Which of the following symptoms is the hallmark sign and is most commonly assessed in a school-age child with a possible brain tumor.
Ataxia and seizures.
Poor fine and gross motor control.
Fever and irritability.
Headache and vomiting, usually upon arising in the morning.
The Correct Answer is D
Choice A rationale
While ataxia, which is impaired coordination, and seizures may occur in children with brain tumors due to pressure or irritation of specific brain regions, they are generally less consistently reported as the earliest or most frequent hallmark symptoms compared to symptoms related to increased intracranial pressure. The primary location of the tumor dictates the presence of these focal neurological signs, making them variable.
Choice B rationale
Poor fine and gross motor control can be observed if the tumor is located in the cerebellum or motor cortex, but this is a non-specific finding that could be related to many other pediatric neurological or developmental disorders. The gradual onset of motor changes often makes them less reliable as the hallmark sign compared to acute symptoms of pressure.
Choice C rationale
Fever and irritability are common but highly non-specific symptoms in pediatrics, frequently associated with routine infections. While some brain tumors may cause fever, and irritability is a sign of general discomfort or pain, these are rarely the primary indicators pointing definitively toward a brain tumor diagnosis.
Choice D rationale
Headache and vomiting, especially when occurring in the morning or upon waking, are classic symptoms indicating increased intracranial pressure (ICP), which is a common consequence of a growing mass in the fixed space of the skull. The change in position from lying down increases ICP, leading to these characteristic symptoms.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Skeletal traction involves inserting a pin directly into the bone to apply a continuous pulling force, typically used for complex fractures or severe orthopedic deformities. This is generally not a primary or common treatment for cerebral palsy, where management focuses on function, muscle tone, movement, and joint stability using non-invasive or less invasive techniques.
Choice B rationale
Physical therapy is a fundamental and expected treatment for cerebral palsy (CP). It focuses on improving muscle strength, mobility, balance, gait, and coordination. Specific exercises and techniques are employed to maximize functional independence and minimize the progression of secondary musculoskeletal complications.
Choice C rationale
Orthotics, such as ankle-foot orthoses (AFOs) or braces, are commonly prescribed treatments in the plan of care for children with CP. They provide support, maintain proper body alignment, prevent or correct deformities, and enhance walking ability by assisting with muscle control and joint stability during movement.
Choice D rationale
Occupational therapy is an essential component of the CP treatment plan. It addresses fine motor skills, activities of daily living (ADLs) like dressing and feeding, and visual-motor integration. The goal is to maximize the child's independence in self-care, school, and play activities tailored to their specific deficits.
Correct Answer is C
Explanation
Choice A rationale
A respiratory rate of 50 breaths/minute falls within the expected normal range for a healthy full-termnewborn, which is typically 30 to 60 breaths/minute. Therefore, this finding alone does not indicate respiratory distress, which is usually signaled by rates consistently below 30 or above 60. Tachypnea (rate > 60) is a more common sign of distress, reflecting the infant's attempt to improve oxygenation.
Choice B rationale
Acrocyanosis, which is the blueness of the hands and feet, is a common and usually transient finding in newborns due to sluggish peripheral circulation and vasomotor instability. It is considered a normal finding in the first 24 to 48 hours of life. Central cyanosis, which involves the mucous membranes and trunk, is a more critical sign of inadequate oxygenation and severe respiratory distress.
Choice C rationale
Asymmetrical chest movement, often referred to as paradoxical breathing, occurs when one side of the chest moves differently from the other during respiration. This is a significant abnormal finding that may indicate a condition like pneumothorax, diaphragmatic hernia, or atelectasis, all of which compromise effective lung expansion and gas exchange, leading to respiratory distress.
Choice D rationale
Short periods of apnea, defined as cessation of breathing lasting less than 15 seconds, are considered a normal variation in a newborn's breathing pattern, known as periodic breathing. Apnea lasting 15 seconds or more, or any apnea accompanied by bradycardia or cyanosis, is a concerning sign and would alert the nurse to potential respiratory or central nervous system issues.
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