The nurse is caring for a child who has been in an MVA. The child continues to fall asleep unless her name is called or she is gently shaken. The nurse knows that this state of consciousness is referred to as: 1. Coma. 2. Delirium. 3. Obtunded. 4. Confusion.
The nurse is caring for a 3-year-old female with an altered state of consciousness. The nurse determines that the child is oriented by asking the child to: 1. Name the president of the United States. 2. Identify her parents and state her own name. 3. State her full name and phone number. 4. Identify the current month but not the date.
2. Identify her parents and state her own name.
The nurse is preparing to assess a 6-year-old male with altered consciousness in the PICU. His parents ask if they can stay during his morning assessment. Select the nurse's best response. 1. "Your child is more likely to answer questions and cooperate with any procedures if you are not present." 2. "Most children feel more at ease when parents are present, so you are more than welcome to stay at the bedside." 3. "It is our policy to ask parents to leave during the first assessment of the shift." 4. "Many children fear that their parents will be disappointed if they do not do well with procedures, so we recommend that no parents be present at this time."
2. "Most children feel more at ease when parents are present, so you are more than welcome to stay at the bedside."
The nurse is caring for a 9-year-old female who is unconscious in the PICU. The child's mother has been calling her name repeatedly and gently shaking her shoulders in an attempt to wake her up. The nurse notes that the child is flexing her arms and wrists while bringing her arms closer to the midline of her body. The child's mother asks, "What is going on?" Select the nurse's best response. 1. "I think your daughter hears you, and she is attempting to reach out to you." 2. "Your child is responding to you; please continue trying to stimulate her." 3. "It appears that your child is having a seizure." 4. "Your child is demonstrating a reflex that indicates she is overwhelmed with the stimulation she is receiving."
4. "Your child is demonstrating a reflex that indicates she is overwhelmed with the stimulation she is receiving."
The nurse is caring for a 6-month-old infant with a diagnosis of hydrocephalus. Which of the following signs best indicates increased ICP in this child? 1. Sunken anterior fontanel. 2. Complaints of blurred vision. 3. High-pitched cry. 4. Increased appetite.
A child is being evaluated in the emergency room for a possible diagnosis. The nurse is assisting with the lumbar puncture and notes that the CSF is cloudy. The nurse is aware that cloudy CSF most likely means: 1. Viral meningitis. 2. Bacterial meningitis. 3. No infection, as CSF is usually cloudy. 4. Sepsis.
The nurse is caring for a child who is being admitted with a diagnosis of meningitis. The child's plan of care includes the following: administration of intravenous antibiotics, administration of maintenance intravenous fluids, placement of a Foley catheter, and obtaining cultures of spinal fluid and blood. Select the procedure the nurse should do first. 1. Administration of intravenous antibiotics. 2. Administration of maintenance intravenous fluids. 3. Placement of a Foley catheter. 4. Send the spinal fluid and blood cultures to the laboratory.
4. Send the spinal fluid and blood cultures to the laboratory.
The nurse is caring for a 6-month-old infant diagnosed with meningitis. When she places the infant in the supine position and flexes his neck, she notes that the infant flexes his knees and hips. The nurse knows that this is referred to as: 1. Brudzinski sign. 2. Cushing triad. 3. Kernig sign. 4. Nuchal rigidity.
A toddler is being admitted to the hospital with a diagnosis of bacterial meningitis. Select the best room assignment for the patient. 1. A semiprivate room with a roommate who also has bacterial meningitis. 2. A semiprivate room with a roommate who has bacterial meningitis but has received intravenous antibiotics for more than 24 hours. 3. A private room that is dark and quiet with minimal stimulation. 4. A private room that is bright and colorful and has developmentally appropriate activities available.
3. A private room that is dark and quiet with minimal stimulation.
The nurse is caring for a child who has just been admitted to the pediatric floor with a diagnosis of bacterial meningitis. When reviewing the child's plan of care, which of the following orders would the nurse question? 1. Maintain isolation precautions until 24 hours after receiving intravenous antibiotics. 2. Intravenous fluids at 1 1/2 times regular maintenance. 3. Neurological checks every 4 hours. 4. Administer acetaminophen for temperatures higher than 38°C (100.4°F).
2. Intravenous fluids at 1 1/2 times regular maintenance.
The nurse is caring for a child with meningitis. The parents call for the nurse as "something is wrong." When the nurse arrives, she notes that the child is having a generalized tonic-clonic seizure. Which of the following should the nurse do first? 1. Administer blow-by oxygen and call for additional help. 2. Reassure the parents that seizures are common in children with meningitis. 3. Call a code and ask the parents to leave the room. 4. Assess the child's temperature and blood pressure.
1. Administer blow-by oxygen and call for additional help.
A 5-year-old female has been diagnosed with a seizure disorder. Her teacher noticed that she has been having episodes where she drops her pencil and simply appears to be daydreaming. This is most likely called: 1. An absence seizure. 2. An akinetic seizure. 3. A non-epileptic seizure. 4. A simple spasm seizure.
The school nurse is called to the preschool classroom to evaluate a child. He has been noted to have periods where he suddenly falls and appears to be weak for a short time after the event. The preschool teacher asks what she should do. Select the nurse's best response. 1. "Have the parents follow up with his pediatrician as this is likely an atonic seizure." 2. "Find out if there have been any new stressors in his life, as it could be attention-seeking behavior." 3. "Have the parents follow up with his pediatrician as this is likely an absence seizure." 4. "The preschool years are a time of rapid growth, and many children appear clumsy. It would be best to watch him, and see if it continues."
1. "Have the parents follow up with his pediatrician as this is likely an atonic seizure."
The nurse is discussing a ketogenic diet with a family. The nurse knows that this diet is sometimes used with children who have had little success with anticonvulsant medication. The diet that produces anticonvulsant effects from ketosis consists of: 1. High fat and low carbohydrates. 2. High fat and high carbohydrates. 3. Low fat and low carbohydrates. 4. Low fat and high carbohydrates.
1. High fat and low carbohydrates.
The nurse is working in the emergency room when an ambulance arrives with a 9-year-old male who has been having a generalized seizure for 35 minutes. The paramedics have provided blow-by oxygen and monitored vital signs. The patient does not have intravenous access yet. Which of the following medications should the nurse anticipate administering first? 1. Establish an intravenous line, and administer intravenous lorazepam. 2. Administer rectal diazepam. 3. Administer an oral glucose gel to the side of the child's mouth. 4. Place a nasogastric tube, and administer oral diazepam.
2. Administer rectal diazepam.
The nurse is providing discharge teaching to the parents of a toddler who has experienced a febrile seizure. The nurse knows that clarification is needed when the mother says: 1. "My child will likely have another seizure." 2. "My child's 7-year-old brother is also at high risk for a febrile seizure." 3. "I'll give my child acetaminophen when ill to prevent the fever from rising too high too rapidly." 4. "Most children with febrile seizures do not require seizure medicine."
2. "My child's 7-year-old brother is also at high risk for a febrile seizure."
The nurse is caring for a 5-year-old female recently diagnosed with epilepsy. She is being evaluated for anticonvulsant medication therapy. The nurse knows that the child will likely be placed on which kind of regimen? 1. Two to three oral anticonvulsant medications so that dosing can be low and side effects minimized. 2. One oral anticonvulsant medication to observe effectiveness and minimize side effects. 3. One rectal gel to be administered in the event of a seizure. 4. A combination of oral and intravenous anticonvulsant medications to ensure compliance.
2. One oral anticonvulsant medication to observe effectiveness and minimize side effects.
Sodium salts draw water out of the blood, and into the kidneys, to be expelled from the body as urine
The nurse is providing discharge instructions to the parents of a 13-year-old girl who has been diagnosed with epilepsy. Her parents ask if there are any activities that she should avoid. Select the nurse's best response. 1. "She should avoid swimming, even with a friend." 2. "She should avoid being in a car at night." 3. "She should avoid any strenuous activities." 4. "She should not return to school right away as her peers will likely cause her to feel inadequate."
2. "She should avoid being in a car at night."
An 8-year-old child is attending a Cub Scout camp picnic. He has a history of epilepsy and has had generalized seizures since the age of 3. The child falls to the ground and has a generalized seizure. Which of the following is the best action for the nurse to take during the child's seizure? 1. Administer the child's rescue dose of oral valium. 2. Loosen the child's clothing, and call for help. 3. Place an oral tongue blade in the child's mouth to prevent aspiration. 4. Carry the child to the infirmary to call 911 and start an intravenous line.
2. Loosen the child's clothing, and call for help.
The nurse is caring for a child who has sustained a closed-head injury. The nurse knows that brain damage can be caused by which of the following factors? 1. Increased perfusion to the brain and increased metabolic needs of the brain. 2. Decreased perfusion to the brain and decreased metabolic needs of the brain. 3. Increased perfusion to the brain and decreased metabolic needs of the brain. 4. Decreased perfusion of the brain and increased metabolic needs of the brain.
4. Decreased perfusion of the brain and increased metabolic needs of the brain.
The emergency room nurse is caring for a 5-year-old child who fell off his bike and sustained a closed-head injury. The child is currently awake and alert, but his mother states that he "passed out" for approximately 2 minutes. The mother appears highly anxious and is very tearful. The child was not wearing a helmet. Which of the following statements is a priority for the nurse at this time? 1. "Was anyone else injured in the accident?" 2. "Tell me more about the accident." 3. "Did he vomit, have a seizure, or display any other behavior that was unusual when he woke up?" 4. "Why was he not wearing a helmet?"
3. "Did he vomit, have a seizure, or display any other behavior that was unusual when he woke up?"
The emergency room nurse is caring for an unconscious 6-year-old girl who has had a severe closed-head injury and notes the following changes in her vital signs. Her heart rate has dropped from 120 to 55, her blood pressure has increased from 110/44 to 195/62, and her respirations are becoming more irregular. After calling the physician, which of the following should the nurse expect to do? 1. Call for additional help, and prepare to administer mannitol. 2. Continue to monitor the patient's vital signs, and prepare to administer a bolus of isotonic fluids. 3. Call for additional help, and prepare to administer an antihypertensive. 4. Continue to monitor the patient, and administer supplemental oxygen.
1. Call for additional help, and prepare to administer mannitol.
The nurse is caring for a 2-year-old male in the PICU with a head injury. The child is comatose and unresponsive at this time. The parents ask if he needs pain medication. Select the nurse's best response. 1. "Pain medication is not necessary as he is unresponsive and cannot feel pain." 2. "Pain medication may interfere with his ability to respond and may mask any signs of improvement." 3. "Pain medication is necessary to promote comfort." 4. "Although pain medication is necessary for comfort, we use it cautiously as it increases the demand for oxygen."
3. "Pain medication is necessary to promote comfort."
The nurse is caring for a 6-year-old female with a skull fracture who is unconscious and has severely increased ICP. The nurse notes the child's temperature to be 104°F (40°C). Which of the following should the nurse do first? 1. Place a cooling blanket on the child. 2. Administer Tylenol via nasogastric tube. 3. Administer Tylenol rectally. 4. Place ice packs in the child's axillary areas.
1. Place a cooling blanket on the child.
The nurse is caring for a 16-year-old female who remains unconscious 24 hours after sustaining a closed-head injury in an MVA. She responds to deep painful stimulation with decorticate posturing. The child has an intracranial monitor that shows periodic increased ICP. All other vital signs remain stable. Select the most appropriate nursing action. 1. Encourage the child's peers to visit and talk to the child about school and other pertinent events. 2. Encourage the child's parents to hold her hand and speak loudly to her in an attempt to help her regain consciousness. 3. Attempt to keep a normal day/night pattern by keeping the child in a bright lively environment during the day and dark quiet environment at night. 4. Attempt to keep the environment dark and quiet, and encourage minimal stimulation.
4. Attempt to keep the environment dark and quiet, and encourage minimal stimulation.
A 2-month-old infant is brought to the emergency room after experiencing a seizure. The nurse notes that the infant appears lethargic with very irregular respirations and periods of apnea. The parents report that the child is no longer interested in feeding and that, prior to the seizure, the infant rolled off the couch. What additional testing should the nurse immediately prepare for? 1. Computed tomography scan of the head and dilation of the eyes. 2. Computed tomography scan of the head and EEG. 3. Close monitoring of vital signs. 4. X-rays of all long bones.
1. Computed tomography scan of the head and dilation of the eyes.
The nurse knows that young infants are at risk for injury from SBS because: 1. Anterior fontanel is open. 2. Insufficient musculoskeletal support and a disproportionate head-to-body ratio. 3. Immature vascular system with veins and arteries that are more superficial. 4. Immature myelination of the nervous system.
2. Insufficient musculoskeletal support and a disproportionate head-to-body ratio.
The nurse is caring for a 13-month-old with meningitis. The child has experienced increased ICP and multiple seizures. The child's parents ask if the child is likely to develop CP. Select the nurse's best response. 1. "When your daughter is stable, she'll undergo computed tomography and magnetic resolution imaging. The physicians will be able to let you know if she has CP." 2. "Most children do not develop CP at this late age." 3. "Your child will be closely monitored after discharge, and a developmental specialist will be able to make the diagnosis." 4. "Most children who have had complications of meningitis develop some amount of CP."
3. "Your child will be closely monitored after discharge, and a developmental specialist will be able to make the diagnosis."
Which term is used to describe a child’s level of consciousness when the child can be aroused with stimulation? a. Stupor c. Obtundation b. Confusion d. Disorientation
Which term is used when a patient remains in a deep sleep, responsive only to vigorous and repeated stimulation? a. Coma c. Obtundation b. Stupor d. Persistent vegetative state
The Glasgow Coma Scale consists of an assessment of: a. Pupil reactivity and motor response. b. Eye opening and verbal and motor responses. c. Level of consciousness and verbal response. d. Intracranial pressure (ICP) and level of consciousness.
b. Eye opening and verbal and motor responses.
The priority nursing intervention when a child is unconscious after a fall is to: a. Establish an adequate airway. b. Perform neurologic assessment. c. Monitor intercranial pressure. d. Determine whether a neck injury is present.
a. Establish an adequate airway.
Which drug would be used to treat a child who has increased intracranial pressure (ICP) resulting from cerebral edema? a. Mannitol c. Atropine sulfate b. Epinephrine hydrochloride d. Sodium bicarbonate
Which statement is most descriptive of a concussion? a. Petechial hemorrhages cause amnesia. b. Visible bruising and tearing of cerebral tissue occur. c. It is a transient, reversible neuronal dysfunction. d. A slight lesion develops remote from the site of trauma.
c. It is a transient, reversible neuronal dysfunction.
Which statement best describes a subdural hematoma? a. Bleeding occurs between the dura and the skull. b. Bleeding occurs between the dura and the cerebrum. c. Bleeding is generally arterial, and brain compression occurs rapidly. d. The hematoma commonly occurs in the parietotemporal region.
b. Bleeding occurs between the dura and the cerebrum.
The nurse should recommend medical attention if a child with a slight head injury experiences: a. Sleepiness. c. Headache, even if slight. b. Vomiting, even once. d. Confusion or abnormal behavior.
d. Confusion or abnormal behavior.
A toddler fell out of a second-story window. She had brief loss of consciousness and vomited four times. Since admission, she has been alert and oriented. Her mother asks why a computed tomography (CT) scan is required when she “seems fine.” The nurse should explain that the toddler: a. May have a brain injury. c. May start having seizures. b. Needs this because of her age. d. Probably has a skull fracture.
a. May have a brain injury.
The nurse is assessing a child who was just admitted to the hospital for observation after a head injury. The most essential part of the nursing assessment to detect early signs of a worsening condition is: a. Posturing. c. Focal neurologic signs. b. Vital signs. d. Level of consciousness.
d. Level of consciousness.
A school-age child has sustained a head injury and multiple fractures after being thrown from a horse. The child’s level of consciousness is variable. The parents tell the nurse that they think their child is in pain because of periodic crying and restlessness. The most appropriate nursing action is to: a. Discuss with parents the child’s previous experiences with pain. b. Discuss with practitioner what analgesia can be safely administered. c. Explain that analgesia is contraindicated with a head injury. d. Explain that analgesia is unnecessary when child is not fully awake and alert.
b. Discuss with practitioner what analgesia can be safely administered.
A 5-year-old girl sustained a concussion when she fell out of a tree. In preparation for discharge, the nurse is discussing home care with her mother. Which statement made by the mother indicates a correct understanding of the teaching? a. “I should expect my child to have a few episodes of vomiting.” b. “If I notice sleep disturbances, I should contact the physician immediately.” c. “I should expect my child to have some behavioral changes after the accident.” d. “If I notice diplopia, I will have my child rest for 1 hour.”
c. “I should expect my child to have some behavioral changes after the accident.”
A child is brought to the emergency department after experiencing a seizure at school. There is no previous history of seizures. The father tells the nurse that he cannot believe the child has epilepsy. The nurse’s best response is: a. “Epilepsy is easily treated.” b. “Very few children have actual epilepsy.” c. “The seizure may or may not mean that your child has epilepsy.” d. “Your child has had only one convulsion; it probably won’t happen again.”
c. “The seizure may or may not mean that your child has epilepsy.”
Which type of seizure involves both hemispheres of the brain? a. Focal c. Generalized b. Partial d. Acquired
The initial clinical manifestation of generalized seizures is: a. Being confused. c. Losing consciousness. b. Feeling frightened. d. Seeing flashing lights.
An important nursing intervention when caring for a child who is experiencing a seizure is to: a. Describe and record the seizure activity observed. b. Restrain the child when seizure occurs to prevent bodily harm. c. Place a tongue blade between the teeth if they become clenched. d. Suction the child during a seizure to prevent aspiration.
a. Describe and record the seizure activity observed.
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
a. Bulging fontanel and dilated scalp veins
An appropriate nursing intervention when caring for an unconscious child should be to: a. Change the child’s position infrequently to minimize the chance of increased intracranial pressure (ICP). b. Avoid using narcotics or sedatives to provide comfort and pain relief. c. Monitor fluid intake and output carefully to avoid fluid overload and cerebral edema. d. Give tepid sponge baths to reduce fever because antipyretics are contraindicated.
c. Monitor fluid intake and output carefully to avoid fluid overload and cerebral edema.
A child is unconscious after a motor vehicle accident. The watery discharge from the nose tests positive for glucose. The nurse should recognize that this suggests: a. Diabetic coma. c. Upper respiratory tract infection. b. Brainstem injury. d. Leaking of cerebrospinal fluid (CSF).
d. Leaking of cerebrospinal fluid (CSF).
A child has been seizure-free for 2 years. A father asks the nurse how much longer the child will need to take the antiseizure medications. The nurse includes which intervention in the response? a. Medications can be discontinued at this time. b. The child will need to take the drugs for 5 years after the last seizure. c. A stepwise approach will be used to reduce the dosage gradually. d. Seizure disorders are a lifelong problem. Medications cannot be discontinued.
c. A stepwise approach will be used to reduce the dosage gradually.
Clinical manifestations of increased intracranial pressure (ICP) in infants are (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.
c. Diplopia and blurred vision. d. Irritability. e. Distended scalp veins.
A nurse should expect which cerebrospinal fluid (CSF) laboratory results on a child diagnosed with bacterial meningitis (Select all that apply)? a. Elevated white blood cell (WBC) count b. Decreased protein c. Decreased glucose d. Cloudy in color e. Increase in red blood cells (RBCs)
a. Elevated white blood cell (WBC) count c. Decreased glucose d. Cloudy in color
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
c. Bulging anterior fontanel d. Weak cry e. Poor muscle tone
The nurse is monitoring an infant for signs of increased intracranial pressure (ICP). Which are late signs of increased 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
b. Alteration in pupil size and reactivity d. Extension or flexion posturing e. Cheyne-Stokes respirations
The nurse has given medication instructions to a patient receiving phenytoin (Dilantin). Which statement by the patient indicates that the patient has an adequate understanding? a. “I will need to take extra care of my teeth and gums while on this medication.” b. “I can go out for a beer while on this medication.” c. “I can skip doses if the side effects bother me.” d. “I will be able to stop taking this drug once the seizures stop.”
a. “I will need to take extra care of my teeth and gums while on this medication.”
When teaching a patient about taking a newly prescribed antiepileptic drug (AED) at home, the nurse will include which instruction? a. “Driving is allowed after 2 weeks of therapy.” b. “If seizures recur, take a double dose of the medication.” c. “Antacids can be taken with the AED to reduce gastrointestinal adverse effects.” d. “Regular, consistent dosing is important for successful treatment.”
d. “Regular, consistent dosing is important for successful treatment.”
A patient has a 9-year history of a seizure disorder that has been managed well with oral phenytoin (Dilantin) therapy. He is to be NPO (consume nothing by mouth) for surgery in the morning. What will the nurse do about his morning dose of phenytoin? a. Give the same dose intravenously. b. Give the morning dose with a small sip of water. c. Contact the prescriber for another dosage form of the medication. d. Notify the operating room that the medication has been withheld.
c. Contact the prescriber for another dosage form of the medication.
The U.S. Food and Drug Administration has issued a warning for users of antiepileptic drugs. Based on this report, the nurse will monitor for which potential problems with this class of drugs? a. Increased risk of suicidal thoughts and behaviors b. Signs of bone marrow depression c. Indications of drug addiction and dependency d. Increased risk of cardiovascular events, such as strokes
a. Increased risk of suicidal thoughts and behaviors
A patient is experiencing status epilepticus. The nurse prepares to give which drug of choice for the treatment of this condition? a. diazepam (Valium) b. midazolam (Versed) c. valproic acid (Depakote) d. carbamazepine (Tegretol)
A patient has been taking an AED for several years as part of his treatment for partial seizures. His wife has called because he ran out of medication this morning and wonders if he can go without it for a week until she has a chance to go to the drugstore. What is the nurse’s best response? a. “He is taking another antiepileptic drug, so he can go without the medication for a week.” b. “Stopping this medication abruptly may cause withdrawal seizures. A refill is needed right away.” c. “He can temporarily increase the dosage of his other antiseizure medications until you get the refill.” d. “He can stop all medications because he has been treated for several years now.”
b. “Stopping this medication abruptly may cause withdrawal seizures. A refill is needed right away.”
A patient is taking gabapentin (Neurontin), and the nurse notes that there is no history of seizures on his medical record. What is the best possible rationale for this medication order? a. The medication is used for the treatment of neuropathic pain. b. The medication is helpful for the treatment of multiple sclerosis. c. The medication is used to reduce the symptoms of Parkinson’s disease. d. The medical record is missing the correct information about the patient’s history of seizures.
a. The medication is used for the treatment of neuropathic pain.
Which statements about antiepileptic drug (AED) therapy are accurate? (Select all that apply.) a. AED therapy can be stopped when seizures are stopped. b. AED therapy is usually lifelong. c. Consistent dosing is the key to controlling seizures. d. A dose may be skipped if the patient is experiencing adverse effects. e. Do not abruptly discontinue AEDs because doing so may cause rebound seizure activity.
b. AED therapy is usually lifelong. c. Consistent dosing is the key to controlling seizures. e. Do not abruptly discontinue AEDs because doing so may cause rebound seizure activity.
The nurse notes documentation that a child is exhibiting an inability to flex the leg when the thigh is flexed anteriorly at the hip. Which condition does the nurse suspect? 1. Meningitis 2. Spinal cord injury 3. Intracranial bleeding 4. Decreased cerebral blood flow
A mother arrives at the emergency department with her 5-year-old child and states that the child fell off a bunk bed. A head injury is suspected. The nurse checks the child's airway status and assesses the child for early and late signs of increased intracranial pressure. Which is a late sign of increased ICP? 1. Nausea 2. Irritability 3. Headache 4. Bradycardia
The nurse is assigned to care for an 8-year-old child with a diagnosis of a basilar skull fracture. The nurse reviews the health care providers prescriptions and should contact the HCP to question which prescription? 1. Obtain daily weight 2. Provide clear liquid intake 3. Nasotracheal suction as needed 4. Maintain a patent intravenous line
3. Nasotracheal suction as needed
The nurse creates a plan of care for a child at risk for tonic-clonic seizures. In the plan of care, the nurse identifies seizure precautions and documents that which item need to be placed at the child's bedside? 1. Emergency cart 2. Tracheotomy set 3. Padded tongue blade 4. Suctioning equipment and oxygen
4. Suctioning equipment and oxygen
A lumbar puncture is performed on a child suspected to have bacterial meningitis, and cerebrospinal fluid is obtained for analysis. The nurse reviews the results of the CSF analysis and determines that which results would verify the diagnosis? 1. Clear CSF, decreased pressure, and elevated protein level 2. Clear CSF, elevated protein, and decreased glucose levels 3. Cloudy CSF, elevated protein, and decreased glucose levels 4. Cloudy CSF, decreased protein, and decreased glucose levels
3. Cloudy CSF, elevated protein, and decreased glucose levels
The nurse is planning care for a child with acute bacterial meningitis. Based on the mode of transmission of this infection, which precautionary intervention should be included in the plan of care? 1. Maintain enteric precautions 2. Maintain neutropenic precautions 3. No precautions are required as long as antibiotics have been started 4. Maintain respiratory isolation precautions for at least 24 hours after the initiation of antibiotics
4. Maintain respiratory isolation precautions for at least 24 hours after the initiation of antibiotics
nurse is creating a plan of care for a child who is at risk for seizures. which interventions apply if the child has a seizure? Select all that apply a. time the seizure b. restrain the child c. stay with the child d. place the child in prone position e. move furniture away f. insert padded tongue blade in childs mouth
a. time the seizure c. stay with the child e. move furniture away