NUR 230 EXAM 4 – QUESTIONS AND ANSWERS |
2026/2027 LATEST UPDATE | PEDIATRIC NURSING
| GALEN COLLEGE OF NURSING
SECTION 1: PEDIATRIC NEUROLOGIC
ASSESSMENT
1. Which assessment should the nurse perform first when evaluating a child with
a neurologic disorder?
A. Pain assessment
B. Level of consciousness
C. Nutritional assessment
D. Skin assessment
Correct Answer: B. Level of consciousness
Rationale: Level of consciousness is a critical indicator of neurologic function and can
deteriorate rapidly with increased intracranial pressure, infection, trauma, or other neurologic
conditions. Changes in LOC should be recognized early and reported promptly.
2. A child has a Glasgow Coma Scale score of 15. How should the nurse interpret
this finding?
A. Severe neurologic impairment
B. Moderate neurologic impairment
C. Normal or fully alert neurologic status
D. Coma
Correct Answer: C. Normal or fully alert neurologic status
Rationale: The Glasgow Coma Scale ranges from 3 to 15. A score of 15 represents the highest
possible score and indicates an alert, appropriately responsive patient.
3. Which Glasgow Coma Scale score represents the most severe impairment?
A. 15
B. 12
C. 8
D. 3
,Correct Answer: D. 3
Rationale: A GCS score of 3 is the lowest possible score and indicates profound impairment of
eye, verbal, and motor responses. The child requires immediate assessment and appropriate
airway and neurologic support.
4. A child with a head injury becomes increasingly difficult to arouse. What
should the nurse do first?
A. Allow the child to sleep
B. Perform an immediate neurologic assessment
C. Offer oral fluids
D. Dim the lights and leave the room
Correct Answer: B. Perform an immediate neurologic assessment
Rationale: A declining level of consciousness can indicate worsening intracranial pressure or
neurologic deterioration. The nurse should immediately reassess neurologic status and escalate
care as indicated.
5. Which finding may indicate increased intracranial pressure in a child?
A. Persistent headache and vomiting
B. Increased appetite
C. Mild nasal congestion
D. Increased urine output
Correct Answer: A. Persistent headache and vomiting
Rationale: Persistent headache, vomiting, altered LOC, pupillary changes, and seizures can
occur with increased intracranial pressure. These findings require prompt neurologic
evaluation.
6. Which nursing intervention is appropriate for a child with increased
intracranial pressure?
A. Encourage excessive stimulation
B. Maintain a calm, low-stimulation environment
C. Place the child in Trendelenburg position
D. Encourage frequent vigorous coughing
Correct Answer: B. Maintain a calm, low-stimulation environment
Rationale: Excessive stimulation can increase intracranial pressure. A quiet environment and
appropriate positioning help minimize factors that can worsen neurologic status.
,7. Which position is generally appropriate for a child with increased intracranial
pressure when not contraindicated?
A. Head elevated with neck in neutral alignment
B. Flat with the neck flexed
C. Trendelenburg
D. Prone with the head turned sharply
Correct Answer: A. Head elevated with neck in neutral alignment
Rationale: Appropriate head elevation and neutral neck alignment can promote venous drainage
from the brain. Extreme flexion or rotation can impair cerebral venous return.
8. A child with a neurologic disorder develops a seizure. What is the nurse's
priority?
A. Restrain the child's arms
B. Protect the child from injury and maintain the airway
C. Place an object in the child's mouth
D. Give oral medication immediately
Correct Answer: B. Protect the child from injury and maintain the airway
Rationale: During a seizure, the priority is safety and airway protection. The child should not be
restrained and nothing should be placed in the mouth. The nurse should observe and document
seizure characteristics.
9. Which action should the nurse avoid during a seizure?
A. Clearing nearby objects
B. Timing the seizure
C. Restraining the child's movements
D. Maintaining airway safety
Correct Answer: C. Restraining the child's movements
Rationale: Restraining a child during a seizure can cause injury. The nurse should instead
protect the child from environmental hazards, maintain airway safety, and monitor the duration
and characteristics of the seizure.
10. Which finding following a seizure requires the most immediate attention?
A. Sleepiness
B. Temporary confusion
C. Respiratory difficulty
D. Mild muscle soreness
, Correct Answer: C. Respiratory difficulty
Rationale: Airway and breathing are immediate priorities after a seizure. Although postictal
sleepiness and confusion are common, respiratory compromise can rapidly become life-
threatening.
SECTION 2: MENINGITIS AND
NEUROLOGIC CONDITIONS
11. Which finding is concerning for meningitis in a child?
A. Fever with neck stiffness
B. Increased appetite
C. Clear skin
D. Mild constipation
Correct Answer: A. Fever with neck stiffness
Rationale: Meningitis may present with fever, headache, neck stiffness, altered LOC, irritability,
vomiting, photophobia, and seizures. Infants may present less specifically, including poor
feeding or a bulging fontanelle.
12. A child is suspected of having bacterial meningitis. Which precaution is
commonly required initially?
A. Airborne precautions
B. Droplet precautions
C. Protective isolation only
D. No precautions
Correct Answer: B. Droplet precautions
Rationale: Bacterial meningitis caused by organisms such as meningococcus requires
appropriate droplet precautions during the infectious period according to institutional policy.
Prompt antimicrobial therapy and supportive care are essential.
13. Which finding in an infant may indicate increased intracranial pressure?
A. Bulging fontanelle
B. Increased appetite
C. Normal feeding
D. Increased activity
2026/2027 LATEST UPDATE | PEDIATRIC NURSING
| GALEN COLLEGE OF NURSING
SECTION 1: PEDIATRIC NEUROLOGIC
ASSESSMENT
1. Which assessment should the nurse perform first when evaluating a child with
a neurologic disorder?
A. Pain assessment
B. Level of consciousness
C. Nutritional assessment
D. Skin assessment
Correct Answer: B. Level of consciousness
Rationale: Level of consciousness is a critical indicator of neurologic function and can
deteriorate rapidly with increased intracranial pressure, infection, trauma, or other neurologic
conditions. Changes in LOC should be recognized early and reported promptly.
2. A child has a Glasgow Coma Scale score of 15. How should the nurse interpret
this finding?
A. Severe neurologic impairment
B. Moderate neurologic impairment
C. Normal or fully alert neurologic status
D. Coma
Correct Answer: C. Normal or fully alert neurologic status
Rationale: The Glasgow Coma Scale ranges from 3 to 15. A score of 15 represents the highest
possible score and indicates an alert, appropriately responsive patient.
3. Which Glasgow Coma Scale score represents the most severe impairment?
A. 15
B. 12
C. 8
D. 3
,Correct Answer: D. 3
Rationale: A GCS score of 3 is the lowest possible score and indicates profound impairment of
eye, verbal, and motor responses. The child requires immediate assessment and appropriate
airway and neurologic support.
4. A child with a head injury becomes increasingly difficult to arouse. What
should the nurse do first?
A. Allow the child to sleep
B. Perform an immediate neurologic assessment
C. Offer oral fluids
D. Dim the lights and leave the room
Correct Answer: B. Perform an immediate neurologic assessment
Rationale: A declining level of consciousness can indicate worsening intracranial pressure or
neurologic deterioration. The nurse should immediately reassess neurologic status and escalate
care as indicated.
5. Which finding may indicate increased intracranial pressure in a child?
A. Persistent headache and vomiting
B. Increased appetite
C. Mild nasal congestion
D. Increased urine output
Correct Answer: A. Persistent headache and vomiting
Rationale: Persistent headache, vomiting, altered LOC, pupillary changes, and seizures can
occur with increased intracranial pressure. These findings require prompt neurologic
evaluation.
6. Which nursing intervention is appropriate for a child with increased
intracranial pressure?
A. Encourage excessive stimulation
B. Maintain a calm, low-stimulation environment
C. Place the child in Trendelenburg position
D. Encourage frequent vigorous coughing
Correct Answer: B. Maintain a calm, low-stimulation environment
Rationale: Excessive stimulation can increase intracranial pressure. A quiet environment and
appropriate positioning help minimize factors that can worsen neurologic status.
,7. Which position is generally appropriate for a child with increased intracranial
pressure when not contraindicated?
A. Head elevated with neck in neutral alignment
B. Flat with the neck flexed
C. Trendelenburg
D. Prone with the head turned sharply
Correct Answer: A. Head elevated with neck in neutral alignment
Rationale: Appropriate head elevation and neutral neck alignment can promote venous drainage
from the brain. Extreme flexion or rotation can impair cerebral venous return.
8. A child with a neurologic disorder develops a seizure. What is the nurse's
priority?
A. Restrain the child's arms
B. Protect the child from injury and maintain the airway
C. Place an object in the child's mouth
D. Give oral medication immediately
Correct Answer: B. Protect the child from injury and maintain the airway
Rationale: During a seizure, the priority is safety and airway protection. The child should not be
restrained and nothing should be placed in the mouth. The nurse should observe and document
seizure characteristics.
9. Which action should the nurse avoid during a seizure?
A. Clearing nearby objects
B. Timing the seizure
C. Restraining the child's movements
D. Maintaining airway safety
Correct Answer: C. Restraining the child's movements
Rationale: Restraining a child during a seizure can cause injury. The nurse should instead
protect the child from environmental hazards, maintain airway safety, and monitor the duration
and characteristics of the seizure.
10. Which finding following a seizure requires the most immediate attention?
A. Sleepiness
B. Temporary confusion
C. Respiratory difficulty
D. Mild muscle soreness
, Correct Answer: C. Respiratory difficulty
Rationale: Airway and breathing are immediate priorities after a seizure. Although postictal
sleepiness and confusion are common, respiratory compromise can rapidly become life-
threatening.
SECTION 2: MENINGITIS AND
NEUROLOGIC CONDITIONS
11. Which finding is concerning for meningitis in a child?
A. Fever with neck stiffness
B. Increased appetite
C. Clear skin
D. Mild constipation
Correct Answer: A. Fever with neck stiffness
Rationale: Meningitis may present with fever, headache, neck stiffness, altered LOC, irritability,
vomiting, photophobia, and seizures. Infants may present less specifically, including poor
feeding or a bulging fontanelle.
12. A child is suspected of having bacterial meningitis. Which precaution is
commonly required initially?
A. Airborne precautions
B. Droplet precautions
C. Protective isolation only
D. No precautions
Correct Answer: B. Droplet precautions
Rationale: Bacterial meningitis caused by organisms such as meningococcus requires
appropriate droplet precautions during the infectious period according to institutional policy.
Prompt antimicrobial therapy and supportive care are essential.
13. Which finding in an infant may indicate increased intracranial pressure?
A. Bulging fontanelle
B. Increased appetite
C. Normal feeding
D. Increased activity
