ATI Pediatrics: Neuro & Musculoskeletal Study Guide 2026 |Questions
|Answers |Rationales
1. A nurse is caring for a child with bacterial meningitis. Which of the following
cerebrospinal fluid (CSF) results should the nurse expect?
A. Increased glucose level
B. Clear appearance
C. Increased white blood cell (WBC) count
D. Decreased protein level
Answer: C
Rationale: Bacterial meningitis typically presents with an elevated WBC count
(pleocytosis), increased protein, and decreased glucose levels in the CSF, which often
appears cloudy.
2. Which of the following is an early clinical manifestation of increased
intracranial pressure (ICP) in an infant?
A. Bradycardia
B. Sunken fontanels
C. High-pitched cry
D. Fixed and dilated pupils
Answer: C
Rationale: In infants, early signs of increased ICP include irritability and a high-pitched
cry. Sunken fontanels indicate dehydration, while bradycardia and pupil changes are late
signs.
,3. A child is admitted with a suspected head injury. The nurse observes a
periodic breathing pattern and bradycardia. These findings are components of:
A. Cushing’s Triad
B. Horner’s Syndrome
C. Reye Syndrome
D. Brown-Séquard Syndrome
Answer: A
Rationale: Cushing’s triad includes systemic hypertension, bradycardia, and respiratory
depression (irregular breathing), signifying late-stage increased ICP.
4. A nurse is assessing a 4-year-old child with a concussion. Which finding should
be reported to the provider immediately?
A. Persistent vomiting
B. Inability to remember the incident
C. Sleepiness but easily aroused
D. Headache relieved by acetaminophen
Answer: A
Rationale: Persistent or projectile vomiting is a red flag indicating increased intracranial
pressure after a head injury.
5. A school-age child is experiencing a tonic-clonic seizure. What is the nurse’s
priority action?
A. Insert a tongue blade into the mouth
B. Place the child in a side-lying position
C. Restrain the child’s limbs
D. Administer oral diazepam immediately
Answer: B
Rationale: The priority during a seizure is safety and airway protection. Placing the child
in a side-lying position prevents aspiration.
, 6. Which of the following instructions should the nurse give parents regarding
the use of a Pavlik harness for developmental dysplasia of the hip?
A. Remove the harness for diaper changes
B. Apply lotion or powder under the straps
C. Check the skin for redness under the straps 2-3 times a day
D. Adjust the straps daily for growth
Answer: C
Rationale: Skin care is vital. Parents should check for redness and avoid lotions/powders
that can cause irritation. The harness is usually worn 24 hours a day and straps are
adjusted only by a professional.
7. A child with spina bifida (myelomeningocele) is scheduled for surgery. What is
a priority preoperative nursing intervention?
A. Apply a dry, sterile dressing to the sac
B. Place the infant in a supine position
C. Feed the infant every 2 hours to ensure nutrition
D. Cover the sac with a moist, sterile, non-adherent dressing
Answer: D
Rationale: The sac must be kept moist with sterile normal saline to prevent drying and
infection until surgical closure.
8. Children with spina bifida are at high risk for developing which of the
following?
A. Iron deficiency anemia
B. Latex allergy
C. Hyperthyroidism
D. Type 1 Diabetes
Answer: B
|Answers |Rationales
1. A nurse is caring for a child with bacterial meningitis. Which of the following
cerebrospinal fluid (CSF) results should the nurse expect?
A. Increased glucose level
B. Clear appearance
C. Increased white blood cell (WBC) count
D. Decreased protein level
Answer: C
Rationale: Bacterial meningitis typically presents with an elevated WBC count
(pleocytosis), increased protein, and decreased glucose levels in the CSF, which often
appears cloudy.
2. Which of the following is an early clinical manifestation of increased
intracranial pressure (ICP) in an infant?
A. Bradycardia
B. Sunken fontanels
C. High-pitched cry
D. Fixed and dilated pupils
Answer: C
Rationale: In infants, early signs of increased ICP include irritability and a high-pitched
cry. Sunken fontanels indicate dehydration, while bradycardia and pupil changes are late
signs.
,3. A child is admitted with a suspected head injury. The nurse observes a
periodic breathing pattern and bradycardia. These findings are components of:
A. Cushing’s Triad
B. Horner’s Syndrome
C. Reye Syndrome
D. Brown-Séquard Syndrome
Answer: A
Rationale: Cushing’s triad includes systemic hypertension, bradycardia, and respiratory
depression (irregular breathing), signifying late-stage increased ICP.
4. A nurse is assessing a 4-year-old child with a concussion. Which finding should
be reported to the provider immediately?
A. Persistent vomiting
B. Inability to remember the incident
C. Sleepiness but easily aroused
D. Headache relieved by acetaminophen
Answer: A
Rationale: Persistent or projectile vomiting is a red flag indicating increased intracranial
pressure after a head injury.
5. A school-age child is experiencing a tonic-clonic seizure. What is the nurse’s
priority action?
A. Insert a tongue blade into the mouth
B. Place the child in a side-lying position
C. Restrain the child’s limbs
D. Administer oral diazepam immediately
Answer: B
Rationale: The priority during a seizure is safety and airway protection. Placing the child
in a side-lying position prevents aspiration.
, 6. Which of the following instructions should the nurse give parents regarding
the use of a Pavlik harness for developmental dysplasia of the hip?
A. Remove the harness for diaper changes
B. Apply lotion or powder under the straps
C. Check the skin for redness under the straps 2-3 times a day
D. Adjust the straps daily for growth
Answer: C
Rationale: Skin care is vital. Parents should check for redness and avoid lotions/powders
that can cause irritation. The harness is usually worn 24 hours a day and straps are
adjusted only by a professional.
7. A child with spina bifida (myelomeningocele) is scheduled for surgery. What is
a priority preoperative nursing intervention?
A. Apply a dry, sterile dressing to the sac
B. Place the infant in a supine position
C. Feed the infant every 2 hours to ensure nutrition
D. Cover the sac with a moist, sterile, non-adherent dressing
Answer: D
Rationale: The sac must be kept moist with sterile normal saline to prevent drying and
infection until surgical closure.
8. Children with spina bifida are at high risk for developing which of the
following?
A. Iron deficiency anemia
B. Latex allergy
C. Hyperthyroidism
D. Type 1 Diabetes
Answer: B
