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What statement is descriptive of a concussion?
- A. Petechial hemorrhages cause amnesia.
- B. Visible bruising and tearing of cerebral tissue occur.
- C. It is a transient and reversible neuronal dysfunction.
- D. It is a slight lesion that develops remote from the site of trauma.
Correct Answer: C
Rationale: A concussion is a transient, reversible neuronal dysfunction causing brief loss of awareness post-trauma. Petechial hemorrhages and tissue tearing describe contusions, and remote lesions indicate contrecoup injuries, not concussions.
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What term is used when a patient remains in a deep sleep, responsive only to vigorous and repeated stimulation?
- A. Coma
- B. Stupor
- C. Obtundation
- D. Persistent vegetative state
Correct Answer: B
Rationale: Stupor describes a deep sleep state requiring vigorous, repeated stimulation to respond. Coma involves no response to painful stimuli, obtundation allows arousal with less stimulation, and persistent vegetative state indicates permanent cerebral cortex loss.
What term is used to describe a childs level of consciousness when the child is arousable with stimulation?
- A. Stupor
- B. Confusion
- C. Obtundation
- D. Disorientation
Correct Answer: C
Rationale: Obtundation describes a child arousable with stimulation but with reduced alertness. Stupor requires vigorous stimulation, confusion involves impaired decision-making, and disorientation pertains to time and place confusion.
The nurse is caring for a child with severe head trauma after a car accident. What is an ominous sign that often precedes death?
- A. Delirium
- B. Papilledema
- C. Flexion posturing
- D. Periodic or irregular breathing
Correct Answer: D
Rationale: Periodic or irregular breathing indicates brainstem dysfunction, often preceding apnea and death. Delirium reflects confusion, papilledema suggests chronic increased ICP, and flexion posturing indicates cerebral or corticospinal damage, not necessarily imminent death.
What nursing intervention is appropriate when caring for an unconscious child?
- A. Avoid using narcotics or sedatives to provide comfort and pain relief.
- B. Change the childs position infrequently to minimize the chance of increased intracranial pressure (ICP).
- C. Monitor fluid intake and output carefully to avoid fluid overload and cerebral edema.
- D. Give tepid sponge baths to reduce fevers above 38.3 C (101 F) because antipyretics are contraindicated.
Correct Answer: C
Rationale: Monitoring fluid intake and output prevents overhydration, which can cause cerebral edema in unconscious children. Narcotics and sedatives are used for comfort, frequent repositioning prevents complications, and antipyretics are preferred over sponge baths for fever.
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.