SAUNDERS NCLEX-RN 9TH EDITION
EXAMINATION TEST 2026 COMPLETE
QUESTIONS AND ANSWERS GRADED A+
⩥ The nurse is caring for a child who has sustained a head injury in an
automobile accident and is monitoring the child for signs of increased
intracranial pressure (ICP). The nurse monitors for the earliest sign of
increased ICP by assessing for:
1. Apnea
2. Posturing
3. Tachycardia
4. Changes in level of consciousness (LOC). Answer: 4
Rationale: An altered level of consciousness is an early sign of increased
ICP. Late signs of increased ICP include tachycardia, leading to
bradycardia, apnea, systolic hypertension, widening pulse pressure, and
posturing.
⩥ The nurse is providing instructions to the parents of an infant with a
ventriculoperitoneal shunt. The nurse includes which of the following
instructions?
1. Call the physician if the infant is fussy.
2. Expect an increased urine output from the shunt.
3. Call the physician if the infant has a high-pitched cry.
, 4. Position the infant on the side of the shunt when the infant is put to
bed.
*ventriculoperitoneal shunt:is a surgical procedure that primarily treats a
condition called hydrocephalus. This condition occurs when excess
cerebrospinal fluid (CSF) collects in the brain's ventricles. CSF cushions
your brain and protects it from injury inside your skull. Answer: 3
Rationale: If the shunt is malfunctioning, the fluid from the ventricle
part of the brain will not be diverted to the peritoneal cavity. The
cerebrospinal fluid will build up in the cranial area. The result is
increased intracranial pressure, which then causes a high-pitched cry in
the infant.
⩥ 4. The nurse reviews the plan of care for a child with Reye's
syndrome. The nurse prioritizes the nursing interventions included in the
plan and prepares to monitor for:
1. Signs of hyperglycemia
2. Signs of a bacterial infection
3. The presence of protein in the urine
4. Signs of increased intracranial pressure
*Reye's syndrome: exact cause of Reye's syndrome is unknown,
although several factors may play a role in its development. Reye's
syndrome seems to be triggered by using aspirin to treat a viral illness or
infection — particularly flu (influenza) and chickenpox — in children
EXAMINATION TEST 2026 COMPLETE
QUESTIONS AND ANSWERS GRADED A+
⩥ The nurse is caring for a child who has sustained a head injury in an
automobile accident and is monitoring the child for signs of increased
intracranial pressure (ICP). The nurse monitors for the earliest sign of
increased ICP by assessing for:
1. Apnea
2. Posturing
3. Tachycardia
4. Changes in level of consciousness (LOC). Answer: 4
Rationale: An altered level of consciousness is an early sign of increased
ICP. Late signs of increased ICP include tachycardia, leading to
bradycardia, apnea, systolic hypertension, widening pulse pressure, and
posturing.
⩥ The nurse is providing instructions to the parents of an infant with a
ventriculoperitoneal shunt. The nurse includes which of the following
instructions?
1. Call the physician if the infant is fussy.
2. Expect an increased urine output from the shunt.
3. Call the physician if the infant has a high-pitched cry.
, 4. Position the infant on the side of the shunt when the infant is put to
bed.
*ventriculoperitoneal shunt:is a surgical procedure that primarily treats a
condition called hydrocephalus. This condition occurs when excess
cerebrospinal fluid (CSF) collects in the brain's ventricles. CSF cushions
your brain and protects it from injury inside your skull. Answer: 3
Rationale: If the shunt is malfunctioning, the fluid from the ventricle
part of the brain will not be diverted to the peritoneal cavity. The
cerebrospinal fluid will build up in the cranial area. The result is
increased intracranial pressure, which then causes a high-pitched cry in
the infant.
⩥ 4. The nurse reviews the plan of care for a child with Reye's
syndrome. The nurse prioritizes the nursing interventions included in the
plan and prepares to monitor for:
1. Signs of hyperglycemia
2. Signs of a bacterial infection
3. The presence of protein in the urine
4. Signs of increased intracranial pressure
*Reye's syndrome: exact cause of Reye's syndrome is unknown,
although several factors may play a role in its development. Reye's
syndrome seems to be triggered by using aspirin to treat a viral illness or
infection — particularly flu (influenza) and chickenpox — in children
