Chapter 27: The Child with Cerebral Dysfunction - Nurselytic

Correct Answer: B

Rationale: Stupor describes a deep sleep state requiring vigorous, repeated stimulation to respond. Coma involves no response to painful stimuli, obtundation allows arousal with less stimulation, and persistent vegetative state indicates permanent cerebral cortex loss.

Correct Answer: C

Rationale: Obtundation describes a child arousable with stimulation but with reduced alertness. Stupor requires vigorous stimulation, confusion involves impaired decision-making, and disorientation pertains to time and place confusion.

Correct Answer: D

Rationale: A sudden fixed and dilated pupil in an unconscious child signals a neurosurgical emergency, often due to increased intracranial pressure or unilateral brain damage. Eye trauma is less likely, brain death involves bilateral fixed pupils, and pinpoint pupils suggest brainstem damage.

Correct Answer: D

Rationale: Periodic or irregular breathing indicates brainstem dysfunction, often preceding apnea and death. Delirium reflects confusion, papilledema suggests chronic increased ICP, and flexion posturing indicates cerebral or corticospinal damage, not necessarily imminent death.

Correct Answer: B

Rationale: The oculovestibular response (caloric test) uses painful ice water instillation, performed only in comatose children. Dolls head maneuver, pyramidal tract assessment, and funduscopic exams are non-painful and can be done on awake children.