41. Which clinical manifestations would suggest hydrocephalus in a neonate?

a. Bulging fontanel and dilated scalp veins

b. Closed fontanel and high-pitched cry

c. Constant low-pitched cry and restlessness

d. Depressed fontanel and decreased blood pressure

42. The nurse is monitoring a 7-year-old child post-surgical resection of an infratentorial brain tumor. Which vital sign findings indicate Cushing’s triad?

a. Increased temperature, tachycardia, tachypnea

b. Decreased temperature, bradycardia, bradypnea

c. Bradycardia, hypertension, irregular respirations

d. Bradycardia, hypotension, tachypnea

43. Which position should the nurse place a 10-year-old child after a large tumor was removed through a supratentorial craniotomy?

a. On the inoperative side with the bed flat

b. On the inoperative side with the head of bed elevated 20 to 30 degrees

c. On the operative side with the bed flat and pillows behind the head

d. On the operative side with the head of bed elevated 45 degrees

MULTIPLE RESPONSE

1. The treatment of brain tumors in children consists of which therapies? (Select all that apply.)

a. Surgery

b. Bone marrow transplantation

c. Chemotherapy

d. Stem cell transplantation

e. Radiation

f. Myelography

2. Which are clinical manifestations of increased intracranial pressure (ICP) in infants? (Select all that apply.)

a. Low-pitched cry

b. Sunken fontanel

c. Diplopia and blurred vision

d. Irritability

e. Distended scalp veins

f. Increased blood pressure

3. An infant with hydrocephalus is hospitalized for surgical placement of a ventriculoperitoneal shunt. Which interventions should be included in the child’s postoperative care? (Select all that apply.)

a. Observe closely for signs of infection.

b. Pump the shunt reservoir to maintain patency.

c. Administer sedation to decrease irritability.

d. Maintain Trendelenburg position to decrease pressure on the shunt.

e. Maintain an accurate record of intake and output.

f. Monitor for abdominal distention.

4. The nurse is evaluating the laboratory results on cerebral spinal fluid (CSF) from a 3-year-old child with bacterial meningitis. Which findings confirm bacterial meningitis? (Select all that apply.)

a. Elevated white blood cell (WBC) count

b. Decreased glucose

c. Normal protein

d. Elevated red blood cell (RBC) count

5. The nurse is caring for a neonate with suspected meningitis. Which clinical manifestations should the nurse prepare to assess if meningitis is confirmed? (Select all that apply.)

a. Headache

b. Photophobia

c. Bulging anterior fontanel

d. Weak cry

e. Poor muscle tone

6. The nurse is monitoring an infant for signs of increased intracranial pressure (ICP). Which are late signs of increased intracranial pressure (ICP) in an infant? (Select all that apply.)

a. Tachycardia

b. Alteration in pupil size and reactivity

c. Increased motor response

d. Extension or flexion posturing

e. Cheyne-Stokes respirations

ESSAY

1. A 6-year-old child is having a generalized seizure in the classroom at school. Place in order the interventions the school nurse should implement starting with the highest-priority intervention sequencing to the lowest-priority intervention. Provide answer using lowercase letters separated by commas (e.g., a, b, c, d, e).

a. Take vital signs.

b. Ease child to the floor.

c. Allow child to rest.

d. Turn child to the side.

e. Integrate child back into the school environment.