Situational Multiple Choice Quiz: Neurologic Disorders in Pediatrics

1. A child presents with difficulty walking, abnormal posture, and involuntary movements. Based on these symptoms, the nurse suspects which type of cerebral palsy?
a. Spastic
b. Athetoid/Dyskinetic
c. Ataxic
d. Hypotonic

2. A nurse is assessing a 3-year-old child who shows difficulty communicating, repetitive behaviors, and poor eye contact. What is the most likely diagnosis?
a. ADHD
b. Autism spectrum disorder
c. Cerebral palsy
d. Rett syndrome

3. A child with cerebral palsy is receiving a Baclofen pump for spasticity. What is the purpose of this intervention?
a. To improve muscle tone
b. To alleviate muscle stiffness
c. To prevent seizures
d. To improve cognitive function

4. A child diagnosed with myelomeningocele is at risk for developing which complication?
a. Hydrocephalus
b. Respiratory distress
c. Cognitive impairment
d. Visual disturbances

5. During a routine checkup, a nurse notes that an 18-month-old child is unable to walk or bear weight. What is the most appropriate nursing action?
a. Reassure the parents that this is normal
b. Refer the child for a developmental evaluation
c. Suggest physical therapy
d. Advise the parents to wait until age 2 for further evaluation

6. A 4-year-old child with autism exhibits repetitive hand-flapping behavior. What nursing intervention is appropriate to help manage this behavior?
a. Physical restraint
b. Administering sedatives
c. Distraction with a favorite toy
d. Ignoring the behavior

7. A child with spina bifida has a meningocele. Which statement by the parents indicates understanding of the condition?
a. "This contains only spinal fluid, not nerves."
b. "This means my child will be paralyzed."
c. "We need to prepare for surgery immediately to fix the spine."
d. "My child will need long-term therapy to walk."

8. A child presents with symptoms of inattention, hyperactivity, and impulsiveness. What condition is most likely?
a. Autism
b. ADHD
c. Cerebral palsy
d. Epilepsy

9. What is the priority nursing action for a child with a newly diagnosed myelomeningocele?
a. Monitor for signs of infection
b. Provide physical therapy
c. Perform bladder catheterization
d. Apply heat to the sac

10. A nurse is educating parents about folic acid supplementation during pregnancy. What condition does this help prevent?
a. Spina bifida
b. Hydrocephalus
c. Autism
d. Cerebral palsy

11. A child with cerebral palsy has difficulty swallowing. What intervention should be prioritized?
a. Thickening the child's liquids
b. Offering smaller meals more frequently
c. Inserting a nasogastric tube
d. Encouraging the child to self-feed

12. Which finding would the nurse expect in a child diagnosed with autism?
a. Constant eye contact
b. Enjoyment of playing with others
c. Sensitivity to changes in routine
d. Early development of language skills

13. What is the first priority in the care of a newborn with myelomeningocele?
a. Cover the exposed sac with sterile, moist dressing
b. Initiate physical therapy
c. Administer prophylactic antibiotics
d. Ensure the newborn is kept in a supine position

14. A nurse is caring for a child with spina bifida who uses a urinary catheter. What complication should the nurse monitor for?
a. Skin breakdown
b. Urinary tract infection
c. Constipation
d. Hyperthermia

15. A nurse notices a 2-year-old child has not developed any speech. What would be the best nursing intervention?
a. Refer the child for hearing tests
b. Encourage the parents to wait until the child is older
c. Suggest the use of sign language
d. Schedule an MRI to check for brain abnormalities

16. A child with ADHD is starting school. What advice should the nurse give the parents to help manage the child’s symptoms?
a. Use positive reinforcement for good behavior
b. Punish the child for every mistake
c. Encourage physical punishment to control hyperactivity
d. Avoid setting any boundaries

17. A 5-year-old child with cerebral palsy has an ankle-foot orthosis (AFO) for ambulation. What is the purpose of this device?
a. Improve muscle tone
b. Prevent contractures
c. Strengthen leg muscles
d. Relieve pain

18. A child with a history of ADHD is prescribed methylphenidate (Ritalin). What is the nurse’s priority concern when educating the parents?
a. Risk of addiction
b. Monitoring for side effects like weight loss and insomnia
c. Ensuring the child does not take the medication at school
d. Avoiding physical activity after taking the medication

19. A child with spina bifida occulta presents with a small patch of hair on the lower back. What should the nurse do?
a. Schedule an MRI to assess for further abnormalities
b. Reassure the parents that this is a benign condition
c. Recommend surgery to repair the spine
d. Advise the parents to monitor the child for skin changes

20. What is the most common symptom in a child with cerebral palsy?
a. Poor muscle control
b. Cognitive impairment
c. Seizures
d. Delayed speech

21. A nurse is teaching parents about caring for their child with cerebral palsy. What intervention can help prevent contractures?
a. Applying cold compresses
b. Administering muscle relaxants
c. Encouraging passive range of motion exercises
d. Keeping the child in a wheelchair

22. A child with spina bifida is undergoing surgery to repair a myelomeningocele. What is the main goal of this surgery?
a. Improve cognitive function
b. Prevent further nerve damage
c. Increase bladder control
d. Improve muscle tone

23. A child with ADHD is having difficulty sitting still in school. What classroom strategy should the nurse recommend?
a. Give the child frequent breaks
b. Isolate the child from other students
c. Assign longer tasks
d. Avoid physical activity in class

24. What is a common characteristic of children with spina bifida?
a. Seizures
b. Loss of bladder control
c. Delayed cognitive development
d. Hearing impairment

25. A nurse is evaluating a child for ADHD. Which observation supports the diagnosis?
a. The child can sit still for long periods
b. The child follows instructions well
c. The child is constantly fidgeting
d. The child completes tasks with focus

26. A child diagnosed with cerebral palsy has muscle spasms. What is the best intervention?
a. Administer Baclofen as prescribed
b. Encourage the child to perform stretching exercises
c. Use a heating pad on the affected muscles
d. Provide a high-protein diet

27. A child with spina bifida is at risk for skin breakdown. What should the nurse prioritize to prevent this complication?
a. Administering antibiotics
b. Turning and repositioning the child frequently
c. Applying a hot compress to the affected area
d. Reducing fluid intake

28. Which factor is most associated with the development of spina bifida in newborns?
a. Folic acid deficiency during pregnancy
b. Premature birth
c. Low birth weight
d. Intrauterine infection

29. A child with autism is sensitive to changes in routine. What nursing intervention can help the child adapt?
a. Use a consistent daily schedule
b. Frequently change the child’s environment
c. Encourage spontaneous activities
d. Limit social interactions with other children

30. A child with cerebral palsy has poor oral muscle control. What is the priority nursing intervention?
a. Thicken liquids to prevent aspiration
b. Offer cold drinks to stimulate swallowing
c. Encourage self-feeding
d. Allow the child to eat solid foods only

Answer Key:

1. b

2. b

3. b

4. a

5. b

6. c

7. a

8. b

9. a

10. a

11. a

12. c

13. a

14. b

15. a

16. a

17. b

18. b

19. a

20. a

21. c

22. b

23. a

24. b

25. c

26. a

27. b

28. a

29. a

30. a