A 3-year-old boy presented with fever, anorexia and headache; examination showed positive meningeal irritation; analysis of cerebrospinal fluid (CSF) showed increased lymphocytand decreased glucose. He has a history of prolonged use of steroid therapy due to nephrotic syndrome. Of the following, the MOST likely diagnosis is

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Pediatric Neurological NCLEX Questions Questions

Question 1 of 5

A 3-year-old boy presented with fever, anorexia and headache; examination showed positive meningeal irritation; analysis of cerebrospinal fluid (CSF) showed increased lymphocytand decreased glucose. He has a history of prolonged use of steroid therapy due to nephrotic syndrome. Of the following, the MOST likely diagnosis is

Correct Answer: B

Rationale: Fungal meningitis fits fever, headache, meningeal signs, lymphocytic CSF pleocytosis, and low glucose in a steroid-treated child, per IDSA. Steroids predispose to fungi (e.g., Candida) by immunosuppression. Bacterial typically shows neutrophils; abscess focal signs; viral normal glucose. Fungal risk make B the correct answer.

Question 2 of 5

Triptans (available in injectable, nasal spray, oral disintegrating, and tablet form) may alleviate migraine symptoms promptly. It acts as

Correct Answer: D

Rationale: Triptans act as serotonin receptor agonists , per pharmacology, binding 5-HT1B/1D to vasoconstrict and inhibit pain pathways in migraines. MAOIs treat depression; benzodiazepinseizures; parasympathomimetics stimulate; parasympatholytics block. Serotonin specificity makes D the correct answer.

Question 3 of 5

A 5-month-old boy presented with brief contractions of the neck, trunk, and arm muscles, followed by a phase of sustained muscle contraction lasting less than 2 seconds. His EEG pattern consists of chaotic high-voltage slow waves, spikes, and polyspikes. Of the following, the first-line treatment in this condition is

Correct Answer: A

Rationale: ACTH is first-line for infantile spasms, per AAN, with chaotic EEG (hypsarrhythmia) and brief flexor/extensor spasms. Phenobarbital and valproate are less effective; midazolam acute; ethosuximide absence. ACTHs efficacy in spasms makes A the correct answer.

Question 4 of 5

Neuromuscular disease affects any component of the lower motor neuron unit. The distribution of muscle weakness can point toward specific diseases. The proximal muscle weakness is seen in

Correct Answer: B

Rationale: Dermatomyositis causproximal weakness, per rheumatology, from inflammatory myopathy affecting shoulder/hip girdles. Polyneuropathy and HMSN are distal; myotonic dystrophy mixed; distal myopathy distal. Proximal pattern make B the correct answer.

Question 5 of 5

Chronic inflammatory demyelinating polyneuropathy (CIDP) is an immune-mediated peripheral neuropathy and can affect patients of all ages. The diagnosis is usually by

Correct Answer: C

Rationale: Nerve conduction velocity diagnosCIDP, per AAN, showing demyelination (slowing, conduction block). Clinical exam supports; genetic for hereditary; MRI spinal; CSF adjunctive. NCVs specificity makes C the correct answer.

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