The nurse has taught the parents of a school-aged child with a newly placed ventriculoperitoneal (VP) shunt to monitor for early signs of shunt malfunction. The nurse determines the parents understand the instructions if they understand they should notify the provider if the child develops which early manifestation?
Lethargy
Seizure activity
Rapid weight gain
Disinterest in attending school
The Correct Answer is A
A. Lethargy is an early sign of increased intracranial pressure (ICP) due to possible shunt malfunction and requires immediate medical attention.
B. Seizure activity can be a late sign of shunt malfunction and is also concerning but lethargy typically appears earlier.
C. Rapid weight gain is less directly related to shunt malfunction and more associated with conditions like hypothyroidism or edema.
D. Disinterest in school could suggest general malaise but is not a specific or early sign of shunt malfunction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. A complete blood count is not specifically required before administering the rubella vaccine.
B. Lead screening is not related to rubella vaccination and is not required for this purpose.
C. The rubella vaccine is a live attenuated vaccine, and it is important to ensure that the patient is not pregnant because the vaccine could potentially harm the fetus. Therefore, a pregnancy test is a necessary precaution.
D. Tuberculosis screening is not related to the rubella vaccination and is not required for this purpose.
Correct Answer is A
Explanation
A. Topical corticosteroid ointments are commonly used to reduce inflammation and treat flare-ups in children with eczema. The nurse should instruct the parent on the proper use of these medications.
B. Bubble baths can be irritating to the skin and should be avoided, especially in children with eczema, as they can exacerbate dryness and irritation.
C. The skin should be patted dry rather than rubbed, and moisturizers should be applied while the skin is still slightly damp to help retain moisture.
D. Fabric softeners can be irritating to sensitive skin and are not recommended for laundering the clothing of children with eczema.
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