Practice Question
The nurse cares for a 6-year-old who had surgical resection of a brain tumor the previous day. The nurse assesses the client's neurological status. Which findings alert the nurse to an increase in intracranial pressure? Select all that apply.
Answer Choices:
Correct Answer:
The client's heart rate is reduced.
Rationale:
The client's heart rate is reduced (bradycardia).
🧠 Bradycardia in a post-craniotomy child is a classic component of Cushing’s triad (↓HR, ↑SBP with widened pulse pressure, irregular respirations), signaling rising intracranial pressure and brainstem compression.
🧠 As ICP rises, vagal (parasympathetic) output increases, slowing the SA node and producing sustained bradycardia—this is pathologic, not a benign postoperative fluctuation.
🧠 Persistent bradycardia alongside altered mentation, vomiting, or blood pressure changes suggests impending herniation and requires immediate escalation (notify provider, prepare for ICP-lowering interventions).
🧠 Corroborate with other neuro signs (LOC trend, blood pressure pattern, respiratory irregularity) and avoid procedures that raise ICP (excess suctioning, pain, agitation).
The left pupil is larger than the right pupil (anisocoria).
👁️New unequal pupils imply third-nerve (CN III) compression from localized swelling, hematoma, or mass effect, all of which can occur with increasing ICP.
👁️ The enlarged or sluggish pupil on the affected side reflects uncal/temporal pressure on the nerve and midbrain, a red-flag sign for neurologic deterioration.
👁️ Pupil asymmetry often precedes dramatic LOC decline, so prompt action (urgent provider notification, readiness for osmotic therapy, imaging) can be limb- and life-saving.
👁️ Assess and document PERRLA trends (size in mm, reactivity, symmetry) hourly or per protocol; any acute change is treated as emergent.
Want to practice more questions like this?
This question is from Examplify CJE Pediatrics Benchmark 1 2025 which contains 44 questions.
More Questions from This Exam
A 4-year-old is seen in the primary care clinic. The child has a history of a repaired congenital heart defect and has been treated frequently for heart failure. The parent is describing their child's symptoms. Which parent statement most closely describes heart failure in children?
Answer Choices:
A 10-year-old is to undergo ureteral re-implants for vesicoureteral reflux. The nurse and child life therapist provide pre-operative education for the client and parents. On which of these principles should they base the teaching?
Answer Choices:
A 2-month-old is recovering from a three-day history of diarrhea. The client is well hydrated, but the client's parent tells the nurse that the child has a "significant case of diaper rash." The nurse examines the child and determines it is contact dermatitis. Which would be the best suggestion by the nurse?
Answer Choices:
A teen client enters the family planning clinic and asks about contraception. The client does not feel comfortable with her body, does not want her partner to know she is seeking birth control and does not feel she will remember to take medication each day. Which statements indicate that the client is selecting an appropriate method for their personal needs? Select all that apply.
Answer Choices:
Question Details
- Category: LPN Nursing Exam(s)
- Subcategory: 💎Examplify-PN
- Domain: 👩🏻🤝👩🏻Pediatrics-PN
- Answer Choices: 6