The nurse is taking care of a child who is alert but showing signs of increased intracranial pressure. Which test is contraindicated in this case?
a. Oculovestibular response
b. Doll's head maneuver
c. Funduscopic examination for papilledema
d. Assessment of pyramidal tract lesions
ANS: A
The oculovestibular response (caloric test) involves the instillation of ice water into the ear of a comatose child. The caloric test is painful and is never performed on an awake child or one who has a ruptured tympanic membrane. Doll's head maneuver, funduscopic examination for papilledema, and assessment of pyramidal tract lesions can be performed on awake children.
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