TESTBANK FOR PEDIATRIC PHYSICAL EXAMINATION:
An Illustrated Handbook 3RD EDITION BY KAREN G
DUDERSTADT/ALL CHAPTERS 1-20
,Chapter 1. Neurological System
1. A Professional nurse is explaining to parent/guardians how the central nervous system of a
child differs from that of an adult. Which statement accurately describes these differences?
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 myelination of peripheral
nerves progresses.
CORRECT ANS:-D
Rationale :->>> Peripheral nerves are not completely myelinated at birth. As myelinization
progresses, so does the child’s coordination and fine muscle movements. An infant has about 50
milliliters of cerebrospinal fluid compared with 150 milliliters in an adult. Papilledema rarely
occurs in infancy because open fontanels and sutures can expand in the presence of increased
intracranial pressure. The brain of the term infant is two-thirds the weight of an adults brain.
2. A Professional nurse is assessing a 1-year-old child for increased intracranial pressure
(ICP). Which sign should the Professional nurse assess for with this age of child?
a. Headache
, b. Bulging fontanel
c. Tachypnea
d. Increase in head circumference
CORRECT ANS:-A
Rationale :->>> 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. A
bulging fontanel is a manifestation of increased ICP in infants. A 10-year-old child would have a
closed fontanel. 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. By 10 years of age,
cranial sutures have fused so that head circumference will not increase in the presence of
increased ICP.
3. The Professional nurse should give a child who is to have magnetic resonance imaging
(MRI) of the brain which information?
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.
CORRECT ANS:-A
Rationale :->>> 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. Drinking fluids is
usually done for gastrointestinal procedures. A child would lie flat after a lumbar puncture, not
, during an MRI. Electrodes are attached to the head for an electroencephalogram.
4. A child with spina bifida is being admitted to the health center for a shunt revision?
The Professional nurse admitting the child anticipates which type of precautions to be
ordered for the child?
a. Latex
b. Bleeding
c. Seizure
d. Isolation
CORRECT ANS:-A
Rationale :->>> Children with spina bifida are at high risk for developing latex allergies
because of frequent exposure to latex during catheterizations, shunt placements, and other
operations. The child with spina bifida does not have a risk for bleeding. Not all children with
spina bifida are at risk for seizures and isolation would not be indicated in a child being admitted
for a shunt revision.
5. Nursing care of the infant who has had a myelomeningocele repair should include
which intervention?
a. Securely fastening the diaper
b. Measurement of pupil size
c. Measurement of head circumference
d. Administration of seizure medications
CORRECT ANS:-C
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