PEDS Final - Neurology
Questions and Answers
- 1.
When using the Glasgow scale, which of the following is not a part of the assessment?
- A.
Blanching
- B.
Eye Opening
- C.
Verbal Response
- D.
Motor Response
Correct Answer
A. BlanchingExplanation
The Glasgow scale is a neurological scale used to assess the level of consciousness and neurological functioning in patients. It consists of three components: eye opening, verbal response, and motor response. Blanching, which refers to the temporary whitening or paleness of the skin due to reduced blood flow, is not a part of the Glasgow scale assessment.Rate this question:
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- 2.
Of the four patient assessment scores listed below, which patient would have no response.
- A.
GCS=3
- B.
GCS
- C.
GCS
- D.
GCS=14
Correct Answer
A. GCS=3Explanation
The Glasgow Coma Scale (GCS) is used to assess the level of consciousness in a patient. A GCS score of 3 indicates that the patient has no eye opening, verbal response, or motor response, suggesting a complete lack of response. Therefore, the patient with a GCS score of 3 would have no response.Rate this question:
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- 3.
An Infant with ICP should be experiencing which of the following symptoms. (select all that apply)
- A.
Poor feeding
- B.
Irritability
- C.
Lethargy
- D.
Bulging anterior fontanel
- E.
Sun Setting Sign
- F.
Headache
- G.
Mood Swings
Correct Answer(s)
A. Poor feeding
B. Irritability
C. Lethargy
D. Bulging anterior fontanel
E. Sun Setting SignExplanation
Infants with increased intracranial pressure (ICP) may experience poor feeding, irritability, lethargy, a bulging anterior fontanel, and the sun setting sign. Poor feeding can occur because increased pressure in the brain can affect the baby's ability to suck and swallow properly. Irritability and lethargy can be signs of discomfort and neurological changes due to increased pressure. A bulging anterior fontanel, the soft spot on a baby's head, can be a visible sign of increased pressure. The sun setting sign refers to the downward deviation of the eyes, which can be a neurological sign of increased pressure. Headache and mood swings are less likely to be seen in infants with ICP, as they may not be able to communicate these symptoms effectively.Rate this question:
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- 4.
A 4yr old male with ICP should be experiencing which of the following symptom? (select all that apply)
- A.
Mood Swing
- B.
Headache
- C.
Diplopia
- D.
AM Nausea & Vomiting
- E.
Altered LOC
- F.
Eyes deviated downward
- G.
Increased head circumference
Correct Answer(s)
A. Mood Swing
B. Headache
C. Diplopia
D. AM Nausea & Vomiting
E. Altered LOCExplanation
ICP stands for intracranial pressure, which refers to the pressure inside the skull. Increased ICP can cause various symptoms. Mood swings can occur due to the pressure affecting the brain's emotional centers. Headache is a common symptom of increased ICP. Diplopia, or double vision, can occur when the pressure affects the nerves controlling eye movements. AM (morning) nausea and vomiting can be a result of increased pressure on the brainstem. Altered LOC (level of consciousness) can occur as the brain's function is affected. However, eyes deviated downward and increased head circumference are not typical symptoms of increased ICP.Rate this question:
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- 5.
A parent explains to the nurse that her son "started acting funny 2 days ago". The nurse suspects ICP. When the nurse assesses the child's eyes, she should expect to see?
- A.
Papiledema
- B.
Diplopia
- C.
Eyes deviated downward
- D.
Jaundice sclera
Correct Answer
A. PapiledemaExplanation
When a nurse suspects increased intracranial pressure (ICP) in a child, one of the expected findings during the eye assessment is papilledema. Papilledema refers to the swelling of the optic disc due to increased pressure within the skull. This can occur as a result of various conditions affecting the brain, such as head trauma, brain tumors, or meningitis. The presence of papilledema indicates that there is increased pressure within the child's skull, which supports the nurse's suspicion of ICP in this case.Rate this question:
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- 6.
To induce cerebral vasoconstriction in a pediatric patient with ICP, which therapeutic method is used?
- A.
Maintain patent airway
- B.
Keep patient supine with HOB at 30 degrees
- C.
Administer Manitol
- D.
Hyperventilation
Correct Answer
D. HyperventilationExplanation
Hyperventilation is used to induce cerebral vasoconstriction in a pediatric patient with ICP. By increasing the rate and depth of breathing, hyperventilation decreases the amount of carbon dioxide in the blood, leading to vasoconstriction of the cerebral blood vessels. This helps to reduce intracranial pressure and improve cerebral perfusion.Rate this question:
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- 7.
You are about to administer a diuretic to an ICP patient when you notice the provider ordered Lasix. When calling the provider, the nurse should ask for
Correct Answer
Manitol
manitolExplanation
The nurse should ask for Manitol because it is a medication commonly used to reduce intracranial pressure (ICP). Lasix, on the other hand, is a diuretic that helps remove excess fluid from the body but does not specifically target ICP. Therefore, it is important for the nurse to clarify the order and request the appropriate medication to effectively manage the patient's condition.Rate this question:
- 8.
When dealing with an 10yr old unconscious child, what findings alert the nurse to a medical emergency? (Patient baseline: BP 120/81, HR 99, RR 21, Temp 37.1°C)
- A.
BP 121/79, HR 100, RR 21, Temp 37°C
- B.
BP 135/60, HR 110, RR 18, Temp 36.5°C
- C.
BP 139/95, HR 55, RR 13, Temp 38.5°C
- D.
BP 111/75, HR 90, RR 20, Temp 37.2°C
Correct Answer
C. BP 139/95, HR 55, RR 13, Temp 38.5°CExplanation
The correct answer is BP 139/95, HR 55, RR 13, Temp 38.5°C. These findings indicate that the child's blood pressure is elevated, heart rate is low, respiratory rate is low, and temperature is high. These abnormalities in vital signs suggest that the child may be experiencing a medical emergency, such as sepsis or shock. Immediate medical intervention is necessary to address the underlying cause and stabilize the child's condition.Rate this question:
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- 9.
A parent questions the nurse about her unconscious toddler's sudden rise in temperature. The nurse should explain;
- A.
The hypothalamus that regulates temperature is now under pressure
- B.
It is the bodies natural response to vascular issues
- C.
Sometimes they will spike a sudden temperature but it fades away
- D.
The body is fighting of a new infection
Correct Answer
A. The hypothalamus that regulates temperature is now under pressureExplanation
The correct answer is that the hypothalamus, which regulates temperature, is now under pressure. This means that there may be some underlying issue or condition causing the sudden rise in temperature. The hypothalamus plays a crucial role in maintaining body temperature, so if it is under pressure, it may not be able to function properly, resulting in a rise in temperature. It is important for the nurse to further investigate and determine the cause of the pressure on the hypothalamus in order to provide appropriate treatment for the child.Rate this question:
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- 10.
Nursing interventions for an unconcious include; (select all that apply)
- A.
Active ROM
- B.
Seizure precautions
- C.
Cooling blanket
- D.
T&P q2h
Correct Answer(s)
B. Seizure precautions
C. Cooling blanket
D. T&P q2hExplanation
The nursing interventions for an unconscious patient include seizure precautions, cooling blanket, and turning and positioning every 2 hours. Seizure precautions are necessary to ensure the safety of the patient in case they experience a seizure. A cooling blanket is used to help regulate the body temperature of an unconscious patient, as they may be unable to control their body temperature effectively. Turning and positioning every 2 hours helps to prevent pressure ulcers and maintain the patient's comfort and circulation.Rate this question:
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- 11.
After using artificial tears for an unconscious patient with eyelids that don't close, the nurse should use____________ to prevent corneal abrasions.
Correct Answer(s)
sterile eye pads
sterile eyepadsExplanation
The nurse should use sterile eye pads or sterile eyepads to prevent corneal abrasions in an unconscious patient with eyelids that don't close. These pads provide a protective barrier for the eyes and help to keep them moist. By using sterile pads, the nurse ensures that there is no risk of introducing any contaminants that could potentially cause an infection.Rate this question:
- 12.
Ataxia, positive Babinski, increased ICP, and hemiparesis are symptoms of
- A.
Glioblastoma
- B.
Seizure Disorder
- C.
Status Epileptus
- D.
Menigitis
Correct Answer
A. GlioblastomaExplanation
Ataxia, positive Babinski, increased ICP (intracranial pressure), and hemiparesis (weakness on one side of the body) are symptoms commonly associated with glioblastoma. Glioblastoma is a type of brain tumor that can cause these neurological symptoms due to its location and effect on the surrounding brain tissue. Seizure disorder and status epilepticus are conditions characterized by recurrent seizures, while meningitis refers to inflammation of the protective membranes covering the brain and spinal cord. Therefore, glioblastoma is the most likely cause of the mentioned symptoms.Rate this question:
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- 13.
Which is not a post-op intervention for Glioblastoma?
- A.
Assess developmental milestones
- B.
Glasgow Coma Scale
- C.
Restrict fluids
- D.
Increase HOB 5°/hr
Correct Answer
A. Assess developmental milestonesExplanation
Assessing developmental milestones is not a post-op intervention for Glioblastoma. Glioblastoma is a type of brain tumor, and post-operative interventions for this condition typically involve monitoring the patient's neurological status, managing pain and swelling, maintaining fluid balance, and preventing complications. Assessing developmental milestones is more relevant in pediatric patients to monitor their growth and development, but it is not directly related to post-operative care for Glioblastoma.Rate this question:
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- 14.
What are the primary etiology factors for seizure disorder? (select all that apply)
- A.
Genetic predisposition
- B.
Birth to early infancy trauma
- C.
Structural or metabolic abnormality
- D.
Meningitis
Correct Answer(s)
A. Genetic predisposition
B. Birth to early infancy traumaExplanation
The primary etiology factors for seizure disorder include genetic predisposition and birth to early infancy trauma. Genetic predisposition refers to the presence of certain genes that increase the likelihood of developing a seizure disorder. Birth to early infancy trauma refers to any injury or trauma that occurs during the birthing process or in the early stages of infancy, which can lead to the development of seizure disorder. Other factors such as structural or metabolic abnormality and meningitis may also contribute to the development of seizure disorder, but they are not mentioned as primary factors in this question.Rate this question:
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- 15.
What are the secondary etiology factors for seizure disorder? (select all that apply)
- A.
Febrile
- B.
Trauma or congenital defects from birth to early infancy
- C.
Cerebral lesions
- D.
Metabolic disorders
Correct Answer(s)
C. Cerebral lesions
D. Metabolic disordersExplanation
Seizure disorder can have various secondary etiology factors. Cerebral lesions refer to any abnormalities or damage in the brain, which can contribute to the development of seizures. Metabolic disorders involve disruptions in the body's chemical processes, which can also lead to seizures. Febrile seizures occur as a result of high fever, but they are considered a primary rather than a secondary cause. Trauma or congenital defects are also potential factors, but they are not mentioned in the given answer.Rate this question:
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- 16.
Which lab test is not used to diagnose seizure disorders?
- A.
Alkaline Phosphatase
- B.
Serum Calcium
- C.
Glucose
- D.
Magnesium
Correct Answer
A. Alkaline PhosphataseExplanation
Alkaline phosphatase is not used to diagnose seizure disorders because it is an enzyme that is primarily used to assess liver and bone health. Seizure disorders are diagnosed through various methods such as electroencephalogram (EEG) to measure brain activity, blood tests for electrolyte imbalances, and imaging tests like MRI or CT scans to identify any structural abnormalities in the brain. Alkaline phosphatase levels are not directly related to seizure disorders and therefore not used as a diagnostic tool for this condition.Rate this question:
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- 17.
A generalized seizure is marked in (select all that apply)
- A.
Both cerebral hemispheres with a change in LOC
- B.
One hemisphere with minimal change in LOC
- C.
Both cerebral hemispheres with symptoms occurring on opposite side
- D.
One Hemisphere with no change in LOC
Correct Answer
A. Both cerebral hemispheres with a change in LOCExplanation
A generalized seizure is characterized by abnormal electrical activity in both cerebral hemispheres of the brain, leading to a loss of consciousness (LOC). This means that the correct answer is "both cerebral hemispheres with a change in LOC." In this type of seizure, the entire brain is affected, resulting in a loss of awareness and often accompanied by convulsions or other physical symptoms.Rate this question:
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- 18.
When a patient has sudden arrest of activity with no memory of event and brief LOC that is mistaken for daydreaming, the patient is experiencing _______________ seizures.
- A.
Petit-mal
- B.
Gran-mal
- C.
Tonic clonic
- D.
Complex partial
Correct Answer
A. Petit-malExplanation
When a patient experiences sudden arrest of activity with no memory of the event and brief loss of consciousness (LOC) that is mistaken for daydreaming, they are likely experiencing petit-mal seizures. Petit-mal seizures, also known as absence seizures, are characterized by brief episodes of altered consciousness where the person may appear to be staring blankly into space. These seizures typically last for a few seconds and are often mistaken for daydreaming or inattentiveness.Rate this question:
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- 19.
Partial seizures are distinguished by the following; (select all that apply)
- A.
Localized motor symptoms
- B.
Repeated purposeless activities
- C.
Eyes deviate towards opposite sides
- D.
Lip smacking, chewing, drooling
Correct Answer(s)
A. Localized motor symptoms
C. Eyes deviate towards opposite sidesExplanation
Partial seizures are characterized by localized motor symptoms and eyes deviating towards opposite sides. These symptoms suggest that the seizure activity is occurring in a specific area of the brain rather than affecting the entire brain. Repeated purposeless activities and lip smacking, chewing, and drooling are not specific to partial seizures and can occur in other types of seizures as well.Rate this question:
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- 20.
Psychomotor seizures that last 5-10 minutes with periods of altered behavior are classified as;
- A.
Complex partial seizures
- B.
Simple partial seizures
- C.
Gran-Mal
- D.
Status Epilepticus
Correct Answer
A. Complex partial seizuresExplanation
Psychomotor seizures that last 5-10 minutes with periods of altered behavior are classified as complex partial seizures. Complex partial seizures are a type of seizure that typically involves a loss of awareness and altered behavior. These seizures can cause a person to engage in repetitive movements or actions, have difficulty speaking or understanding language, and experience changes in emotions or sensations. The duration of 5-10 minutes aligns with the typical length of complex partial seizures.Rate this question:
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- 21.
Patient is seizing, becoming hypoxic, and reaching the 30 minute mark. What would be the appropriate actions for the nurse? (select all that apply)
- A.
Administer Ativan
- B.
Maintain airway
- C.
Administer Valium
- D.
Start CPR
Correct Answer(s)
A. Administer Ativan
B. Maintain airwayExplanation
Ativan has less respiratory depression than valium, an extra consideration since patient is hypoxicRate this question:
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- 22.
The protocol for discontinuing seizure meds does not include;
- A.
Patient should be seizure free for 2yrs
- B.
Normal EEG
- C.
Slowly taper of medications
- D.
EKG's Q6H
Correct Answer
D. EKG's Q6HExplanation
EKG's are for cardiac assessments, not used for seizuresRate this question:
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- 23.
When a patient is on seizure precautions, the nurse can; (select all that apply)
- A.
Pad the bad rails
- B.
O2 and suction
- C.
Use bed restraints
- D.
Allow patient OOB ADLIB
Correct Answer(s)
A. Pad the bad rails
B. O2 and suctionExplanation
When a patient is on seizure precautions, it is important for the nurse to pad the bed rails to prevent injury during a seizure. Additionally, having O2 and suction equipment readily available is necessary to manage any respiratory or airway complications that may arise during a seizure. However, using bed restraints is not recommended as it can increase the risk of injury during a seizure. Allowing the patient to be out of bed as tolerated and moving freely (OOB ADLIB) is also important to promote mobility and prevent complications associated with immobility.Rate this question:
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- 24.
With meningitis, blood pressure increase more than 15 points can be a sign of increased ICP?
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
An increase in blood pressure of more than 15 points can be a sign of increased intracranial pressure (ICP) in individuals with meningitis. Meningitis is an inflammation of the meninges, which are the protective membranes surrounding the brain and spinal cord. Increased ICP occurs when there is an excessive build-up of pressure within the skull, which can be caused by various factors including inflammation. Monitoring blood pressure is crucial in assessing ICP, as an increase in blood pressure can indicate the body's attempt to compensate for the elevated pressure. Therefore, the statement "True" is an accurate explanation of the given answer.Rate this question:
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- 25.
CSF analysis suggests a positive meningitis result with which lab findings? (select all that apply)
- A.
Increased protein
- B.
Decrease glucose
- C.
Increased WBC
- D.
Increase RBC
Correct Answer(s)
A. Increased protein
B. Decrease glucose
C. Increased WBCExplanation
CSF analysis is a diagnostic test used to evaluate the cerebrospinal fluid for various conditions, including meningitis. In meningitis, there is inflammation of the meninges, which leads to certain changes in the CSF. Increased protein levels in the CSF are commonly seen in meningitis due to the breakdown of the blood-brain barrier. Decreased glucose levels occur because the bacteria or viruses causing meningitis consume glucose as a source of energy. Increased white blood cell (WBC) count is also observed in meningitis as the immune system responds to the infection. However, an increase in red blood cells (RBCs) is not typically seen in meningitis.Rate this question:
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- 26.
To diagnose a patient with meningitis, the doctor has ordered a lumbar puncture. Which is not a patient contraindication for this procedure?
- A.
Low grade fever
- B.
ICP
- C.
MRSA/Staph of skin
- D.
Unstable patient
Correct Answer
A. Low grade feverExplanation
A low-grade fever is not a patient contraindication for a lumbar puncture. A lumbar puncture is a procedure used to collect cerebrospinal fluid (CSF) from the spinal canal for diagnostic purposes. It is commonly performed to diagnose meningitis. While a low-grade fever may be present in a patient with meningitis, it is not a contraindication for the procedure. Contraindications for a lumbar puncture include increased intracranial pressure (ICP), presence of MRSA/Staph infection on the skin, and an unstable patient.Rate this question:
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Mar 21, 2023Quiz Edited by
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May 13, 2013Quiz Created by
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