A nurse is conducting a postoperative assessment on an infant who has just had a ventriculoperitoneal shunt placed for hydrocephalus. Which assessment finding would indicate a malfunction in the shunt?

Movement of all extremities.

Negative Brudzinski sign.

Incisional pain.

Bulging fontanel.

Answer and Explanation

The Correct Answer is D

Choice A reason: Movement of all extremities is expected and does not indicate a shunt malfunction.
Choice B reason: A negative Brudzinski sign is a normal finding and does not suggest a shunt malfunction.
Choice C reason: While incisional pain is common after surgery, it is not a specific indicator of shunt malfunction.
Choice D reason: This is the correct choice. A bulging fontanel can indicate increased intracranial pressure, which may suggest a shunt malfunction.

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Correct Answer is A

Explanation

Choice A reason: Allowing parents to hold their infant is a compassionate act that acknowledges their need for closure and can help them begin the grieving process.

Choice B reason: Interviewing parents to determine the cause of the incident is not considered supportive care; it may be part of an investigation but does not provide comfort.

Choice C reason: Providing mementos can be a cherished way for parents to remember their infant and can offer some solace during a difficult time.

Choice D reason: Advising parents about the necessity of an autopsy is not supportive care; it is a medical decision that should be discussed with sensitivity to the parents' feelings and needs. Autopsies can be important for understanding SIDS and preventing future occurrences.

A. Maintain the child NPO (nothing by mouth). B. Encourage fluids. C. Restrict fluids. D. Turn frequently.

Correct Answer is C

Explanation

Choice A reason: Maintaining the child NPO is not necessary unless there are other medical reasons for doing so.
Choice B reason: Encouraging fluids is contraindicated in SIADH as it can exacerbate fluid overload.
Choice C reason: This is the correct choice. Fluid restriction is a key component of managing SIADH to prevent further dilutional hyponatremia.
Choice D reason: Turning frequently is important for all hospitalized patients to prevent pressure ulcers but is not specific to the management of SIADH.

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A nurse is conducting a postoperative assessment on an infant who has just had a ventriculoperitoneal shunt placed for hydrocephalus. Which assessment finding would indicate a malfunction in the shunt?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which two interventions are considered supportive care for a family whose infant has died from sudden infant death syndrome (SIDS)?

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