Rasmussen

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Sample questions from Rasmussen

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A 9-year-old is admitted to a pediatric neurology unit after 8 months of increasingly frequent right-hand twitching and episodes of right facial jerking. The child is awake, has mild right-hand weakness, and has stable vital signs. MRI shows progressive left hemispheric cortical atrophy. Which condition best explains this pattern?

   • A.Rasmussen encephalitis
   • B.Acute bacterial meningitis
   • C.Generalized absence epilepsy
   • D.Myasthenia gravis

   Rationale: Rasmussen encephalitis is a progressive inflammatory disorder that typically causes focal seizures and worsening neurologic deficits associated with unilateral cerebral atrophy. Bacterial meningitis usually presents acutely with systemic illness and meningeal signs, not a slowly progressive unilateral pattern. Absence epilepsy causes brief generalized lapses without progressive focal weakness, and myasthenia causes fatigable weakness rather than focal seizures and brain atrophy. The exam takeaway is to connect progressive focal seizures plus unilateral cerebral changes with Rasmussen encephalitis.

2. 2.A 7-year-old in the emergency department has continuous right facial and arm twitching for 12 minutes, remains responsive, and has oxygen saturation 97% on room air. The nurse suspects focal motor status epilepticus related to Rasmussen encephalitis. What is the priority action?

   • A.Protect the child from injury, position the airway safely, and prepare to administer the prescribed rescue antiseizure medication
   • B.Ask the parent to hold the affected arm still to stop the movements
   • C.Obtain a detailed developmental history before intervening
   • D.Offer oral antiseizure medication with water during the seizure

   Rationale: Prolonged seizure activity requires immediate seizure precautions, airway support, and timely administration of prescribed rescue therapy. Holding the moving limb can cause injury and does not stop seizure activity. History gathering is important after stabilization, and oral medication is unsafe during active seizure activity because of aspiration risk. The exam takeaway is to manage airway and safety first during a prolonged seizure.

3. 3.A 10-year-old with Rasmussen encephalitis is having a focal seizure in the hospital; the right arm is jerking and the child is drooling. Which action should the nurse take?

   • A.Turn the child to the side and move nearby objects away
   • B.Insert a padded tongue blade between the teeth
   • C.Restrain the right arm against the mattress
   • D.Give a sip of water to clear the drooling

   Rationale: Side positioning and clearing the surrounding area help maintain drainage and reduce injury risk during a seizure. Nothing should be placed in the mouth, because this can cause oral injury or airway obstruction. Restraint can cause injury and does not stop the seizure, while oral fluids create an aspiration risk. The exam takeaway is to protect without restraining or placing objects in the mouth.

4. 4.A 6-year-old with suspected Rasmussen encephalitis is scheduled for brain MRI. The child has focal seizures and mild left-sided weakness; temperature is 36.8 C, heart rate 92/min, and oxygen saturation 99%. Which MRI finding would most strongly support the suspected diagnosis?

   • A.Progressive atrophy and signal abnormality confined mainly to one cerebral hemisphere
   • B.Symmetric enlargement of the ventricles without cortical changes
   • C.A ring-enhancing lesion with surrounding edema in both temporal lobes
   • D.Diffuse white matter changes affecting both hemispheres equally

   Answer and rationale are in the full material.

5. 5.A 12-year-old with Rasmussen encephalitis is being evaluated for worsening focal seizures. The nurse reviews the plan for continuous video EEG. What is the primary purpose of this test?

   • A.Correlate the child's clinical episodes with electrical seizure activity and identify seizure patterns
   • B.Measure intracranial pressure continuously
   • C.Determine the exact cause of the inflammation from a blood sample
   • D.Replace MRI as the only test for unilateral brain atrophy

   Answer and rationale are in the full material.