ESTUDYR
NCLEX-Style Case Study: Pediatric Seizure Disorder
(Febrile Seizure)
Client Scenario (Applies to all items)
The nurse in the pediatric emergency department cares for a 2-year-old male client.
Health History, Assessment, and Vital Signs:
A 2-year-old child is brought to the emergency department by his mother after experiencing
a generalized seizure at home lasting approximately 3 minutes. The mother reports the
child had a fever earlier in the day and became suddenly stiff with rhythmic jerking of the
arms and legs.
The child is now postictal, appearing drowsy but arousable. No prior history of seizures is
reported. Immunizations are up to date.
Vital signs on arrival:
Temperature: 39.0°C (102.2°F)
Heart rate: 136/min
Respiratory rate: 28/min
Blood pressure: 92/58 mmHg
Oxygen saturation: 96% on room air
Item 1 of 6
Question:
Click to select the findings that require immediate follow-up by the nurse.
(Select all that apply)
Recent seizure activity
Fever 39.0°C
Postictal drowsiness
Oxygen saturation 96%
No prior seizure history
Generalized tonic-clonic movements
, ESTUDYR
Correct Answers:
Recent seizure activity
Postictal drowsiness
Generalized tonic-clonic movements
Rationale:
Seizure activity and altered level of consciousness require immediate neurological
assessment. Postictal drowsiness must be monitored to ensure recovery and rule out
complications.
Fever is expected in febrile seizures. Oxygen saturation is within normal range. Lack of prior
history is important but not an immediate concern.
Item 2 of 6
Question:
For each finding, indicate whether it is most consistent with febrile seizure, epilepsy, or
central nervous system infection.
Finding Febrile Seizure Epilepsy CNS Infection
Fever ☐ ☐ ☐
Generalized seizure ☐ ☐ ☐
Postictal drowsiness ☐ ☐ ☐
No prior seizure history ☐ ☐ ☐
Neck stiffness ☐ ☐ ☐
Correct Answers:
Fever → Febrile seizure, CNS infection
Generalized seizure → All three
Postictal drowsiness → All three
No prior seizure history → Febrile seizure
Neck stiffness → CNS infection
Rationale:
Febrile seizures are associated with fever and typically occur in children without prior
seizure history.
Epilepsy involves recurrent seizures without fever. CNS infections may present with fever,
seizures, and neck stiffness.
NCLEX-Style Case Study: Pediatric Seizure Disorder
(Febrile Seizure)
Client Scenario (Applies to all items)
The nurse in the pediatric emergency department cares for a 2-year-old male client.
Health History, Assessment, and Vital Signs:
A 2-year-old child is brought to the emergency department by his mother after experiencing
a generalized seizure at home lasting approximately 3 minutes. The mother reports the
child had a fever earlier in the day and became suddenly stiff with rhythmic jerking of the
arms and legs.
The child is now postictal, appearing drowsy but arousable. No prior history of seizures is
reported. Immunizations are up to date.
Vital signs on arrival:
Temperature: 39.0°C (102.2°F)
Heart rate: 136/min
Respiratory rate: 28/min
Blood pressure: 92/58 mmHg
Oxygen saturation: 96% on room air
Item 1 of 6
Question:
Click to select the findings that require immediate follow-up by the nurse.
(Select all that apply)
Recent seizure activity
Fever 39.0°C
Postictal drowsiness
Oxygen saturation 96%
No prior seizure history
Generalized tonic-clonic movements
, ESTUDYR
Correct Answers:
Recent seizure activity
Postictal drowsiness
Generalized tonic-clonic movements
Rationale:
Seizure activity and altered level of consciousness require immediate neurological
assessment. Postictal drowsiness must be monitored to ensure recovery and rule out
complications.
Fever is expected in febrile seizures. Oxygen saturation is within normal range. Lack of prior
history is important but not an immediate concern.
Item 2 of 6
Question:
For each finding, indicate whether it is most consistent with febrile seizure, epilepsy, or
central nervous system infection.
Finding Febrile Seizure Epilepsy CNS Infection
Fever ☐ ☐ ☐
Generalized seizure ☐ ☐ ☐
Postictal drowsiness ☐ ☐ ☐
No prior seizure history ☐ ☐ ☐
Neck stiffness ☐ ☐ ☐
Correct Answers:
Fever → Febrile seizure, CNS infection
Generalized seizure → All three
Postictal drowsiness → All three
No prior seizure history → Febrile seizure
Neck stiffness → CNS infection
Rationale:
Febrile seizures are associated with fever and typically occur in children without prior
seizure history.
Epilepsy involves recurrent seizures without fever. CNS infections may present with fever,
seizures, and neck stiffness.
