stimulation. 
D)  Avoid activities that cause pain or crying. 
A)  Suction the child frequently. 
B)  Turn the child's head side to side every hour. 
C)  Provide environmental stimulation. 
D)  Avoid activities that cause pain or crying.

Question 13

The health care provider has prescribed carbamazepine (Tegretol) 20 mg/kg/day divided bid for a child with a seizure disorder. The child weighs 33 lb. The nurse is preparing to administer the 0900 dose. Calculate the dose the nurse should administer in milligrams. Record your answer below in a whole number.
__________

Accepted Answer

150
The correct calculation is

Exam 32: The Child with Cerebral Dysfunction

What is a priority of care when a child has an external ventricular drain (EVD)?

The nurse is teaching the parents of a 3-year-old child who has been diagnosed with tonic-clonic seizures. What statement by the parent should indicate a correct understanding of the teaching?

What is the antiepileptic medication that requires monitoring of vitamin D and folic acid?

What cerebrospinal fluid (CSF) analysis should the nurse expect with viral meningitis? (Select all that apply.)

The mother of a 1-month-old infant tells the nurse she worries that her baby will get meningitis like the child's younger brother had when he was an infant. The nurse should base a response on which information?

A child is admitted for revision of a ventriculoperitoneal shunt for noncommunicating hydrocephalus. What is a common reason for elective revision of this shunt?

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

A 6-year-old child is admitted for revision of a ventriculoperitoneal shunt for noncommunicating hydrocephalus. What sign or symptom does the child have that indicates a revision is necessary?

What type of seizure may be difficult to detect?

The nurse is preparing to admit a 5-year-old with an epidural hemorrhage. What clinical manifestations should the nurse expect to observe? (Select all that apply.)

What is a nursing intervention to reduce the risk of increasing intracranial pressure (ICP) in an unconscious child?

Perspectives of Pediatric Nursing

Social, Cultural, Religious, and Family Influences on Child Health Promotion

Hereditary Influences on Health Promotion of the Child and Family

Communication, Physical, and Developmental Assessment

Pain Assessment and Management in Children

Childhood Communicable and Infectious Diseases

Health Promotion of the Newborn and Family

Health Problems of Newborns

The High-Risk Newborn and Family

Health Promotion of the Infant and Family

Health Problems of the Infant

Health Promotion of the Toddler and Family

Health Promotion of the Preschooler and Family

Health Problems of Early Childhood

Health Promotion of the School-Age Child and Family

Health Problems of the School-Age Child

Health Promotion of the Adolescent and Family

Health Problems of the Adolescent

Family-Centered Care of the Child with Chronic Illness or Disability

Family-Centered Palliative Care

The Child with Cognitive, Sensory, or Communication Impairment

Family-Centered Care of the Child During Illness and Hospitalization

Pediatric Nursing Interventions and Skills

The Child with Fluid and Electrolyte Imbalance

The Child with Renal Dysfunction

The Child with Gastrointestinal Dysfunction

Overview of Oxygen and Carbon Dioxide Exchange

The Child with Respiratory Dysfunction

The Child with Cardiovascular Dysfunction

The Child with Hematologic or Immunologic Dysfunction

The Child with Cancer

The Child with Endocrine Dysfunction

The Child with Musculoskeletal or Articular Dysfunction

The Child with Neuromuscular or Muscular Dysfunction

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