Chapter 22: Alterations in Neurologic and Sensory Function

1. An otherwise healthy 18-month-old child with a history of febrile seizures is in the well-child clinic. Which statement by the father would indicate to the nurse that additional teaching should be done? A. "I have ibuprofen available in case it's needed." B. "My child will likely outgrow these seizures by age 5." C. "I always keep phenobarbital with me in case of a fever." D. "The most likely time for a seizure is when the fever is rising." ANS: C Rationale: Anticonvulsants, such as phenobarbital, are administered to children with prolonged seizures or neurologic abnormalities. Ibuprofen, not phenobarbital, is given for fever. Febrile seizures usually occur after age 6 months and are unusual after age 5. Treatment is to decrease the temperature because seizures occur as the temperature rises. PTS: 1 REF: p. 395 OBJ: 4 NAT: Client Needs: Physiological Integrity: Physiological Adaptation TOP: Chapter 22: Neurologic and Sensory Disorders BLM: Cognitive Level: Apply 2. A 6-month-old infant is admitted with a diagnosis of bacterial meningitis. The nurse would place the infant in which room? A. A room with a 12-month-old infant with a urinary tract infection B. A room with an 8-month-old infant with failure to thrive C. A private room near the nurses' station D. A two-bed room in the middle of the hall ANS: C Rationale: A child who has the diagnosis of bacterial meningitis will need to be placed in a private room until that child has received I.V. antibiotics for 24 hours because the child is considered contagious. Additionally, bacterial meningitis can be quite serious; therefore, the child should be placed near the nurses' station for close monitoring and easier access in case of a crisis. PTS: 1 REF: p. 389 OBJ: 8 NAT: Client Needs: Safe, Effective Care Environment: Safety and Infection Control TOP: Chapter 22: Neurologic and Sensory Disorders BLM: Cognitive Level: Apply 3. The parents of a child with a history of seizures who has been taking phenytoin (Dilantin) ask the nurse why it's difficult to maintain therapeutic plasma levels of this medication. Which statement by the nurse would be most accurate? A. "A drop in the plasma drug level will lead to a toxic state." B. "The capacity to metabolize the drug becomes overwhelmed over time." C. "Small increments in dosage lead to sharp increases in plasma drug levels." D. "Large increments in dosage lead to a more rapid stabilizing therapeutic effect." ANS: C TEST BANK FOR PEDIATRIC NURSING 1ST BY TAGHER WWW.NURSING-TESTBANK.COM N U R S I N G - T E S T B A N K . C O M Rationale: Within the therapeutic range for phenytoin, small increments in dosage produce sharp increases in plasma drug levels. The capacity of the liver to metabolize phenytoin is affected by slight changes in the dosage of the drug, not necessarily the length of time the client has been taking the drug. Large increments in dosage will greatly increase plasma levels, leading to drug toxicity. PTS: 1 REF: p. 397 OBJ: 6 NAT: Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies TOP: Chapter 22: Neu