Pediatric Neurologic Conditions (9 Questions)

Nurse Grace is caring for 10-month-old Aiden, who is showing signs of possible increased intracranial pressure (ICP). Which of the following findings should Nurse Grace report to the doctor right away?

• Soft, flat anterior fontanelle

• Increased appetite

• High-pitched cry

• Spontaneous movements

Answer explanation

A high-pitched cry in infants can indicate increased intracranial pressure (ICP) and is a sign of distress. This finding should be reported to the doctor immediately, as it may require urgent intervention.

During a classroom role-play, Mason pretends to be a doctor and observes that his patient, Benjamin, is showing decerebrate posturing. What should Mason prioritize in his interpretation?

• Normal in infants

• Indicates a mild neurologic injury

• Indicates brainstem injury and poor prognosis

• Suggests cerebellar involvement

Answer explanation

Decerebrate posturing indicates severe brain dysfunction, particularly involving the brainstem. This condition is associated with a poor prognosis, making it crucial for Mason to recognize its significance in his role-play.

Charlotte is caring for a child who just had a ventriculoperitoneal (VP) shunt placed. Which of the following should she do to help her patient recover?

• Place in Trendelenburg position

• Keep head flat for 24 hours

• Increase environmental stimulation

• Perform hourly abdominal girth checks

Answer explanation

Keeping the head flat for 24 hours after a VP shunt placement helps prevent complications such as increased intracranial pressure and promotes proper drainage of cerebrospinal fluid.

Imagine you’re the nurse on duty when James suddenly begins having a generalized tonic-clonic seizure in the ward. What is your top nursing priority in this situation?

Answer explanation

The top nursing priority during a generalized tonic-clonic seizure is to ensure the patient's safety. This includes protecting them from injury, positioning them safely, and ensuring the airway is clear, while monitoring their vital signs.

During class, Nurse Zoe notices that Lily sometimes seems to "zone out" for a few seconds. Which assessment finding would best support the suspicion of absence seizures?

• Brief staring spells during class

• Rhythmic clonic movements of extremities

• Loss of consciousness with tonic stiffness

• Audible cry followed by jerking

Answer explanation

The best supporting finding for absence seizures is brief staring spells, as they are characteristic of this type of seizure. Other options describe different seizure types, such as tonic-clonic or myoclonic seizures.

Aria and Mason are learning about different diets in science class. What is the main reason doctors might recommend a ketogenic diet to help manage seizures?

• Increases glucose for brain metabolism

• Inhibits sodium-potassium pump

• Promotes fat metabolism to reduce seizures

• Supports liver detoxification

Answer explanation

The ketogenic diet promotes fat metabolism, which provides an alternative energy source for the brain, helping to reduce the frequency and severity of seizures in individuals with epilepsy.

Mia is a nurse caring for a child named Arjun who is experiencing status epilepticus. What is the first-line medication Mia should give to help Arjun?

• Phenytoin

• Midazolam IM

• Lorazepam IV

• Acetazolamide PO

Answer explanation

Lorazepam IV is the first-line treatment for status epilepticus due to its rapid onset and effectiveness in terminating seizures. Other options like phenytoin and midazolam are used later in management.

Nurse Avery is performing a neurological assessment on little Mason, who is a preverbal child. In the Glasgow Coma Scale (GCS), what adorable cue replaces the “oriented verbal response” for kids like Mason?

• Crying when touched

• Smiling or cooing

• Pupillary dilation

• Withdrawal from pain

Answer explanation

For preverbal children like Mason, the GCS substitutes 'oriented verbal response' with 'smiling or cooing', indicating a positive neurological response. This is more appropriate than other options for assessing their engagement.

Samuel is caring for his baby sister and notices something unusual. Which finding would make Samuel suspect hydrocephalus in an infant?

• Low-pitched cry

• Decreased head circumference

• Frontal bossing

• Hyperactive reflexes

Answer explanation

Frontal bossing, or an enlarged forehead, is a classic sign of hydrocephalus in infants due to increased intracranial pressure. This finding, along with other symptoms, would lead Samuel to suspect hydrocephalus.

Nurse Zoe is checking on 11-month-old Ethan, who might be dehydrated after a long day of play. Which sign would tell Nurse Zoe that Ethan has severe dehydration?

• Sunken eyes, alert behavior

• Cap refill of 1.5 seconds

• Tenting >2 seconds, lethargy

• Moist mucous membranes, no tears

Answer explanation

Severe dehydration in infants is indicated by signs like tenting of the skin for more than 2 seconds and lethargy. These symptoms reflect significant fluid loss, making this choice the most concerning for Ethan's condition.