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Toddler w meningitis. Resistance when the lower legs are extended. She also cries when her legs are raised to change her diaper. Documents this as which of the following? a. Kernigs sign b. Brudinski sign c. Nuchal rigidity d. Battle sign - A. Kernig sign - back pain and resistance to lower l...

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Musculoskeletal and Neuro CCRN
Questions
Toddler w meningitis. Resistance when the lower legs are extended. She also cries when her legs are
raised to change her diaper. Documents this as which of the following?

a. Kernigs sign

b. Brudinski sign

c. Nuchal rigidity

d. Battle sign - A. Kernig sign

- back pain and resistance to lower leg extension is referred to as kernig sign. Brudinski's sign occurs
when hips and knees flex in response to neck flexion. Nuchal rigidity is neck stiffness. Battle sign is
basilar skull fracture.



At change of shift nurse describes the child's seizure to the oncoming nurse. Which of the following best
describes the clonic phase?

a. Staring straight ahead and seemed to be daydreaming

b. Said she tasted metal

c. Very stiff and rigid

d. Rhythmic contractions and relaxation of her arms and legs - d. rhythmic contractions and
relaxations of arms and legs.

- experiencing a taste or sensation is an aura. Rigidity occurs during tonic phase.



Child admitted w TBI. Nurse notes CSF leaking from her ear, bruising below her eyes, and swelling behind
her ear. Which of the following bones was most likely fractured in the injury.

a. The mandible

b. The frontal bone

c. The parietal bone

d. The sphenoid bone - d. the sphenoid bone

- leakage of CSF from the ear, bruising below the eyes, and a hematoma behind the ear are
manifestations of a basilar skull fracture that typically involves the temporal, occipital, sphenoid, and/or
ethmoid bones.

, Closed head injury. When nurse stimulates her, the child flexes her arms, clenches her fists, and extends
her legs. which of the following is accurate?

a. Child is demonstrating decorticate posturing which indicates cerebral damage.

b. Child is demonstrating decorticate posturing which indicates damage to the midbrain

c. Child is demonstrating deceberate posturing which indicates cerebral damage

d. Child is demonstrating deceberate posturing which indicates damage to the midbrain. - a. child
is demonstrating decorticate posturing which indicates cerebral damage.

- deceberate posturing is extension of the arms which indicates damage to the mid brain.




Which of the following is an early sign of a basilar skull fracture?

a. Irritability

b. Raccoon's eyes

c. Battle sign

d. leakage of CSF from ear - d. leakage of CSF from ear

- Battle sign and raccoon's eyes LATE signs



TBI. Unresponsive and intubated. Nurse initiates ETCO2 monitoring. Which of the following statements is
FALSE?

a. Increased ICP can be caused from decreased CO2 levels which promote cerebral vasodilation

b. Cerebral perfusion is optimal in the presence of normally to mildly reduced CO2.

c. Markedly decreased CO2 levels can lead to ischemia

d. Decreased CO2 levels promote cerebral vasoconstriction. - a. Increased icp can be caused from
decreased CO2 levels which promote vasodilation

- increased ICP can be caused from INCREASED CO2 levels which promote vasodilation. Cerebral
perfusion is optimal in the presence of normal to mildly reduced CO2 where a small degree of
vasoconstriction can be maintained. Markedly decreased CO2 levels cause vasoconstriction which can
lead to ischemia.



Which of the following is true of an AVM?

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