NR 602 MIDTERM 2026 SPRING TEST QUESTIONS WITH ACCURATE SOLUTIONS
Paul, 14, is accompanied by his guardian with complaints of fever, headache, neck
stiffness, and nausea. He is alert but not oriented to time and place. Which of the following
diagnoses is likely?
Meningitis
Annabella is a 5-day-old newborn who is accompanied by her mother. Her mother is
concerned that the baby is crying inconsolably and not eating well. She states that
Annabella was diagnosed with hydrocephalus at birth and a shunt was placed. Which of
the following assessment finding is a priority concern?
Bulging fontanelles
hydrocephalus
abnormal accumulation of fluid (CSF) in the brain
hydrocephalus s/sx in children
In an infant include a progressively enlarging head, bulging fontanelles, and enlarged scalp
veins. Older children may experience headaches, drowsiness, decreased cognitive ability,
and blurred vision.
How to treat hydrocephalus
Referral to a neurosurgeon for ventriculoperitoneal (VP) shunt or surgical correction is
warranted.
,Cerebral palsy
is a neurologic condition characterized by motor impairment from a gestational brain injury
Cerebral palsy risks
CP rates are higher in low-birth-weight infants, those born before 32 weeks, and those born
after difficult labor. Over 75% of CP cases are spastic or characterized by muscular rigidity
Ataxic CP is characterized by difficulties with balance and control, whereas athetoid
(dyskinetic) CP involves a lack of muscular control.
Concussion
A concussion is a mild traumatic brain injury that affects normal brain function. It occurs as
a result of a direct or indirect blow to the head. Signs and symptoms of concussion may be
subtle and may appear immediately or even hours after impact. They include headache,
drowsiness, dizziness, photophobia, and impaired cognition.
Migraine headache
Migraine signs and symptoms include at least 2 of the following: unilateral location,
pulsating quality, moderate to severe pain with an increase during exertion,
nausea/vomiting, photophobia, or phonophobia. HA lasts 4 to 72 hours.
Meningitis
Meningitis is a bacterial, viral, fungal, or parasitic infection within the subarachnoid space
or meningeal or ependymal cells. The infection leads to inflammatory responses causing
,neurologic damage. Signs and symptoms of meningitis include headache, fever, stiff neck,
and altered mental status
Cluster HA
Cluster headaches, or trigeminal autonomic cephalgia, are a group of idiopathic
headaches that are associated with trigeminal neuralgia. The location is always unilateral
around the eye. Presents as a deep explosive excruciating pain that begins quickly, ptosis
of the eyelid, and miosis. Lacrimation, swollen eyelids, and nasal discharge may also
occur. Duration is 30 minutes to 3 hours.
Sinus HA
The sinus headache is associated with sinusitis. It is accompanied by pressure in the
cheeks or forehead, congestion, and fatigue. Pain increases with bending forward. It
involves the nasal mucosa, turbinates, or septum.
Tension-type HA
Tension-type HATension headache, or stress headache, is often musculoskeletal in origin
and is the most common headache. The location of the headache is usually bilateral
around the forehead area but may present as unilateral pain. It is described as a band-like
pressure or tightness that comes and goes. It can also be described as a steady, pulsating
mild to moderate pain. The duration is usually variable with no associated symptoms.
Reducing SIDS
, recommended screening age for lead?
All children with Medicaid are recommended to have lead testing two times: at 12 months
and 24 months
Lead levels
if the initial screening level is higher than 3.5 µg/dl, a venous blood lead level should be
obtained to confirm findings. The higher the level, the more urgent the need for
confirmation.
What to do about lead poisoning
education about lead exposure prevention
environmental investigation into potential sources
report test results to the local health department
assess for calcium and iron deficiencies
obtain abdominal X-ray
contact a Pediatric Environmental Health Specialty Unit (PEHSU) or poison control center
repeat test in 2 weeks to 1 month
medication for lead poisoning
Chelation therapy, a medication that binds to lead to excrete via urine, is recommended for
levels greater than 45 µg/dL.
primary, secondary, tertiary
Paul, 14, is accompanied by his guardian with complaints of fever, headache, neck
stiffness, and nausea. He is alert but not oriented to time and place. Which of the following
diagnoses is likely?
Meningitis
Annabella is a 5-day-old newborn who is accompanied by her mother. Her mother is
concerned that the baby is crying inconsolably and not eating well. She states that
Annabella was diagnosed with hydrocephalus at birth and a shunt was placed. Which of
the following assessment finding is a priority concern?
Bulging fontanelles
hydrocephalus
abnormal accumulation of fluid (CSF) in the brain
hydrocephalus s/sx in children
In an infant include a progressively enlarging head, bulging fontanelles, and enlarged scalp
veins. Older children may experience headaches, drowsiness, decreased cognitive ability,
and blurred vision.
How to treat hydrocephalus
Referral to a neurosurgeon for ventriculoperitoneal (VP) shunt or surgical correction is
warranted.
,Cerebral palsy
is a neurologic condition characterized by motor impairment from a gestational brain injury
Cerebral palsy risks
CP rates are higher in low-birth-weight infants, those born before 32 weeks, and those born
after difficult labor. Over 75% of CP cases are spastic or characterized by muscular rigidity
Ataxic CP is characterized by difficulties with balance and control, whereas athetoid
(dyskinetic) CP involves a lack of muscular control.
Concussion
A concussion is a mild traumatic brain injury that affects normal brain function. It occurs as
a result of a direct or indirect blow to the head. Signs and symptoms of concussion may be
subtle and may appear immediately or even hours after impact. They include headache,
drowsiness, dizziness, photophobia, and impaired cognition.
Migraine headache
Migraine signs and symptoms include at least 2 of the following: unilateral location,
pulsating quality, moderate to severe pain with an increase during exertion,
nausea/vomiting, photophobia, or phonophobia. HA lasts 4 to 72 hours.
Meningitis
Meningitis is a bacterial, viral, fungal, or parasitic infection within the subarachnoid space
or meningeal or ependymal cells. The infection leads to inflammatory responses causing
,neurologic damage. Signs and symptoms of meningitis include headache, fever, stiff neck,
and altered mental status
Cluster HA
Cluster headaches, or trigeminal autonomic cephalgia, are a group of idiopathic
headaches that are associated with trigeminal neuralgia. The location is always unilateral
around the eye. Presents as a deep explosive excruciating pain that begins quickly, ptosis
of the eyelid, and miosis. Lacrimation, swollen eyelids, and nasal discharge may also
occur. Duration is 30 minutes to 3 hours.
Sinus HA
The sinus headache is associated with sinusitis. It is accompanied by pressure in the
cheeks or forehead, congestion, and fatigue. Pain increases with bending forward. It
involves the nasal mucosa, turbinates, or septum.
Tension-type HA
Tension-type HATension headache, or stress headache, is often musculoskeletal in origin
and is the most common headache. The location of the headache is usually bilateral
around the forehead area but may present as unilateral pain. It is described as a band-like
pressure or tightness that comes and goes. It can also be described as a steady, pulsating
mild to moderate pain. The duration is usually variable with no associated symptoms.
Reducing SIDS
, recommended screening age for lead?
All children with Medicaid are recommended to have lead testing two times: at 12 months
and 24 months
Lead levels
if the initial screening level is higher than 3.5 µg/dl, a venous blood lead level should be
obtained to confirm findings. The higher the level, the more urgent the need for
confirmation.
What to do about lead poisoning
education about lead exposure prevention
environmental investigation into potential sources
report test results to the local health department
assess for calcium and iron deficiencies
obtain abdominal X-ray
contact a Pediatric Environmental Health Specialty Unit (PEHSU) or poison control center
repeat test in 2 weeks to 1 month
medication for lead poisoning
Chelation therapy, a medication that binds to lead to excrete via urine, is recommended for
levels greater than 45 µg/dL.
primary, secondary, tertiary
