Neurology Flashcards
A child admitted for a C6-C7 vertebral dislocation is quickly placed in halo traction. In the initial hours following injury, the nursing priority is A. maintaining aseptic halo pin sites B. checking the skin under the vest C. monitoring respiratory status D. initiating nurtitional support
C. monitoring respiratory status
Which of the following assessment findings suggests brain death? A. a positive knee jerk B. a positive Babinski response C. agonal respirations D. a negative oculovestibular test
D. a negative oculovestibular test
An infant is born with a mass of tissue protuding from the spine. A bedside technique to identify whether the defect is a meningocele or a myelomeningocele involves
A. shining a bright light through the tissue mass
B. using Doppler ultrasound to detect blood flow
C. obtaining a radiograph with the child prone
D. auscultating the base of the mass for a bruit
A. shining a bright light through the tissue mass
A child has a tuft of hair along the lumbar spine. Which type of neural tube defect does this represent? A. Spina bifida cystica B. Spina bifida occulta C. Meningocele D. Myelomeningocele
B. Spina bifida occulta
Patients with spina bifida often require which of the following surgical procedures within the first few weeks of life? A. Tethered cord release B. Syrinx repair C. Ventriculoperioneal shunt placement D. Chiari malformation repair
C. Ventriculoperioneal shunt placement
An otherwise healthy 15-year-old paient presents with new onset seizures and dysrhythmias. A brain magnetic resonance imaging scan shows changes consistent with chronic toxic encephalopathy. Which of the following substances is the most likely cause of these findings? A. Lead B. Mercury C. Hydrocarbons D. Arsenic
C. Hydrocarbons
An emergent caesarean section is performed for loss of fetal heart tones. The neonate is floppy, acidotic, and has low APGAR scores. The nurse anticipates which of the following interventions? Endotrcaheal intubation,
A. controlled rewarming, and magnetic resonance imaging
B. inotropic support, and fluid resuscitation
C. terapeutic hypothermia, and seizure monitoring
D. trophic feeding, and 100% oxtgen administration
C. terapeutic hypothermia, and seizure monitoring
A mechanically ventilated brain-injured patient with a ventriculostomy has an intracranial pressure (ICP) of 25 mm Hg. Which of the following interventions would most rapidly reduce ICP? A. Hyperventilate the patient B. Bolus with mannitol C. Initiate a midaxolam drip D. Open the ventricular drain
D. Open the ventricular drain
Which of the following skull fracture types is most likely to occur in an infant? A. linear fracture B. basilar fracture C. ping pong fracture D. open fracture
C. ping pong fracture
A 4-year-old child with a ventriculoperitoneal shunt presents with a 2-day history of progressive lethargy, anorexia, nausea, and vomiting. The most likely cause of these findings is shunt A. infection B. obstruction C. migration D. disconnection
B. obstruction
A child presents with findings suggestive of a subarachnoid hemorrhage. Which of the following diagnositc studies will best identify the aneurysm location and size? A. Computed tomography B. CT angiography C. Magnetic resonance imaging D. Lumbar puncture
B. CT angiography
A 1-week-old infant underwent surgery for repair of a complex cardiac defect. To reduce the postoperative risk of intraventricular hemorrhage, which of the following nursing interventions is CONTRAINDICATED?
A. Perform leg range of motion exercises
B. Maintain the child’s head in a midline position
C. Avoid frequent endotracheal suctioning
D. Minimize auditory and tactile stimulation
A. Perform leg range of motion exercises
An acutely ill 6-year-old child presents with fever and meningeal signs. A lumbar puncture is performed with the following results: glucose 32 mg/dL; protein 247 mg/dL; white blood cells 1,850 mm3. Based on these results, this child most likely has which type of meningitis? A. Viral B. Bacterial C. Chemical D. Fungal
B. Bacterial
A Guillain-Barre syndrome patient’s parents are very upset because, “he’s going to be paralyzed and on a ventilator for the rest of his life.” The nurse explains that –regardless of disease severity– most children with Guillain-Barre syndrome will
A. recover partially, with residual deficits.
B. regain extremity function but remain ventilator-dependent.
C. recover completely within 3 years of onset.
D. die within 3 years of diagnosis.
C. recover completely within 3 years of onset.
A 6-week-old infant is admitted to the PICU for respiratory distress, poor feeding, a weak cry, and hypotonia. The child regularly receives honey on her pacifier. This patient is at greatest risk for A. respiratroy failure. B. cardiovascular failure. C. poor urinary output. D. intractable seizures.
A. respiratroy failure.
Following transsphenoidal resection of a tumor a child appears to be recovering without complications. However, the nurse notes a clear nasal discharge. To determine whether the discharge is cerebral spinal fluid, the nurse tests the drainage for the presense of A. sodium B. glucose C. white cells D. lipids
B. glucose
The parents of a young child describe frequent episodes of "zoning out" that last only a few seconds. Sometimes these events occur when the child is seated; other times while she is walking. During each episode the child's eyes deviate to the left, accompanied by lip smacking. This description is consistent with which seizure type? A. Absence B. Simple partial C. Atonic D. Complex partial
A. Absence
An unusual but devastating adverse dermal hypersensitivity reaction to intravenous phenytoin administration is A. scalded skin sydrome B. Reye's syndrome C. toxic shock syndrome D. Stevens-Johnson syndrome
D. Stevens-Johnson syndrome
The parents of a 5-year-old report the child goes to bed each night feeling normal but awakens around 4 A.M. with a pounding headache. This pattern has persisted for 2 weeks. This history suggests the headaches are due to A. viral meningitis B. early hydrocephalus C. a brain tumor D. a slow-leaking aneurysm
C. a brain tumor
Unlike adults, the majority of childhood brain tumors occur A. in the frontal lobe B. around the circle of Willis C. in the ventricles D. in the posterior fossa
D. in the posterior fossa
A severely scoliotic child with cerebral palsy is admitted to the PICU following spinal fusion. In the early postoperative hours, which body system is at greatest risk? A. Cardiovascular B. Respiratory C. Gastrointestinal D. Hematologic
B. Respiratory
An 8-year-old child was involved in a frontal motor vehical collision while sitting in the front passenger seat, wearing a standard shoulder and lap belt. The child is now alert but unable to move the right arm or leg and has speech impairment. These findings suggest A. cervical spinal cord damage B. diffuse axonal injury C. carotid artery trauma D. subarachnoid hemorrhage
C. carotid artery trauma
