CPEN Neurological Emergencies 2

Question 1

A 3-year-old presents with sudden onset of left-sided hemiplegia and facial droop. Which condition should be highest on the differential?

Accepted Answer

Arterial ischemic stroke

Answer

Arterial ischemic stroke in children presents with acute focal neurological deficits and requires immediate neuroimaging to guide treatment.

Question 2

Which finding on CT head is MOST concerning for non-accidental trauma in a 6-month-old with altered mental status?

Accepted Answer

Bilateral subdural hematomas in different stages

Answer

Bilateral subdural hematomas in varying stages of evolution are a classic and highly concerning finding for non-accidental trauma (abusive head trauma).

Question 3

A 7-year-old with known VP shunt presents with headache and vomiting for 24 hours. His temperature is 38.8°C. What is the priority intervention?

Accepted Answer

Obtain immediate neurosurgical consultation for shunt evaluation

Answer

Fever with VP shunt malfunction symptoms requires urgent neurosurgical evaluation because shunt infection or obstruction can be life-threatening.

Question 4

During lumbar puncture in a child with suspected bacterial meningitis, CSF opening pressure is 38 cmH2O. Which action is MOST appropriate?

Accepted Answer

Collect minimal CSF, remove needle promptly, and initiate ICP management

Answer

Elevated opening pressure signals increased ICP; collect minimal CSF and remove the needle quickly to reduce herniation risk, then manage ICP.

Question 5

An 8-year-old is brought in after a diving accident with complaints of neck pain and inability to move his arms. Which initial action takes highest priority?

Accepted Answer

Maintain spinal immobilization and secure the airway

Answer

Airway and spinal immobilization are the immediate priorities in suspected cervical spinal cord injury to prevent secondary injury.

CPEN - Certified Pediatric Emergency Nurse Practice Test

CPEN - Certified Pediatric Emergency Nurse Practice Test

CPEN Neurological Emergencies 2