The nurse is monitoring a child with hydrocephalus who received a ventriculoperitoneal (VP) shunt yesterday. Which assessment finding indicates to the nurse that the shunt is functioning normally?

The child has grown in height since the previous shunt placement

The child reports no evidence of continuous headaches

An intracranial pressure (ICP) monitoring probe is in place

The child is afebrile with normal vital signs postoperatively.

Answer and Explanation

The Correct Answer is B

Choice B rationale
The absence of continuous headaches in the child indicates that the VP shunt is functioning normally. A VP shunt is used to treat hydrocephalus by draining excess cerebrospinal fluid from the brain to the abdomen. If the shunt is functioning properly, it should relieve pressure on the brain and reduce symptoms such as headaches.
Choice A rationale
While growth in height could be a positive sign of overall health and development, it does not specifically indicate that a VP shunt is functioning properly.
Choice C rationale
The presence of an intracranial pressure (ICP) monitoring probe does not indicate whether the shunt is functioning properly. The probe is a device used to measure ICP and does not provide information about the functionality of the shunt.
Choice D rationale
Being afebrile with normal vital signs postoperatively is a positive sign, but it does not specifically indicate that the shunt is functioning properly.

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Correct Answer is B

Explanation

Choice A rationale
While placing a toy in the child’s hands might distract the child during the assessment, it does not actively involve the child in the process or help them understand what is happening.
Choice B rationale
Allowing the child to use a stethoscope on a stuffed animal can help the child understand what is happening and feel more comfortable with the procedure. This technique is often used to ensure the cooperation of a preschooler during an assessment of lung sounds.
Choice C rationale
Offering the child bubbles before the stethoscope is placed might distract the child, but it does not directly involve them in the procedure or help them understand what is happening.
Choice D rationale
Having the child blow a cotton ball and having the parent catch it might distract the child, but it does not directly involve them in the procedure or help them understand what is happening.

A. The thyroxine level is low because the TSH level is high. B. High thyroxine levels normally occur in breastfeeding infants. C. The thyroid gland does not produce normal levels of thyroxine for several weeks after birth. D. The TSH is high because of the low production of T4 by the thyroid.

Correct Answer is D

Explanation

Choice A rationale
While it’s true that TSH levels can influence thyroxine levels, this statement is misleading. High TSH levels do not cause low thyroxine levels. Instead, the pituitary gland produces more TSH when thyroxine levels are low in an attempt to stimulate the thyroid gland to produce more thyroxine.
Choice B rationale
Thyroxine levels in breastfeeding infants should be within the normal range. High thyroxine levels are not typical and could indicate a problem with the infant’s thyroid gland.
Choice C rationale
This statement is incorrect. The thyroid gland begins producing thyroxine before birth, and levels should be within the normal range shortly after birth.
Choice D rationale
This is the correct explanation. In congenital hypothyroidism, the thyroid gland does not produce enough thyroxine, leading to high levels of TSH. The pituitary gland produces more TSH in an attempt to stimulate the thyroid gland to produce more thyroxine.

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The nurse is monitoring a child with hydrocephalus who received a ventriculoperitoneal (VP) shunt yesterday. Which assessment finding indicates to the nurse that the shunt is functioning normally?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is assessing the lung sounds of a preschooler. Which action should the nurse implement to ensure the child’s cooperation?

Correct Answer is B

Explanation

A breastfeeding infant, screened for congenital hypothyroidism, is found to have low levels of thyroxine (T4) and high levels of thyroid-stimulating hormone (TSH). What is the best explanation for this finding?

Correct Answer is D

Explanation

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