Answer :
A sign of a VP shunt malfunction in an older child is a headache upon awakening due to improper drainage of cerebrospinal fluid, while bulging fontanels are not applicable to older children as these close during infancy. the correct answer is 1) headache upon awakening.
An indication of a malfunction of a ventriculoperitoneal (VP) shunt in an older child would be the presence of a headache upon awakening. A VP shunt is a medical device that relieves pressure on the brain caused by fluid accumulation, known as hydrocephalus. The signs of a shunt malfunction can include headaches, particularly upon waking up when lying down for an extended time increases cerebrospinal fluid (CSF) pressure due to the shunt not properly draining. Option 4, bulging fontanels, would be incorrect for an older child since fontanels are soft spots on an infant's head that typically close by the age of 18 months. A temperature greater than 100.8 degrees Fahrenheit could indicate infection but is not specifically a sign of shunt malfunction, and an increase in activity is not generally a symptom of VP shunt complications. Hence the correct answer is 1) headache upon awakening.
