TESTBANK FOR PEDIATRIC PHYSICAL EXAMINATION:
An Illustrated Handbook 3RD EDITION BY KAREN G
DUDERSTADT/ALL CHAPTERS 1-20
,Chapter 1. Neurological System
1. A nurse is explaining to parent/guardians how the central nervous system of a infant 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 infant.
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.
RIGHT CHOICE:-D
Reasoning:->Peripheral nerves are not completely myelinated at birth. As myelinization
progresses, so does the infant’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 Medical caretaker is assessing a 1-year-old infant for increased intracranial pressure
(ICP). Which sign should the Medical caretaker assess for with this age of infant?
a. Headache
, b. Bulging fontanel
c. Tachypnea
d. Increase in head circumference
RIGHT CHOICE:-A
Reasoning :->Headaches are a clinical manifestation of increased ICP in infantren. A change in
the infant’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 infant 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 Medical caretaker should give a infant 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.
RIGHT CHOICE:-A
Reasoning:->To reduce fear and enhance cooperation during the MRI, the infant should be made
aware that his head will be restricted to obtain accurate information. Drinking fluids is usually
done for gastrointestinal procedures. A infant would lie flat after a lumbar puncture, not during
, an MRI. Electrodes are attached to the head for an electroencephalogram.
4. A infant with spina bifida is being admitted to the health center for a shunt revision?
The Medical caretaker admitting the infant anticipates which type of precautions to be
ordered for the infant?
a. Latex
b. Bleeding
c. Seizure
d. Isolation
RIGHT CHOICE:-A
Reasoning:->Infantren 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 infant with spina bifida does not have a risk for bleeding. Not all infantren with spina bifida
are at risk for seizures and isolation would not be indicated in a infant 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
RIGHT CHOICE:-C
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