A nurse is assessing a school-age child who has an infratentorial brain tumor. Which of the following findings should the nurse identify as a manifestation of increased intracranial pressure?
Decreased attention span
Hyperactivity
Tachycardia
Hypotension
The Correct Answer is A
A. Decreased attention span is a common manifestation of increased intracranial pressure, as pressure on the brain can affect cognitive function.
B. Hyperactivity is not typically associated with increased intracranial pressure. It would be more common for the child to exhibit lethargy or irritability.
C. Tachycardia is not a primary symptom of increased intracranial pressure. Typically, bradycardia (slow heart rate) is seen in cases of severe intracranial pressure.
D. Hypotension is not usually associated with increased intracranial pressure. In fact, increased intracranial pressure often leads to elevated blood pressure and a widening pulse pressure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Carrying a water bottle is appropriate as hydration is important, especially for those with spinal cord injuries who may have a higher risk of urinary tract infections.
B. For an adolescent with spina bifida, bladder function is often impaired, and intermittent catheterization is usually required 4-6 times a day to prevent urinary retention and infections. Twice a day may be insufficient.
C. Using a suppository for bowel management is a common and recommended practice for individuals with spina bifida.
D. Doing wheelchair exercises is an appropriate way to maintain muscle strength and prevent complications related to immobility.
Correct Answer is D
Explanation
A. Pulmonary atresia involves a blockage of blood flow to the lungs, but it does not specifically lead to differences in blood pressure in the extremities.
B. Tetralogy of Fallot involves four defects, but it does not directly correlate with differences in blood pressure between the extremities.
C. A ventricular septal defect can cause heart failure, but it typically doesn’t affect blood pressure in the extremities.
D. Coarctation of the aorta is a congenital defect where the aorta is narrowed, leading to higher blood pressure in the upper extremities and lower blood pressure in the lower extremities. This is why blood pressures are measured in all four extremities to identify this condition.
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