Disorders of the head Flashcards

1
Q

A mother is concerned about her infant who presents with an abnormal shaped head due to his sleeping position. Propose an accurate statement regarding this disorder.

Factors that contribute to plagiocephaly include back-sleeping.

This condition is typically due to increased intracranial pressure.

This is an uncommon condition that requires shunting.

Reshaping of the head is not recommended.

A

Factors that contribute to plagiocephaly include back-sleeping.

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2
Q

A parent is asking questions regarding her child’s treatment plan for craniosynostosis. Determine which statement reflects a need for further education.

Treatment for this disorder is often surgical.

This surgery is typically not done for cosmetic reasons.

Surgery for the release of sutures is recommended before 6 months of age.

Surgery is done when closure of multiple sutures increases intracranial pressure.

A

This surgery is typically not done for cosmetic reasons.

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3
Q

When assessing a patient for macrocephaly, the nurse practitioner completes transillumination in the infant. Predict what transillumination of the skull with an intensely bright light in a completely darkened room may disclose.

Vomiting

Hyperpigmentation

Subdural atrophy

Hydranencephaly

A

Hydranencephaly

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4
Q

Establish a factor that contributes to positional plagiocephaly.

Supervised tummy time

Baby carrier

Craniosynostosis

Prone positioning for 60 minutes

A

Baby carrier

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5
Q

A pediatric patient presents to the clinic for evaluation of a head disorder. Recommend how to diagnose hydrocephaly.

Ultrasound

Exploratory surgery

Patient history

Shunting

A

Ultrasound

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6
Q

When completing a pediatric patient assessment, determine which of the following warrants a follow-up.

A patient presenting with a symmetrical skull examination

A patient with an anterior fontanel closure at 22 months of age

A head circumference more than two standard deviations below the mean for age and sex

A head circumference more than one standard deviations below the mean for age and sex

A

A head circumference more than two standard deviations below the mean for age and sex

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7
Q

A nurse practitioner is completing a physical assessment of a pediatric patient. Predict which requires further evaluation.

Fontanels that are flat on palpation

Anterior fontanelsthat are open at 16 months of age

Head circumference more than two standard deviations below the mean for age and sex

Posterior fontanels that are closed by 10 weeks

A

Head circumference more than two standard deviations below the mean for age and sex

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8
Q

A parent is asking questions regarding her child’s treatment plan for craniosynostosis. Determine which statement reflects a need for further education.

An orthotic helmet may be used for several months to help with skull reshaping.

Surgery for the release of sutures is recommended before 6 months of age.

Treatment is not usually needed for children with craniosynostosis.

Treatment for this disorder is often surgical.

A

Treatment is not usually needed for children with craniosynostosis.

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9
Q

A nurse practitioner is educating a group of students on pediatric head disorders. Conclude which statement indicates a need for further education.

The newborn has two fontanels at the juncture of the cranial bones.

Abnormal skull shape can result from premature closure of sutures.

When assessing for head shape disorders, the occipital angle is most relevant.

Treatment of head shape disorders is specific to the disorder.

A

When assessing for head shape disorders, the occipital angle is most relevant.

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10
Q

A mother is concerned about her infant who presents with an abnormal shaped head due to his sleeping position. Propose an accurate statement regarding this disorder.

This condition is typically due to increased intracranial pressure.

A multidisciplinary craniofacial team is needed for optimal outcome.

This is an uncommon condition that requires shunting.

Factors that contribute to plagiocephaly include back-sleeping.

A

Factors that contribute to plagiocephaly include back-sleeping.

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11
Q

A nurse practitioner is providing information on children with hydrocephalus to a community support group. Establish which statement is inaccurate.

Hydrocephalus is caused by an imbalance of cerebral spinal fluid.

Hydrocephalus can be corrected with intravenous antibiotics.

Hydrocephalus may be congenital or acquired.

Congenital hydrocephalus arises as a result of a malformation in the brain.

A

Congenital hydrocephalus arises as a result of a malformation in the brain

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12
Q

A nurse is educating parents regarding treatment of hydrocephalus. Determine which statement is accurate.

Early shunting after birth is contraindicated.

Initial shunt placement is usually completed at age 1–2 years.

Placement of a shunt system helps reduce the accumulation of CSF.

Shunt placement cancounteract the accumulation of CSF in the brain.

A

Placement of a shunt system helps reduce the accumulation of CSF

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13
Q

A nurse practitioner is completing a history and physical examination on a pediatric patient. Predict which finding is consistent with microcephaly.

Microcephaly is typically caused by hydrocephalus.

The patient has a history of fetal alcohol syndrome.

A 5-month-old infant with microcephaly presents with a head circumference that exceeds chest circumference.

The patient typically presents with a brain neoplasm.

A

The patient has a history of fetal alcohol syndrome.

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14
Q

When evaluating a patient for craniosynostosis, predict which statement the nurse practitioner identified as accurate.

Craniosynostosis results in deformity of the skull.

Increased intracranial pressure is an uncommon finding.

The most common form of craniosynostosis occurs more commonly in females.

Primary craniosynostosis involves the failure of brain growth and expansion.

A

Craniosynostosis results in deformity of the skull.

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15
Q

A nurse practitioner is completing a physical examination on a pediatric patient. Propose what the evaluation of the child with an abnormally large head or a head growing at an excessive rate should include.

Four generations of family medical history

Treatment that will return the infant’s head to its natural size

Ultrasound to assess ventricle size if the fontanel is closed

Detailed family history and measurement of the parent’s head circumference

A

Detailed family history and measurement of the parent’s head circumference

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16
Q

A nurse practitioner is educating a group of students on macrocephaly. Identify that statement that provides a need for further education.

Genetic mutations of the fibroblast growth factor receptor have been linked to macrocephaly.

Supervised tummy time decreases the incidence of macrocephaly.

Infants with macrocephaly commonly have a flat spot on their skull.

Macrocephaly is defined as a head circumference more than two standard deviations above the mean for age and gestation.

A

Macrocephaly is defined as a head circumference more than two standard deviations above the mean for age and gestation.

17
Q

A nurse practitioner is educating a group of students on pediatric physical assessments. Propose an accurate statement when evaluating for pediatric head disorders.

The head should be evaluated from all angles when completing the physical evaluation.

The head circumference is equal to the chest circumference by 6 months of age.

Most infants have asymmetric, oval heads.

The head circumference is typically routinely measured until 5 years of age.

A

The head should be evaluated from all angles when completing the physical evaluation.

18
Q

A nurse practitioner is completing a physical assessment of a pediatric patient. Predict which requires further evaluation.

Posterior fontanels that are closed by 10 weeks

Anterior fontanelsthat are open at 16 months of age

Closure of the anterior fontanels by 6 months of age

Infants with a rounded skull with a prominent occipital area

A

Closure of the anterior fontanels by 6 months of age

19
Q

A mother is concerned about her infant who presents with an abnormal shaped head due to his sleeping position. Propose an accurate statement regarding this disorder.

A multidisciplinary craniofacial team is needed for optimal outcome.

This condition is typically due to increased intracranial pressure.

This is an uncommon condition that requires shunting.

Factors that contribute to plagiocephaly include back-sleeping.

A

Factors that contribute to plagiocephaly include back-sleeping.

20
Q

A nurse practitioner is completing a physical examination on a pediatric patient. Propose what the evaluation of the child with an abnormally large head or a head growing at an excessive rate should include.

Ultrasound to assess ventricle size if the fontanel is closed

Four generations of family medical history

Detailed family history and measurement of the parent’s head circumference

Management with supportive care only

A

Detailed family history and measurement of the parent’s head circumference

21
Q

A pediatric patient presents to the clinic for evaluation of a head disorder. Recommend how to diagnose hydrocephaly.

Patient history

CT scan

Shunting

Palpation of bony ridge along skull suture

A

CT scan

22
Q

When evaluating a patient for craniosynostosis, predict which statement the nurse practitioner identified as accurate.

Primary craniosynostosis involves the failure of brain growth and expansion.

Increased intracranial pressure is an uncommon finding.

A radiograph is standard for a skull shape deformity.

Craniosynostosis is a common feature of children with genetic syndromes.

A

Craniosynostosis is a common feature of children with genetic syndromes.

23
Q

A nurse is educating parents regarding treatment of hydrocephalus. Determine which statement is accurate.

Shunt placement cancounteract the accumulation of CSF in the brain.

Early shunting after birth is contraindicated.

Shunt infections are typically mild and rare.

Surgery may be required to create a pathway to divert excess CSF.

A

Surgery may be required to create a pathway to divert excess CSF.

24
Q

A nurse practitioner is educating a group of students on microcephaly. Determine the accurate statement.

Microcephaly can only be diagnosed after the baby is born.

Radiographis most helpful in definitive diagnosis and prognosisof microcephaly.

A helmet can be used to return the patient’s head to normal size.

Diagnosis is confirmed via CT scan.

A

Diagnosis is confirmed via CT scan.

25
Q

A nurse practitioner is educating a group of students on pediatric head disorders. Conclude which statement indicates a need for further education.

The newborn has two fontanels at the juncture of the cranial bones.

An infant’s head circumference is usually measured until 2 years of age.

Treatment of head shape disorders is specific to the disorder.

Deviations from head growth in infants are considered normal.

A

Deviations from head growth in infants are considered normal.

26
Q

A nurse practitioner is educating a group of students on macrocephaly. Identify that statement that provides a need for further education.

Computed tomography scans are used to assess ventricular size or to define any structural cause of macrocephaly.

Genetic mutations of the fibroblast growth factor receptor have been linked to macrocephaly.

Macrocephaly is defined as a head circumference less than two standard deviations above the mean for age and sex.

Supervised tummy time decreases the incidence of macrocephaly.

A

Computed tomography scans are used to assess ventricular size or to define any structural cause of macrocephaly.