MULTIPLE CHOICE

1. The nurse has documented that a child’s level of consciousness is obtunded. Which describes this level of consciousness?

a. Slow response to vigorous and repeated stimulation

b. Impaired decision making

c. Arousable with stimulation

d. Confusion regarding time and place

2. The nurse has received report on four children. Which child should the nurse assess first?

a. A school-age child in a coma with stable vital signs

b. A preschool child with a head injury and decreasing level of consciousness

c. An adolescent admitted after a motor vehicle accident is oriented to person and place

d. A toddler in a persistent vegetative state with a low-grade fever

3. The nurse is performing a Glasgow Coma Scale on a school-age child with a head injury. The child opens eyes spontaneously, obeys commands, and is oriented to person, time, and place. Which is the score the nurse should record?

a. 8

b. 11

c. 13

d. 15

4. The nurse is closely monitoring a child who is unconscious after a fall and notices that the child suddenly has a fixed and dilated pupil. The nurse should interpret this as:

a. eye trauma.

b. neurosurgical emergency.

c. severe brainstem damage.

d. indication of brain death.

5. The nurse is caring for a child with severe head trauma after a car accident. Which is an ominous sign that often precedes death?

a. Papilledema

b. Delirium

c. Doll’s head maneuver

d. Periodic and irregular breathing

6. The nurse is taking care of a child who is alert but showing signs of increased intracranial pressure. Which test is contraindicated in this case?

a. Oculovestibular response

b. Doll’s head maneuver

c. Funduscopic examination for papilledema

d. Assessment of pyramidal tract lesions

7. The nurse is preparing a school-age child for computed tomography (CT scan) to assess cerebral function. The nurse should include which statement in preparing the child?

a. “Pain medication will be given.”

b. “The scan will not hurt.”

c. “You will be able to move once the equipment is in place.”

d. “Unfortunately, no one can remain in the room with you during the test.”

8. Which neurologic diagnostic test gives a visualized horizontal and vertical cross-section of the brain at any axis?

a. Nuclear brain scan

b. Echoencephalography

c. CT scan

d. Magnetic resonance imaging (MRI)

9. Which is the priority nursing intervention for an unconscious child after a fall?

a. Establish adequate airway.

b. Perform neurologic assessment.

c. Monitor intracranial pressure.

d. Determine whether a neck injury is present.

10. Which drug should the nurse expect to administer to a preschool child who has increased intracranial pressure (ICP) resulting from cerebral edema?

a. Mannitol (Osmitrol)

b. Epinephrine hydrochloride (Adrenalin)

c. Atropine sulfate (Atropine)

d. Sodium bicarbonate (Sodium bicarbonate)