Nokea
A recommendation to prevent neural tube defects (NTDs) is the supplementation of what?
- A. Vitamin A throughout pregnancy
- B. Folic acid for all women of childbearing age
- C. Folic acid during the first and second trimesters of pregnancy
- D. Multivitamin preparations as soon as pregnancy is suspected
Correct Answer: B
Rationale: Folic acid supplementation for women of childbearing age, especially preconceptionally, reduces NTD incidence significantly, as defects occur early (3-5 weeks). Vitamin A is unrelated, and supplementation only during pregnancy or with multivitamins is less effective.
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What is the most common cause of cerebral palsy (CP)?
- A. Central nervous system (CNS) diseases
- B. Birth asphyxia
- C. Cerebral trauma
- D. Neonatal encephalopathy
Correct Answer: D
Rationale: Neonatal encephalopathy, often from unknown prenatal causes, is implicated in about 80% of CP cases, particularly in term and preterm infants. CNS diseases, birth asphyxia, and cerebral trauma contribute but are less common causes.
What statement is most accurate in describing tetanus?
- A. Inflammatory disease that causes extreme, localized muscle spasm.
- B. Disease affecting the salivary gland with resultant stiffness of the jaw.
- C. Acute infectious disease caused by an exotoxin produced by an anaerobic spore-forming, gram-positive bacillus.
- D. Acute infection that causes meningeal inflammation resulting in symptoms of generalized muscle spasm.
Correct Answer: C
Rationale: Tetanus, caused by Clostridium tetani?s exotoxins, affects the central nervous system, causing muscle stiffness and spasms, starting with the jaw (lockjaw). It?s not inflammatory, doesn?t affect salivary glands, and isn?t caused by meningeal inflammation.
A child, age 3 years, has cerebral palsy (CP) and is hospitalized for orthopedic surgery. His mother says he has difficulty swallowing and cannot hold a utensil to feed himself. He is slightly underweight for his height. What is the most appropriate nursing action related to feeding this child?
- A. Bottle or tube feed him a specialized formula until he gains sufficient weight.
- B. Stabilize his jaw with caregivers hand (either from a front or side position) to facilitate swallowing.
- C. Place him in a well-supported, semireclining position.
- D. Place him in a sitting position with his neck hyperextended to make use of gravity flow.
Correct Answer: B
Rationale: Stabilizing the jaw from the front or side improves swallowing control in CP, addressing compromised jaw function. Bottle or tube feeding doesn?t address jaw issues, and semireclining or hyperextended positions increase aspiration risk.
An adolescent has just been brought to the emergency department with a spinal cord injury and paralysis from a diving accident. The parents keep asking the nurse, How bad is it? The nurses response should be based on which knowledge?
- A. Families adjust better to life-threatening injuries when information is given over time.
- B. Immediate loss of function is indicative of the long-term consequences of the injury.
- C. Extent and severity of damage cannot be determined for several weeks or even months.
- D. Numerous diagnostic tests will be done immediately to determine extent and severity of damage.
Correct Answer: C
Rationale: Spinal cord injury extent and severity are unclear initially due to physiologic responses, with improvement possible over weeks or months. Immediate loss doesn?t predict long-term outcomes, and while tests are done, prognosis requires time. Gradual information helps, but extent is the key issue.
The nurse is preparing a staff education in-service session for a group of new graduate nurses who will be working in a long-term care facility for children; many of the children have cerebral palsy (CP). What statement should the nurse include in the training?
- A. Children with dyskinetic CP have a wide-based gait and repetitive movements.
- B. Children with spastic pyramidal CP have a positive Babinski sign and ankle clonus.
- C. Children with hemiplegia CP have mouth muscles and one lower limb affected.
- D. Children with ataxic CP have involvement of pharyngeal and oral muscles with dysarthria.
Correct Answer: B
Rationale: Spastic pyramidal CP is characterized by a positive Babinski sign and ankle clonus due to hypertonicity. Dyskinetic CP involves oral muscles and dysarthria, hemiplegia affects one side with upper limbs more impacted, and ataxic CP features a wide-based gait.