| The nurse caring for a child with a cranial injury knows that broad-spectrum antibiotics
are used to reduce cerebral edema. | False |
| The nurse is discussing with a parent the difference between a breath-holding spell and
a seizure. The nurse would be correct in telling the parent what information in regard to
seizures? | Convulsive activity occurs |
| A child is diagnosed with bacterial meningitis. The nurse would suspect which
abnormality of cerebrospinal fluid (CSF)? | Cloudy appearance |
| When caring for an infant who is hospitalized with Haemophilus influenzae meningitis,
an important nursing intervention for the child would be for the nurse to: | check the child's neurological status every 2 hours. |
| What information is most correct regarding the nervous system of the child? | As the child grows, the gross and fine motor skills increase. |
| Haemophilus influenzae meningitis is usually spread by which of the following methods
of transmission? | Droplet |
| The health care provider orders phenytoin 4 mg/kg/day in three divided doses for a child
who has a seizure disorder. The child weighs 35 lb and the medication is available at
30mg/5mL. What is the amount in mL for one dose of this child's medication? Round to
the nearest tenth. | 3.5 mL |
| The physician has ordered rectal diazepam for a 2-year-old boy with status epilepticus.
Which instruction is essential for the nurse to teach the parents? | Monitor their child's level of sedation. |
| The nurse inspects the eyes of a child and observes that the sclera is showing over the
top of the iris. The nurse documents this finding as: | Sunsetting |
| A nurse is preparing a school-aged child for a lumbar puncture. The nurse would expect
to position the child in which manner? | On her side with the head flexed forward and knees flexed to the abdomen |
| A 6-month-old infant is admitted with a diagnosis of bacterial meningitis. The nurse
would place the infant in which room? | A private room near the nurses’ station |
| A nurse is assessing a 3-year-old child for possible bacterial meningitis. Which sign
would indicate irritation of the meninges? | Positive Kernig sign |
| Which nursing assessment data should be given the highest priority for a child with
clinical findings related to meningitis? | Signs of increased intracranial pressure (ICP) |
| To detect complications as early as possible in a child with meningitis who’s receiving
I.V. fluids, monitoring for which condition should be the nurse’s priority? | Cerebral edema |
| The nurse is assisting to position a child for a lumbar puncture. Which statement
describes the correct positioning for this procedure? | “For a lumbar puncture, the child will be placed in a side-lying position with
knees bent and neck flexed to assist with arching the back. |
| The nurse is preparing a room for a child being admitted with meningitis. What is the
appropriate action by the nurse? | Gather appropriate equipment and signage for respiratory isolation precautions. |
| The mother of a 6-month-old states that she does not understand how her child has
contracted botulism. What is the best response by the nurse? | "Botulism is caused by contaminated food. Honey is a common source." |
| The nurse is providing teaching to the parents of a child recently prescribed
carbamazepine for a seizure disorder. Which statement by a parent indicates successful
teaching? | "I need to watch for any new bruises or bleeding and let my health care provider
know about it." |
| The nurse is caring for a school-age child who has been having a continuous seizure for
the last 40 minutes. What is the priority action by the nurse? | Administer lorazepam IV as prescribed. |
| The nurse is caring for an infant who is at risk for increased intracranial pressure. What
statement by the parent would alert the nurse to further assess the child's neurological
status? | "She has been irritable for the last hour....seems like she is just upset for some
reason." |
| A doctor orders the placement of an ICP monitor in a patient with cerebral edema. The
nurse is aware that this surgery will take place in the infratentorial region of the brain. | False |
| The nurse is educating the family of a 7-year-old with epilepsy about care and safety for
this child. What comment will be most valuable in helping the parent and the child cope? | “Use this information to teach family and friends.” |
| What is a true statement regarding status epilepticus? | It is a common neurologic emergency in children. |
| The nurse is caring for a 12-month-old infant diagnosed with Haemophilus
influenzae meningitis. Which clinical manifestation would likely have been noted in this
child? | High-pitched cry and nuchal rigidity |
| Isabelle, age 7, has been complaining of headache, coughing, and an aching chest. The
care provider makes a diagnosis of a viral infection. The child's mother tells the nurse
that when Isabelle first said she had a headache, the child's father gave her half of an
adult aspirin. The mother has heard of Reye syndrome and asks the nurse if her child
could get this. Which statement would be best for the nurse to say to this mother? | “This might or might not be a problem. Watch Isabelle for signs of lethargy,
unusual irritability, confusion, or vomiting. If you notice any of these, bring her to
the emergency room immediately so she can be checked for Reye syndrome.” |
| The mother of a child newly diagnosed with an intellectual disability tells the nurse that
her partner disagrees with the diagnosis and believes that the child is perfectly normal.
The mother shares with the nurse that she finds this reaction frustrating and confusing.
Which action by the nurse would be appropriate in supporting this mother? | Reassure the mother that her partner's reaction is a normal stage in the grieving
process. |
| In caring for the child with meningitis, the nurse recognizes that which nursing diagnosis
would be most important to include in this child's plan of care? | Risk for injury related to seizure activity |
| A 6-month-old infant is admitted with suspected bacterial meningitis. She is crying,
irritable, and lying in the opisthotonic position. Which intervention should the nurse
take initially? | Institute droplet precautions in addition to standard precautions. |
| A 9-year-old boy is suffering from headaches but has no signs of physical or neurologic
illness. Which intervention would be most appropriate? | Teach the child and his parents to keep a headache diary. |
| A 6-year-old has had a viral infection for the past 5 days and is having severe vomiting,
confusion, and irritability, although he is now afebrile. During the assessment, the nurse
should ask the parent which question? | "Did you use any medications like aspirin for the fever?" |
| The nurse is educating the parents of a 7-year-old girl with epilepsy about managing
treatment of the disorder at home. Which intervention is most effective for eliminating
breakthrough seizures? | Understanding the side effects of medications |
| The nurse is caring for a child hospitalized with Reye syndrome who is in the acute
stage of the illness. The nurse would assess the child most carefully for what finding? | Indications of increased intracranial pressure |
| A 4-year-old boy has a febrile seizure during a well-child visit. What action would be
a priority? | Protecting the child from harm during the seizure |
| The nurse is caring for an 8-year-old boy who has chronic epilepsy. What would
be most important to address when teaching the child and parents about living with this
condition? | Support for maintaining self-esteem because of his altered lifestyle |
| A preschool-age child has just been admitted to the pediatric unit with a diagnosis of
bacterial meningitis. The nurse would include which recommendation in the nursing
plan? | Decrease environmental stimulation |
| An otherwise healthy 18-month-old child with a history of febrile seizures is in the wellchild clinic. Which statement by the father would indicate to the nurse that additional
teaching should be done? | “I always keep phenobarbital with me in case of a fever.” |
| A 9-year-old girl who is suspected of having an infection of the central nervous system
is undergoing a lumbar puncture to withdraw cerebrospinal fluid for analysis. The nurse
knows that the needle will be introduced into the subarachnoid space at the level of
which of the following vertebrae? | L4 or L5 |
| Put the following events of a generalized epileptic seizure in correct order: | Prodromal period
Tonic stage
Clonic stage
Postictal period |
| A nursing instructor has completed a class session on Guillain-Barré syndrome. Which
statement by a student indicates a need for further education? | "Paralysis peaks at about 3 weeks before recovery, but most do not completely
recover from the paralysis." |
| The nurse is caring for a child who has suffered a febrile seizure. While speaking with
the child’s parents, which statement by a parent indicates a need for further education? | "I hate to think that I will need to be worried about his having seizures for the rest
of his life." |
| The eyes of a 9-year-old who suffered a head injury are crossed. Besides checking ICP,
which intervention would be most important for the nurse to perform? | Assess the child's level of consciousness. |
| The premise behind using plasmapheresis in patient diagnosed with Guillain-Barré
syndrome includes which of the following? | Prevention of demyelination |
| During a well-child visit, the nurse assesses an infant's ability to suck on a pacifier. The
nurse is assessing which cranial nerve? | Trigeminal |
| A 15-year-old adolescent is brought to the emergency department by his parents. The
adolescent is febrile with chills that started suddenly. He states, “I had a sinus infection
and sore throat a couple of days ago.” The nurse suspects bacterial meningitis based
on which findings? Select all that apply. | Complaints of stiff neck
Photophobia
Vomiting |
| The nurse is collecting data from a child who may have a seizure disorder. Which
nursing observations suggest an absence seizure? | Minimal or no alteration in muscle tone, with a brief loss of consciousness |
| Antibiotic therapy to treat meningitis should be instituted immediately after which event? | Collection of cerebrospinal fluid (CSF) and blood for culture |
| A nurse is caring for a 6-year-old boy with Guillain-Barré syndrome who has been in the
hospital with this condition for 3 weeks. Which intervention should the nurse be
implementing to prevent deep vein thrombosis in this child? | Applying support stockings |
| A panicked mother calls the health care provider's office and reports that her 5-year-old
has a high fever and just had a seizure. The mother asks the nurse what she should do.
Which is the nurse's best response? | Report to the emergency room for medical evaluation |
| While caring for a child who will be undergoing a lumbar puncture, the nurse explains
the procedure to the infant’s mother. Which statement by the mother would indicate a
need for further education? | “I will cradle her in my arms after the procedure for at least 30 minutes.” |
| The nurse is caring for a child diagnosed with Sturge-Weber syndrome. Which
assessment finding supports this diagnosis? | port-wine birthmark on the upper part of the face |
| The nurse is in the room when a child with a seizure disorder is having a seizure. The
child is exhibiting generalized jerking muscle movement, and the nurse notes the bed
appears to be wet with urine. The child is in which stage of the generalized seizure? | Clonic |
| The nurse is discussing discipline issues with a group of caregivers of preschool-aged
children who have a cognitive impairment. One father tells the group that after he tells
his child to stop doing something, the child just continues. Parents in the group make
the following statements. Which statement indicates an understanding of disciplining the
cognitively impaired child? | “We wait until a behavior happens a second time and immediately put our child
in time out.” |
| In caring for a child with a seizure disorder, the primary goal of treatment is: | the child will be free from injury during a seizure |
| The nurse is observing a group of children diagnosed with various types of cerebral
palsy. One of the children has an awkward and wide-based gait. The nurse recognizes
this characteristic as common in which type of cerebral palsy? | Ataxic cerebral palsy |
| A 16-year-old boy reports to the school nurse of headaches and a stiff neck. Which sign
or symptom would alert the nurse that the child may have bacterial meningitis? | Sunlight is “too bright” |
| A nurse is talking with the parents of a child who has had a febrile seizure. The nurse
would integrate an understanding of what information into the discussion? | Febrile seizures are benign in nature. |
| A nurse is performing a complete neurological examination of a 7-year-old boy. She will
now test his cerebellar function. Which of the following tests would be appropriate for
this purpose? | Ask the boy to touch each finger on one hand with the thumb that hand in rapid
succession |
| When caring for a child who has a history of seizures, which nursing interventions would
be appropriate? Select all that apply | The nurse pads the crib or side rails before a seizure.
The nurse positions the child on the side during a seizure.
The nurse stays with the child and calls for help when a seizure begins.
The nurse has oxygen available to use during a seizure.
The nurse teaches the caregivers regarding seizure precautions. |
| In completing a neurologic assessment on a preschool-aged client, the student nurse
plans to assess for stereognosis. Which technique demonstrates the proper way to
assess for stereognosis? | Ask the child to close the eyes and hold out a hand; place a key in the hand.
Then ask the child to identify the object |
| The nurse is caring for a child who has suffered a head injury and has had an ICP
monitor placed. Which prescription by the health care provider would the nurse
question? | Initiate an IV of 0.9% NS to run at 250 mL/hr. |
| The emergency room nurse is taking a history of a 1-year-old child whose parent said
that she had a “fit" at home. Which inquiry would be best to start with? | “What happened just before the seizures?” |
| The nurse is caring for a child who had a seizure, fell to the ground, and hit and injured
his face, head, and shoulders. When notifying the healthcare provider, which type of
seizure is the nurse most likely to report? | Atonic |
| The nurse is doing an in-service with a group of peers. The topic of the four stages seen
in tonic-clonic seizures is being discussed. Place the following stages seen in the tonicclonic seizure in the order they would occur. | Clonic phase
Aura
Postictal period
Tonic phase
Prodromal period |
| A nurse is preparing a presentation for a local health fair about meningitis and has
developed a display that lists the following causes:
Streptococcus group B
Haemophilus influenzae type B
Streptococcus pneumoniae
Neisseria meningitidis
What would the nurse highlight as the most common cause of meningitis in newborns? | Streptococcus group B |
| To detect complications as early as possible in a child with meningitis who’s receiving
I.V. fluids, monitoring for which condition should be the nurse’s priority? | Cerebral edema |
| A nurse is performing a neurologic examination of a 5-year-old child. She asks the boy
to close his eyes, and then she places a crayon in his hand and asks him to identify it.
Which type of ability is the nurse testing for in this boy? | Stereognosis |
| The student nurse is preparing to perform a neurologic exam on a 4-year-old child.
Which statement by the student would require an intervention by the nursing instructor? | “I will test the child’s remote memory by showing the child my car keys and
asking him to remember it and recall it in about 5 minutes. |
| The nurse is providing teaching to the parents of a child recently prescribed
carbamazepine for a seizure disorder. Which statement by a parent indicates successful
teaching? | "I need to watch for any new bruises or bleeding and let my health care provider
know about it." |
| The nurse is caring for a school-age child who has been having a continuous seizure for
the last 40 minutes. What is the priority action by the nurse? | Administer lorazepam IV as prescribed. |
| The mother of a child newly diagnosed with an intellectual disability tells the nurse that
her partner disagrees with the diagnosis and believes that the child is perfectly normal.
The mother shares with the nurse that she finds this reaction frustrating and confusing.
Which action by the nurse would be appropriate in supporting this mother? | Reassure the mother that her partner's reaction is a normal stage in the grieving
process |
| A 6-month-old infant is admitted with suspected bacterial meningitis. She is crying,
irritable, and lying in the opisthotonic position. Which intervention should the nurse
take initially? | Institute droplet precautions in addition to standard precautions. |
| The nurse is caring for a child who was injured in a bike accident. The nurse determines
that a child is experiencing late signs of increased intracranial pressure based on which
assessment findings? Select all that apply. | Bradycardia
Fixed dilated pupils
Irregular respirations |
| A nurse is examining a boy with cerebral palsy. He has hypertonic muscles and
abnormal clonus in his legs and walks on his toes. Which of the following is the type of
cerebral palsy that this boy is demonstrating? | Spastic |
| Put the following events of a generalized epileptic seizure in correct order: | Prodromal period
Tonic stage
Clonic stage
Postictal period |
| What finding would lead the nurse to suspect that a child is beginning to develop
increased intracranial pressure? | Projectile vomiting |
| A 15-year-old adolescent is brought to the emergency department by his parents. The
adolescent is febrile with chills that started suddenly. He states, “I had a sinus infection
and sore throat a couple of days ago.” The nurse suspects bacterial meningitis based
on which findings? Select all that apply. | Complaints of stiff neck
Photophobia
Vomiting |
| Which intervention prevents a 17-month-old child with spastic cerebral palsy from going
into a scissoring position? | Placing the child on your hip |
| A nurse is providing information to the parents of a child diagnosed with absence
seizures. What information would the nurse expect to include when describing this type
of seizure? Select all that apply | This type of seizure is more common in girls than it is in boys.
You might see a blank facial expression after a sudden stoppage of speech.
This type of seizure is usually short, lasting for no more than 30 seconds.
You might have mistaken this type of seizure for lack of attention. |
| A nurse is performing a complete neurological examination of a 7-year-old boy. She will
now test his cerebellar function. Which of the following tests would be appropriate for
this purpose? | Ask the boy to touch each finger on one hand with the thumb that hand in rapid
succession |
| In completing a neurologic assessment on a preschool-aged client, the student nurse
plans to assess for stereognosis. Which technique demonstrates the proper way to
assess for stereognosis? | Ask the child to close the eyes and hold out a hand; place a key in the hand.
Then ask the child to identify the object. |
| A nurse is caring for an infant who has just undergone a ventricular tap. In what position
should the nurse place the infant immediately after the procedure? | semi-Fowler's position with a parent at the bedside |
| A nurse is talking with the parents of a child who has had a febrile seizure. The nurse
would integrate an understanding of what information into the discussion? | Febrile seizures are benign in nature. |
| The nurse is caring for a child hospitalized with Reye syndrome who is in the acute
stage of the illness. The nurse would assess the child most carefully for what finding? | Indications of increased intracranial pressure |
