To render quality care for your patients, you need this 15-item NCLEX style questionnaire that will also test your understanding regarding Pediatric Nursing. This nursing exam covers the neurologic and cognitive disorders among infants, children, and the main role of pediatric nurses.
EXAM TIP: Test questions are made to be direct and to the point so you don’t need to read extra meaning to the question. The question asks for one particular response and you should not read or add other information into the question.
Perfection is not attainable, but if we chase perfection we can catch excellence.
― Vince Lombardi
Topics or concepts included in this exam are:
- Structure and function of the neurologic system
- Seizure disorders
- Head injury
- Lead poisoning
- Near drowning
- Increased intracranial pressure
- Neural tube defects
- Reye’s syndrome
- Mental retardation (MR) or Intellectual disability (ID)
To make the most out of this quiz, follow the guidelines below:
- Read each question carefully and choose the best answer.
- You are given one minute per question. Spend your time wisely!
- Answers and rationales (if any) are given below. Be sure to read them.
- If you need more clarifications, please direct them to the comments section.
In Exam Mode: All questions are shown but the results, answers, and rationales (if any) will only be given after you’ve finished the quiz.
Pediatric Nursing: Neurologic and Cognitive Disorders
Practice Mode: This is an interactive version of the Text Mode. All questions are given in a single page and correct answers, rationales or explanations (if any) are immediately shown after you have selected an answer. No time limit for this exam.
Pediatric Nursing: Neurologic and Cognitive Disorders
Text Mode: All questions and answers are given on a single page for reading and answering at your own pace. Be sure to grab a pen and paper to write down your answers.
1. A child diagnosed with intellectual disability (ID) is under the supervision of Nurse Tasha. The nurse is aware that the signs and symptoms of mild ID include which of the following?
A. Few communication skills
B. Lateness in walking
C. Mental age of a toddler
D. Noticeable developmental delays
2. Nurse Gloria is teaching the Mr. and Mrs. Diaz about the early signs and symptoms of lead poisoning; which of the following if stated by the couple would indicate the need for further understanding of the case?
3. Daya’s child is scheduled for surgery due to myelomeningocele; the primary reason for surgical repair is which of the following?
4. Nurse Lorna is assessing infantile reflexes in a 9-month-old baby; which of the following would she identify as normal?
A. Persistent rooting
B. Bilateral parachute
C. Absent moro reflex
D. Unilateral grasp
5. Reye’s syndrome is a rare and severe illness affecting children and teenagers. Its development has been linked with the use of aspirin and which of the following?
C. Strep throat
6. Tiffany is diagnosed with increased intracranial pressure (ICP); which of the following if stated by her parents would indicate a need for Nurse Charlie to reexplain the purpose for elevating the head of the bed at a 10 to 20-degree angle?
A. Help alleviate headache
B. Increase intrathoracic pressure
C. Maintain neutral position
D. Reduce intra-abdominal pressure.
7. The American Association on Mental Deficiency (AAMD), now American Association on Intellectual and Developmental Disabilities (AAIDD) definition of mental retardation emphasizes which of the following?
A. An IQ level that must be below 50
B. Cognitive impairment occurring after age 22 years
C. Deficits in adaptive behavior with intellectual impairment
D. No responsiveness to contact
8. Nurse Maritza is caring for a child with Category A Near Drowning; she should do which of the following? (Select all that apply.)
A. Give furosemide as ordered.
B. Check for increased intracranial pressure
C. Plan for discharge in 12 to 24 hours.
D. Check for electrolyte imbalances.
E. Keep mechanical ventilation.
F. Provide oxygen as ordered.
9. In diagnosing seizure disorder, which of the following is the most beneficial?
10. After explaining to the parents about their child’s unique psychological needs related to a seizure disorder and possible stressors, which of the following interests uttered by them would indicate further teaching?
A. Feeling different from peers
B. Poor self-image
C. Cognitive delays
11. Spina bifida is one of the possible neural tube defects that can occur during early embryological development. Which of the following definitions most accurately describes meningocele?
A. Complete exposure of spinal cord and meninges
B. Herniation of spinal cord and meninges into a sac
C. Sac formation containing meninges and spinal fluid
D. B and C
E. Spinal cord tumor containing nerve roots
12. Janae has a seizure disorder; which of the following would be the lowest priority when caring for her?
A. Observing and taking down data on all seizures
B. Assuring safety and protection from injuring
C. Assessing for signs and symptoms of increased intracranial pressure (ICP)
D. Educating the family about anticonvulsant therapy
13. Angie is an adolescent who has seizure disorder; which of the following would not be a focus of a teaching program?
A. Ability to obtain a driver’s license
B. Drug and alcohol abuse
C. Increased risk of infections
D. Peer pressure
14. Bennett was rushed to the emergency department with possible increased intracranial pressure (ICP); which of the following is an early clinical manifestation of increased ICP in older children? (Select all that apply.)
A. Macewen’s sign
B. Setting sun sign
15. While examining a 2-year-old child, Nurse Galina sees that the anterior fontanel is open. She should:
A. Notify the doctor
B. Look for other signs of abuse
C. Recognize this as a normal finding
D. Ask about a family history of Tay-Sachs disease
Answers and Rationale
1. Answer: B. Lateness in walking
- B: Mild intellectual disability is minimally noticeable in young children, with one of the signs being a delay in achieving developmental milestones, such as walking at a later stage.
- A and C: Severe intellectual disability is marked by the mental age of a toddler and little or no communication skills.
- D: Children with moderate intellectual disability have noticeable developmental delays.
2. Answer: B. Seizures
- B: Seizures usually are associated with encephalopathy, a late sign of lead poisoning. Typically, lead levels have already exceeded 70 mg/dl.
- A, C, and D: Anemia, irritability, and anorexia are early signs.
3. Answer: B. To reduce the risk of infection
- B: Surgical closure decreases the risk of infection stemming from damage to the fragile sac, which can lead to meningitis.
- A: Surgical repair does not help relieve hydrocephalus. In fact, some researchers believe that repair exaggerates the Arnold-Chiari malformation and decreases the absorptive surface for cerebrospinal fluid, leading to more rapid development of hydrocephalus.
- C: The neurologic deficit cannot be corrected. However, some surgeons believe that early surgery reduces risk of stretching spinal nerves and preventing further damage.
- D: Surgical repair of the sac doesn’t prevent seizure disorder, an impairment of the brain neuron tissue.
4. Answer: B. Bilateral parachute
- B: The parachute reflex appears to about 9 months of age is normal.
- A, C, and D: All of the following are considered abnormal when evaluating infantile reflexes: reflexes that persist after they should have disappeared (rooting), reflexes are absent when they should be present (Moro), and reflexes that are unilateral (grasp).
5. Answer: D. Varicella
- D: Reye’s syndrome has been linked with the ingestion of aspirin in children with viral infections like varicella.
- A and C: There is no association between meningitis or bacterial infections such as strep throat and the development of Reye’s syndrome.
- B: Encephalitis is a component of Reye’s syndrome.
6. Answer: B. Increase intrathoracic pressure
- B: Head elevation decreases, not increases, intrathoracic pressure.
- A, C, and D: Elevating the head of the bed in a child with increased ICP helps to alleviate headache, maintain neutral position, and reduce intra-abdominal pressure, which may contribute to increased ICP.
7. Answer: C. Deficits in adaptive behavior with intellectual impairment
- C: Mental retardation is part of a broad category of developmental disability and is defined by the American Association of Mental Deficiency as “significantly subaverage, general intellectual functioning existing concurrently with deficits in adaptive behavior and manifested during the developmental period (18 years of age).”
- A: IQ of 70 or below is considered significantly subaverage intellectual functioning.
- B: Cognitive impairment isn’t part of the definition. However, the definition does states that the impairment or compromise must occur before age 18 years old.
8. Answer: C, D, and F
- C, D, and F: Children with Category A Near Drowning are awake with minimal injury. Care includes checking electrolyte status, administering oxygen and warming, and preparing for discharge in 12 to 24 hours.
9. Answer: B. EEG
- B: The EEG recognizes abnormal electrical activity in the brain. The pattern of multiple spikes can assist in the diagnosis of particular seizure disorders.
- A: Skull radiographs can distinguish fractures and structural abnormalities.
- C: Brain scans confirm space-occupying lesions.
- D: Lumbar puncture confirms problems related to cerebrospinal fluid infection or trauma.
10. Answer: C. Cognitive delays
- C: Children with seizure disorders do not necessarily have cognitive delays.
- A, B, and D: Feelings of being different from peers, poor self-image, and dependency can put additional stress on a child trying to understand and manage chronic illness.
11. Answer: C. Sac formation containing meninges and spinal fluid
- C: Meningocele is a sac formation containing meninges and cerebrospinal fluid (CSF).
- A: Meningocele doesn’t involve complete exposure of the spinal cord and meninges; this is a massive defect that’s incompatible with life.
- B: Myelomeningocele is a herniation of the spinal cord, meninges, and CSF into a sac that protrudes through a defect in the vertebral arch.
- E: Tumor formation is not associated with this defect.
12. Answer: C. Assessing for signs and symptoms of increased intracranial pressure (ICP)
- C: Signs and symptoms of increased intracranial pressure (ICP) are not associated with seizure activity and therefore would be the lowest priority.
- A: Careful observation and documentation of seizures provide valuable information to aid prevention and treatment.
- B: Safety is always a priority in the care of a child with seizure disorder because seizures may occur at any given time.
- D: Improper administration of and incomplete compliance with anticonvulsant therapy can lead to status epilepticus; thus education is a priority.
13. Answer: C. Increased risk of infections
- C: Adolescents with seizure disorders are at no greater risk for infections than other adolescents.
- A: The ability to get a driver’s license may be determined by the adolescent’s seizure history.
- B: Drug and alcohol use may conflict with or cause adverse reactions from anticonvulsants.
- D: Peer pressure may put the child at risk for increased risk-taking behaviors that may intensify seizure activity.
14. Answer: D. Diplopia
- D: Diplopia is an early sign of increased ICP in an older child.
- A and B: Macewen’s sign (cracked-pot sound) and the setting sun appearance of the eyes are noted in infants with increased ICP.
- C: Papilledema is a late sign of increased ICP.
15. Answer: A. Notify the doctor
- A: Because the anterior fontanel normally closes between ages 12 and 18 months, the nurse should notify the doctor promptly of this finding.
- B and D: An open fontanel does not indicate abuse and is not associated with Tay-Sachs disease.
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