Nursing 101 Chapter 20 Alterations of Neurologic Function in Children Test Bank

Chapter 20: Alterations of Neurologic Function in Children

MULTIPLE CHOICE

1. The neural groove closes dorsally during which week of gestational life?
a.
Second c. Eighth
b.
Fourth d. Twelfth

ANS: B
During the fourth gestational week, the neural groove deepens, its folds develop laterally, and
it closes dorsally to form the neural tube, epithelial tissue that ultimately becomes the central
nervous system (CNS). The second week is too early, and the other options represent times
periods after the groove closes.

PTS: 1 REF: Page 660

2. Which nutritional deficiency in a pregnant woman is associated with neural tube
defect (NTD)?
a.
Iron c. Zinc
b.
Vitamin C d. Folate

ANS: D
Maternal folate deficiency is associated with NTDs, but the specific mechanism that relates to
how folate supplements prevent these anomalies is unknown. The other options are not
thought to cause such a defect.

PTS: 1 REF: Page 663

3. Which defect of neural tube closure is most
common?
a.
Anterior c. Lateral
b.
Posterior d. Midline

ANS: B
Posterior defects are most common. The other options are not the most common.

PTS: 1 REF: Page 663

4. What is the anomaly in which the soft bony component of the skull and much of the brain is
missing?
a.
Anencephaly c. Cranial meningocele
b.
Myelodysplasia d. Hydrocephaly

ANS: A
Anencephaly is an anomaly in which the soft, bony component of the skull and much of the
brain are missing. The other options do not represent this condition.

PTS: 1 REF: Pages 663-664

5. The most common cause of obstructive hydrocephalus in infants is:
a.
Obstructed arachnoid villi
b.
Stenosis of the aqueduct of Sylvius

, c.
Excessive production of cerebrospinal fluid
d.
Impaired cerebrospinal fluid circulation in the subarachnoid space
ANS: B
Congenital aqueduct stenosis most commonly causes obstructive hydrocephalus. The other
options do not represent the most common cause of this condition.

PTS: 1 REF: Page 669

6. What is the term for a herniation or protrusion of brain and meninges through a defect in
the skull?
a.
Encephalocele c. Arachnoidocele
b.
Meningocele d. Cephacephalocele

ANS: A
Encephalocele refers to a herniation or protrusion of brain and meninges through a defect in
the skull, resulting in a saclike structure. The other terms are not used to describe an en-
cephalocele.

PTS: 1 REF: Page 664

7. What is the result of a Chiari type II malformation associated with a myelomeningocele?
a.
Upward displacement of the cerebellum into the diencephalon
b.
Motor and sensory lesions below the level of the myelomeningocele
c.
Downward displacement of the cerebellum, brainstem, and fourth ventricle
d.
Generalized cerebral edema and hydrocephalus
ANS: C
One serious, potentially life-threatening problem associated with myelomeningocele is the
Chiari type II malformation. This deformity involves the downward displacement of the cere-
bellum, cerebellar tonsils, brainstem, and fourth ventricle. The other options do not appropri-
ately describe the pathologic characteristics resulting from a Chiari type II malformation.

PTS: 1 REF: Page 665

8. Prompt surgical repair of a myelomeningocele is critical to best prevent:
a.
Infection c. Mental retardation
b.
Paralysis d. Additional nervous system damage

ANS: D
Until the myelomeningocele is surgically closed, cerebrospinal fluid (CSF) may accumulate,
resulting in further dilation and enlargement of the sac, which may risk more damage to the
nervous system. The other options are included as possible damage caused by the increased
leaking of CSF.

PTS: 1 REF: Page 665

9. Which body system is the largest site for human immunodeficiency virus (HIV) infection
in infants and children?
a.
Central nervous system c. Integumentary system
b.
Gastrointestinal system d. Musculoskeletal system

ANS: A