The nurse is reviewing the record of a child with increased intracranial pressure and notes that the child has exhibited signs of decerebrate posturing. On assessment of the child, the nurse expects to note which characteristic of this type of posturing?

Adduction of the arms at the shoulders

Abnormal flexion of the upper extremities and extension and adduction of lower extremities

Flaccid paralysis of all extremities

Rigid extension and pronation of the arms and legs

Answer and Explanation

The Correct Answer is D

D. This is the correct characteristic of decerebrate posturing. Decerebrate posturing is characterized by rigid extension and pronation (turning inward) of the arms and legs. It indicates severe neurological dysfunction and increased intracranial pressure, often involving damage to the brainstem.

A. This characteristic is not associated with decerebrate posturing. Adduction refers to movement toward the midline of the body, which is not typically observed in decerebrate posturing.

B. This description is not characteristic of decerebrate posturing. Decerebrate posturing involves extension, not flexion, of the upper extremities, along with extension and pronation (not adduction) of the lower extremities.

C. Flaccid paralysis refers to the absence of muscle tone and movement, which is not characteristic of decerebrate posturing. Decerebrate posturing involves increased muscle tone and abnormal, rigid extension of the arms and legs.

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Correct Answer is A

Explanation

A. This option is the most appropriate choice for an infant with respiratory syncytial virus (RSV). RSV is highly contagious and primarily spreads through respiratory secretions. Placing the infant in a private room helps to minimize the risk of transmission to other patients. Contact and droplet precautions should be implemented to further prevent the spread of the virus.

B. This choice is not ideal because both RSV and croup are respiratory infections that can spread easily among infants. Placing an infant with RSV in a semi-private room with another infant increases the risk of transmission of both infections to each other.

C. While isolating the infant in a private room is appropriate for preventing the spread of RSV, the term "protective isolation" typically refers to a type of isolation used for patients who have compromised immune systems.

D. Placing the infant with RSV in a semi-private room with a toddler who has pneumonia is not recommended. Both RSV and pneumonia are respiratory infections that can spread easily among patients, especially infants and young children who are more susceptible to complications.

A. "My child will take the enzymes to help digest the fat in foods." B. "My child will chew the capsules." C. "My child will take the enzymes to prevent nausea." D. "My child will take the enzymes 2 hours before meals."

Correct Answer is A

Explanation

A. This statement indicates that the mother understands the purpose of giving pancreatic enzymes to her child with cystic fibrosis. Cystic fibrosis can cause pancreatic insufficiency, leading to difficulty digesting fats and other nutrients. Pancreatic enzymes help to supplement the deficient digestive enzymes, aiding in the digestion of fats and improving nutrient absorption.

B. Pancreatic enzyme capsules are typically meant to be swallowed whole, not chewed. Chewing the capsules could affect their effectiveness by prematurely releasing the enzymes in the mouth rather than in the stomach where they are needed for digestion.

C. While pancreatic enzymes can help with digestion and may indirectly reduce symptoms like nausea by improving nutrient absorption, their primary purpose is not to prevent nausea.

D. Pancreatic enzymes are usually taken with meals or snacks to aid in the digestion of food. The timing of pancreatic enzyme administration may vary depending on the child's eating schedule and the specific instructions provided by the healthcare provider, but taking them 2 hours before meals would not typically be recommended.

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The nurse is reviewing the record of a child with increased intracranial pressure and notes that the child has exhibited signs of decerebrate posturing. On assessment of the child, the nurse expects to note which characteristic of this type of posturing?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assisting with the admission of an infant who has respiratory syncytial virus (RSV). Which of the following rooms should the nurse assign the infant?

Correct Answer is A

Explanation

A nurse is reinforcing teaching with the mother of a child who has cystic fibrosis and is to take pancreatic enzymes three times per day. Which of the following statements indicates the mother understands the information?

Correct Answer is A

Explanation

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