NURS 649 COMPREHENSIVE TEST BANK FINAL EXAM
2026/2027 AND HIGH YIELD PRACTICE QUESTIONS
COMPLETE ACCURATE EXAM APPROVED QUESTIONS AND
CORRECT VERIFIED SOLUTIONS (100% CORRECT
VERIFIED ANSWERS) CURRENTLY UPDATED VERSION
2026 EDITION |GUARANTEED PASS
Pediatric CNS/Brain Tumors Diagnostic Testing
Imaging
• CT
• MRI with / without contrast
Referral
• to ED for evaluation, especially if lethargic, ataxic, pupillary irregularity,
ill-appearing • Referral to Neurosurgery-evaluation or consultation for
imaging
• Urgency based on clinical presentation
Treatment
• Radiation, Chemotherapy, Immunotherapy, Surgical removal
Role of Primary Care PNP
• Monitor development and manage any related support needs
• ↑ risk for secondary malignancy
• Support family in treatment journey
• Manage primary care needs in general
,Pediatric Stroke
• 1 in 1600-4000 neonates at birth
• 2.3-13 per 100,000 older children per year
• Ischemic (55%) vs Hemorrhagic (cerebral sinovenous thrombosis,
ruptured vascular malformations, trauma)
Pediatric National Institutes of Health Stroke Scale (PedNIHSS)
• 11-item scale to assess the severity of stroke
• Validated for use in children and infants
• Available online for free
Pediatric Conditions with Increased Risk of Stroke
-Vasculopathies (Sickle Cell, Moyamoya Syndrome)
-Cardiac disorders (CHD (esp cyanotic), Cardiac cath / surgery, ECMO,
LVAD, Endocarditis, Cardiomyopathy, Valvular abnormalities)
-Prothrombotic disorders (Polycythemia, Factor V Leiden, ↑ Factor VIII, ↑
von Willebrand, ↑ lipoprotein, antiphospholipid antibodies, Migraine
w/Aura, OCPs w/estrogen, malignancy)
-Infection (Meningitis, Varicella, Sinusitis, Mastoiditis, Sepsis)
-Vascular anomalies (AVM, aneurysm, AV fistula)
-Collagen vascular disorders (Ehlers Danlos, Marfan syndrome, COL4A1
mutations)
-Vasculitis / autoimmune disorders (Polyarteritis nodosa, Takayasu
arteritis, SLE, MCTD, HSP, Kawasaki's, IBD, HIV,
-Vasospasm (cerebral vasoconstriction syndrome, subarachnoid
hemorrhage, cocaine)
-Metabolic disorders
-Coagulation disorders (Thrombocytopenia, Hemophilia, Vit K deficiency)
,Pediatric Stroke Symptoms
Sudden onset of focal neurologic deficits (Hallmark)
Headache
Altered mental status
Abnormal eye movement
Ataxia
Dizziness
Vomiting
Seizure
Stroke Exam Findings
• Vomiting
• Weakness, dizziness, gait change
• Pupil and EOM abnormalities
• Changes in voice or swallowing
• Sensory deficits
• Decreased LOC
Concussion Recovery
-80% recover in 3 weeks
-20% may take months
Concussion Epidemiology
● 30% - sports related
● 1/3 athletes - undiagnosed concussion
● High school athletes - more severe cognitive issues, longer recovery
, Highest Risk Sports for Concussion
● Football (>60%)
● Soccer
● Lacrosse
● Hockey
● Wrestling
Concussion Definition
Concussion: a "temporary loss or altered state of brain function from a
mechanical injury" caused by a direct blow to the head or body and
resultant rotational force
* Involves acceleration & deceleration of the brain within the skull and
cellular damage
Concussion Pathophys
-Stretching & Twisting of Neurons
-Massive Release of Neurotrasmitters
-Impaired Neuronal Function "Energy Crisis"
-Vulnerable to 2nd Impact
Concussion Diagnostic Criteria
-Mechanism of injury
-Neuro changes
-Being dazed or having bell rung
2026/2027 AND HIGH YIELD PRACTICE QUESTIONS
COMPLETE ACCURATE EXAM APPROVED QUESTIONS AND
CORRECT VERIFIED SOLUTIONS (100% CORRECT
VERIFIED ANSWERS) CURRENTLY UPDATED VERSION
2026 EDITION |GUARANTEED PASS
Pediatric CNS/Brain Tumors Diagnostic Testing
Imaging
• CT
• MRI with / without contrast
Referral
• to ED for evaluation, especially if lethargic, ataxic, pupillary irregularity,
ill-appearing • Referral to Neurosurgery-evaluation or consultation for
imaging
• Urgency based on clinical presentation
Treatment
• Radiation, Chemotherapy, Immunotherapy, Surgical removal
Role of Primary Care PNP
• Monitor development and manage any related support needs
• ↑ risk for secondary malignancy
• Support family in treatment journey
• Manage primary care needs in general
,Pediatric Stroke
• 1 in 1600-4000 neonates at birth
• 2.3-13 per 100,000 older children per year
• Ischemic (55%) vs Hemorrhagic (cerebral sinovenous thrombosis,
ruptured vascular malformations, trauma)
Pediatric National Institutes of Health Stroke Scale (PedNIHSS)
• 11-item scale to assess the severity of stroke
• Validated for use in children and infants
• Available online for free
Pediatric Conditions with Increased Risk of Stroke
-Vasculopathies (Sickle Cell, Moyamoya Syndrome)
-Cardiac disorders (CHD (esp cyanotic), Cardiac cath / surgery, ECMO,
LVAD, Endocarditis, Cardiomyopathy, Valvular abnormalities)
-Prothrombotic disorders (Polycythemia, Factor V Leiden, ↑ Factor VIII, ↑
von Willebrand, ↑ lipoprotein, antiphospholipid antibodies, Migraine
w/Aura, OCPs w/estrogen, malignancy)
-Infection (Meningitis, Varicella, Sinusitis, Mastoiditis, Sepsis)
-Vascular anomalies (AVM, aneurysm, AV fistula)
-Collagen vascular disorders (Ehlers Danlos, Marfan syndrome, COL4A1
mutations)
-Vasculitis / autoimmune disorders (Polyarteritis nodosa, Takayasu
arteritis, SLE, MCTD, HSP, Kawasaki's, IBD, HIV,
-Vasospasm (cerebral vasoconstriction syndrome, subarachnoid
hemorrhage, cocaine)
-Metabolic disorders
-Coagulation disorders (Thrombocytopenia, Hemophilia, Vit K deficiency)
,Pediatric Stroke Symptoms
Sudden onset of focal neurologic deficits (Hallmark)
Headache
Altered mental status
Abnormal eye movement
Ataxia
Dizziness
Vomiting
Seizure
Stroke Exam Findings
• Vomiting
• Weakness, dizziness, gait change
• Pupil and EOM abnormalities
• Changes in voice or swallowing
• Sensory deficits
• Decreased LOC
Concussion Recovery
-80% recover in 3 weeks
-20% may take months
Concussion Epidemiology
● 30% - sports related
● 1/3 athletes - undiagnosed concussion
● High school athletes - more severe cognitive issues, longer recovery
, Highest Risk Sports for Concussion
● Football (>60%)
● Soccer
● Lacrosse
● Hockey
● Wrestling
Concussion Definition
Concussion: a "temporary loss or altered state of brain function from a
mechanical injury" caused by a direct blow to the head or body and
resultant rotational force
* Involves acceleration & deceleration of the brain within the skull and
cellular damage
Concussion Pathophys
-Stretching & Twisting of Neurons
-Massive Release of Neurotrasmitters
-Impaired Neuronal Function "Energy Crisis"
-Vulnerable to 2nd Impact
Concussion Diagnostic Criteria
-Mechanism of injury
-Neuro changes
-Being dazed or having bell rung
