Nokea
What are quick, jerky, grossly uncoordinated, irregular movements that may disappear on relaxation called?
- A. Twitching
- B. Spasticity
- C. Choreiform movements
- D. Associated movements
Correct Answer: C
Rationale: Choreiform movements are quick, jerky, uncoordinated, and irregular, often subsiding with relaxation. Twitching is brief spasms, spasticity involves prolonged muscle contractions, and associated movements are involuntary motions accompanying voluntary ones.
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An injury to which part of the brain will cause a coma?
- A. Brainstem
- B. Cerebrum
- C. Cerebellum
- D. Occipital lobe
Correct Answer: A
Rationale: Brainstem injury disrupts consciousness, leading to stupor or coma. Cerebral injuries cause specific deficits like memory loss, cerebellar injuries impair coordination, and occipital lobe injuries affect vision, none of which directly cause coma.
The nurse is assessing a child who was just admitted to the hospital for observation after a head injury. What clinical manifestation is the most essential part of the nursing assessment to detect early signs of a worsening condition?
- A. Posturing
- B. Vital signs
- C. Focal neurologic signs
- D. Level of consciousness
Correct Answer: D
Rationale: Level of consciousness is the earliest and most sensitive indicator of worsening neurologic status post-head injury. Posturing and focal signs appear later, and vital sign changes are less immediate or specific in children with head injuries.
An 18-month-old child is brought to the emergency department after being found unconscious in the family pool. What does the nurse identify as the primary problem in drowning incidents?
- A. Hypoxia
- B. Aspiration
- C. Hypothermia
- D. Electrolyte imbalance
Correct Answer: A
Rationale: Hypoxia is the primary problem in drowning, causing rapid global cell damage, especially to neurons, within 4-6 minutes. Aspiration leads to pulmonary complications, hypothermia occurs but is secondary, and electrolyte imbalances are not the primary cause of morbidity.
What 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.
Correct Answer: B
Rationale: Subdural hematoma involves bleeding between the dura and cerebrum from ruptured cortical veins. Bleeding between dura and skull is epidural, arterial bleeding with rapid compression is typical of epidural hematomas, and parietotemporal location is more common in epidural cases.
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. How should the nurse interpret this?
- A. Eye trauma
- B. Brain death
- C. Severe brainstem damage
- D. Neurosurgical emergency
Correct Answer: D
Rationale: A sudden fixed and dilated pupil in an unconscious child signals a neurosurgical emergency, often due to increased intracranial pressure or unilateral brain damage. Eye trauma is less likely, brain death involves bilateral fixed pupils, and pinpoint pupils suggest brainstem damage.