Nursing Care of Children Principles and Practice 3rd edition by Susan R. James
Nursing Care of Children Principles and Practice 3rd edition by Susan R. James
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Chapter 28: The Child with a Neurologic Alteration
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
| a. | The infant has 150 milliliters of cerebrospinal fluid compared with 50 milliliters in the adult. |
| b. | Papilledema is a common manifestation of increased intracranial pressure in the very young child. |
| c. | The brain of a term infant weighs less than half of the weight of the adult brain. |
| d. | Coordination and fine motor skills develop as myelinization of peripheral nerves progresses. |
ANS: D
| Feedback | |
| A | An infant has about 50 milliliters of cerebrospinal fluid compared with 150 milliliters in an adult. |
| B | Papilledema rarely occurs in infancy because open fontanels and sutures can expand in the presence of increased intracranial pressure. |
| C | The brain of the term infant is two thirds the weight of an adult’s brain. |
| D | Peripheral nerves are not completely myelinated at birth. As myelinization progresses, so does the child’s coordination and fine muscle movements. |
DIF: Cognitive Level: Knowledge REF: Text Reference: pg 919
OBJ: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance
| a. | Headache |
| b. | Bulging fontanel |
| c. | Tachypnea |
| d. | Increase in head circumference |
ANS: A
| Feedback | |
| A | Headaches are a clinical manifestation of increased ICP in children. A change in the child’s normal behavior pattern may be an important early sign of increased ICP. |
| B | This is a manifestation of increased ICP in infants. A 10-year-old child would have a closed fontanel. |
| C | A change in respiratory pattern is a late sign of increased ICP. Cheyne-Stokes respiration may be evident. This refers to a pattern of increasing rate and depth of respirations followed by a decreasing rate and depth with a pause of variable length. |
| D | By 10 years of age, cranial sutures have fused so that head circumference will not increase in the presence of increased ICP. |
DIF: Cognitive Level: Knowledge REF: Text Reference: pg 928
OBJ: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
| a. | “Your head will be restrained.” |
| b. | “You will have to drink a special fluid before the test.” |
| c. | “You will have to lie flat after the test is finished.” |
| d. | “You will have electrodes placed on your head with glue.” |
ANS: A
| Feedback | |
| A | To reduce fear and enhance cooperation during the MRI, the child should be made aware that his head will be restricted to obtain accurate information. |
| B | Drinking fluids is usually done for gastrointestinal procedures. |
| C | A child would lie flat after a lumbar puncture, not during an MRI. |
| D | Electrodes are attached to the head for an electroencephalogram. |
DIF: Cognitive Level: Implementation REF: Text Reference: pg 921
OBJ: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity
| a. | Prone |
| b. | Supine |
| c. | Trendelenburg |
| d. | Sitting |
ANS: A
| Feedback | |
| A | The prone position keeps pressure off the exposed sac. |
| B | The supine position, which results in pressure to the sac, is inappropriate even postoperatively. |
| C | The Trendelenburg position is contraindicated because it could increase intracranial pressure. |
| D | The sitting position is unrealistic for a neonate and will also result in pressure to the sac. |
DIF: Cognitive Level: Application REF: Text Reference: pg 933
OBJ: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
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