A teen begins therapy w\/ methylphenidate (Ritalin). The nurse correctly counsels
the pt and her pratens that:
a) report any strange, uncontrollable facial movements, such as grimacing,as this is
a possible side effect
b) “don’t drive as this med may make you sleepy”
c) “this drug can be abused, so take care not to lose your meds”
d) “report weekly for blood tests to monitor your drug levels” – ANSWER- c) “this
drug can be abused, so take care not to lose your meds”
*control substance; make sure to supervise administration and keep locked
up; similar to Adderal
Which behaviors are NOT commonly found in autistic children?
a) savant or unusual aptitude
b) communication impairments
c) abnormal social skill development
d) preference for sameness – ANSWER- a) savant or unusual aptitude
**this can happen, but it is rare\/not common; shown a lot on tv as “super
intelligence” ex: good dr
Which of the following is NOT an early sign of increased intracranial pressure?
a) visual disturbance, like diplopia
b) headache
c) seizures
d) sunsetting eyes – ANSWER- c) seizures
*this is a late sign; refer to Table 27-4 “Signs of ICP”
A child is being admitted to the hospital w\/ symptoms suspicious of meningitis.
Which of the following should be completed 1st?
a) start IV antibiotics immediately
b) administer bolus of isotonic IV fluids
c) obtain samples of CSF to send for analysis
d) place foley cath to monitor stric output – ANSWER- c) obtain samples of CSF to
send for analysis
*important to get spinal fluid culture to determine if bacterial vs virus, then
start broad spectrum antibiotics until labs come back
Which position should an infant be placed who just retuned from having
ventriculoperitoneal (VP) shunt placed?
a) semi-fowlers in infant seat
b) flat in crib
c) trendelenburg
d) in crib in high fowelers position – ANSWER- b) flat in crib
*this surgery is for hydrocephalus (excessive CSF) to drain fluid
*have pt in flat position on unoperated side so doesn’t drain too quickly and
cause subdural hematoma
A child w\/ a seizure disorder has been having episode in which they appear to be
staring off into space. What type of seizure is suspected?
a) febrile
b) absence
c) partial
d) focal – ANSWER- b) absence
*suddenly stop motor activity or speech, blank face, short duration, multiple
episodes\/day, eye blinking, verbal\/touch does not stop seizure
A child diagnosed w\/ meningitis is having a generalized seizure. What is the
nurse’s priority action?
a) assess child’s VS
b) administer O2 and call for help
c) administer oral diazepam
d) have parents leave room to allow extra hospital personnel – ANSWER- b)
administer O2 and call for help
*generalized seizures diffuse electrical activity in both sides of brain; will have
tonic-clonic and postical phase
*will be difficult to check VS; never but anything in mouth during seizure
Potential clinical manifestations of cerebral palsy may include (select all apply):
a) spasticity
b) seizures
c) hydrocephalus
d) feeding difficulties
e) accelerated developmental milestones – ANSWER- a) spasticity (most common)
b) seizures
d) feeding difficulties
*also abnormal muscle tone, lack of coordination, motor impairment, delayed
dev milestones, maybe intellectual disabilities, vision\/hearing impairments,
speech\/language impairments
*ataxia, athetosis, dystonia less common
A child presents to ER following febrile seizure. Appropriate treatment would
include all of the following except:
a) administer antiepileptic drug
b) adminster antipyretic drug
c) careful assessment of neuro status
d) obtaining diagnositc labs, such as CBC and cultures – ANSWER- a) administer
antiepileptic drug
*occurs 1 time during illness and last usually short duration so dont treat w\/
AED; may occur in next illness
*can give tylenol or motrin (if >6 mos) to lower temp
A child receiving albuterol, 2 puffs every 3 hrs, for asthma exacerbation is a risk
for developing which adverse effects?
a) tachycardia, insomnia, and restlessness
b) constipation, rash, and blurred vision
c) bradypnea, leathargy, and tinnitus<\/p>\n\n\n\n
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