NURS 2222:CHILD WITH CEREBRAL DYSFUNCTION
QUESTIONS WITH ANSWERS 2023 A+
MULTIPLE CHOICE
Which is the priority nursing intervention for an unconscious child after a fall?
a.
Establish adequate airway.
b.
Perform neurologic assessment.
c.
Monitor intracranial pressure.
d.
Determine whether a neck injury is present.
ANS: A
Respiratory effectiveness is the primary concern in the care of the unconscious child.
Establishment of an adequate airway is always the first priority. A neurologic assessment and
determination of whether a neck injury is present will be performed after breathing and
circulation are stabilized. Intracranial, not intercranial, pressure is monitored if indicated after
airway, breathing, and circulation are maintained.
PTS: 1 DIF: Cognitive Level: Apply REF: 935
TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Physiologic Integrity: Physiologic Adaptation
Which drug should the nurse expect to administer to a preschool child who has increased
intracranial pressure (ICP) resulting from cerebral edema?
a.
Mannitol (Osmitrol)
b.
Epinephrine hydrochloride (Adrenalin)
, NURS 2222:CHILD WITH CEREBRAL DYSFUNCTION
QUESTIONS WITH ANSWERS 2023 A+
c.
Atropine sulfate (Atropine)
d.
Sodium bicarbonate (Sodium bicarbonate)
ANS: A
For increased ICP, mannitol, an osmotic diuretic, administered intravenously, is the drug
used most frequently for rapid reduction. Epinephrine hydrochloride, atropine sulfate, and
sodium bicarbonate are not used to decrease ICP.
PTS: 1 DIF: Cognitive Level: Apply REF: 936
TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Physiologic Integrity: Pharmacologic and Parenteral Therapy
An appropriate nursing intervention when caring for an unconscious child should be to:
a.
change the child’s position infrequently to minimize the chance of increased ICP.
b.
avoid using narcotics or sedatives to provide comfort and pain relief.
c.
monitor fluid intake and output carefully to avoid fluid overload and cerebral
edema.
d.
give tepid sponge baths to reduce fever because antipyretics are contraindicated.
ANS: C
Often comatose patients cannot cope with the quantity of fluids that they normally tolerate.
Overhydration must be avoided to prevent fatal cerebral edema. The child’s position should
be changed frequently to avoid complications such as pneumonia and skin breakdown.
Narcotics and sedatives should be used as necessary to reduce pain and discomfort, which can
increase ICP. Antipyretics are the method of choice for fever reduction.
, NURS 2222:CHILD WITH CEREBRAL DYSFUNCTION
QUESTIONS WITH ANSWERS 2023 A+
PTS: 1 DIF: Cognitive Level: Apply REF: 937
TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Physiologic Integrity: Physiologic Adaptation
The nurse is planning care for an 8-year-old child with a concussion. Which is descriptive of
a concussion?
a.
Petechial hemorrhages cause amnesia.
b.
Visible bruising and tearing of cerebral tissue occur.
c.
It is a transient and reversible neuronal dysfunction.
d.
A slight lesion develops remotely from the site of trauma.
ANS: C
A concussion is a transient, reversible neuronal dysfunction with instantaneous loss of
awareness and responsiveness resulting from trauma to the head. Petechial hemorrhages along
the superficial aspects of the brain along the point of impact are a type of contusion, but are
not necessarily associated with amnesia. A contusion is visible bruising and tearing of
cerebral tissue. Contrecoup is a lesion that develops remote from the site of trauma as a result
of an acceleration-deceleration injury.
PTS: 1 DIF: Cognitive Level: Understand REF: 939-940
TOP: Integrated Process: Nursing Process: Planning
MSC: Area of Client Needs: Physiologic Integrity: Physiologic Adaptation
The nurse is teaching nursing students about childhood fractures. Which describes
a compound skull fracture?
, NURS 2222:CHILD WITH CEREBRAL DYSFUNCTION
QUESTIONS WITH ANSWERS 2023 A+
a.
Involves the basilar portion of the occipital bone
b.
Bone is exposed through the skin
c.
Traumatic separations of the cranial sutures
d.
Bone is pushed inward, causing pressure on the brain
ANS: B
A compound fracture has the bone exposed through the skin. A basilar fracture involves the
basilar portion of the frontal, ethmoid, sphenoid, temporal, or occipital bone. Diastatic skull
fractures are traumatic separations of the cranial sutures. A depressed fracture has the bone
pushed inward, causing pressure on the brain.
PTS: 1 DIF: Cognitive Level: Understand REF: 940
TOP: Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Physiologic Integrity: Physiologic Adaptation
Which statement best describes a subdural hematoma?
a.
Bleeding occurs between the dura and the skull.
b.
Bleeding occurs between the dura and the cerebrum.
c.
Bleeding is generally arterial, and brain compression occurs rapidly.
d.
The hematoma commonly occurs in the parietotemporal region.
ANS: B
QUESTIONS WITH ANSWERS 2023 A+
MULTIPLE CHOICE
Which is the priority nursing intervention for an unconscious child after a fall?
a.
Establish adequate airway.
b.
Perform neurologic assessment.
c.
Monitor intracranial pressure.
d.
Determine whether a neck injury is present.
ANS: A
Respiratory effectiveness is the primary concern in the care of the unconscious child.
Establishment of an adequate airway is always the first priority. A neurologic assessment and
determination of whether a neck injury is present will be performed after breathing and
circulation are stabilized. Intracranial, not intercranial, pressure is monitored if indicated after
airway, breathing, and circulation are maintained.
PTS: 1 DIF: Cognitive Level: Apply REF: 935
TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Physiologic Integrity: Physiologic Adaptation
Which drug should the nurse expect to administer to a preschool child who has increased
intracranial pressure (ICP) resulting from cerebral edema?
a.
Mannitol (Osmitrol)
b.
Epinephrine hydrochloride (Adrenalin)
, NURS 2222:CHILD WITH CEREBRAL DYSFUNCTION
QUESTIONS WITH ANSWERS 2023 A+
c.
Atropine sulfate (Atropine)
d.
Sodium bicarbonate (Sodium bicarbonate)
ANS: A
For increased ICP, mannitol, an osmotic diuretic, administered intravenously, is the drug
used most frequently for rapid reduction. Epinephrine hydrochloride, atropine sulfate, and
sodium bicarbonate are not used to decrease ICP.
PTS: 1 DIF: Cognitive Level: Apply REF: 936
TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Physiologic Integrity: Pharmacologic and Parenteral Therapy
An appropriate nursing intervention when caring for an unconscious child should be to:
a.
change the child’s position infrequently to minimize the chance of increased ICP.
b.
avoid using narcotics or sedatives to provide comfort and pain relief.
c.
monitor fluid intake and output carefully to avoid fluid overload and cerebral
edema.
d.
give tepid sponge baths to reduce fever because antipyretics are contraindicated.
ANS: C
Often comatose patients cannot cope with the quantity of fluids that they normally tolerate.
Overhydration must be avoided to prevent fatal cerebral edema. The child’s position should
be changed frequently to avoid complications such as pneumonia and skin breakdown.
Narcotics and sedatives should be used as necessary to reduce pain and discomfort, which can
increase ICP. Antipyretics are the method of choice for fever reduction.
, NURS 2222:CHILD WITH CEREBRAL DYSFUNCTION
QUESTIONS WITH ANSWERS 2023 A+
PTS: 1 DIF: Cognitive Level: Apply REF: 937
TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Physiologic Integrity: Physiologic Adaptation
The nurse is planning care for an 8-year-old child with a concussion. Which is descriptive of
a concussion?
a.
Petechial hemorrhages cause amnesia.
b.
Visible bruising and tearing of cerebral tissue occur.
c.
It is a transient and reversible neuronal dysfunction.
d.
A slight lesion develops remotely from the site of trauma.
ANS: C
A concussion is a transient, reversible neuronal dysfunction with instantaneous loss of
awareness and responsiveness resulting from trauma to the head. Petechial hemorrhages along
the superficial aspects of the brain along the point of impact are a type of contusion, but are
not necessarily associated with amnesia. A contusion is visible bruising and tearing of
cerebral tissue. Contrecoup is a lesion that develops remote from the site of trauma as a result
of an acceleration-deceleration injury.
PTS: 1 DIF: Cognitive Level: Understand REF: 939-940
TOP: Integrated Process: Nursing Process: Planning
MSC: Area of Client Needs: Physiologic Integrity: Physiologic Adaptation
The nurse is teaching nursing students about childhood fractures. Which describes
a compound skull fracture?
, NURS 2222:CHILD WITH CEREBRAL DYSFUNCTION
QUESTIONS WITH ANSWERS 2023 A+
a.
Involves the basilar portion of the occipital bone
b.
Bone is exposed through the skin
c.
Traumatic separations of the cranial sutures
d.
Bone is pushed inward, causing pressure on the brain
ANS: B
A compound fracture has the bone exposed through the skin. A basilar fracture involves the
basilar portion of the frontal, ethmoid, sphenoid, temporal, or occipital bone. Diastatic skull
fractures are traumatic separations of the cranial sutures. A depressed fracture has the bone
pushed inward, causing pressure on the brain.
PTS: 1 DIF: Cognitive Level: Understand REF: 940
TOP: Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Physiologic Integrity: Physiologic Adaptation
Which statement best describes a subdural hematoma?
a.
Bleeding occurs between the dura and the skull.
b.
Bleeding occurs between the dura and the cerebrum.
c.
Bleeding is generally arterial, and brain compression occurs rapidly.
d.
The hematoma commonly occurs in the parietotemporal region.
ANS: B
