Nokea
An 8-year-old child is hospitalized with infectious polyneuritis (Guillain-Barré syndrome [GBS]). When explaining this disease process to the parents, what should the nurse consider?
- A. Paralysis is progressive with little hope for recovery.
- B. Disease is inherited as an autosomal, sex-linked, recessive gene.
- C. Disease results from an apparently toxic reaction to certain medications.
- D. Muscle strength slowly returns, and most children recover.
Correct Answer: D
Rationale: GBS involves progressive paralysis with recovery of muscle strength starting within 2-3 weeks, with most children regaining full strength, especially younger ones. It?s immune-mediated, not inherited or medication-induced, and has a good prognosis.
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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.
During a well-child visit, the mother tells the nurse that her 4-month-old infant is constipated, is less active than usual, and has a weak-sounding cry. The nurse suspects botulism and questions the mother about the childs diet. What factor should support this diagnosis?
- A. Breastfeeding
- B. Commercial formula
- C. Infant cereal with honey
- D. Improperly sterilized bottles
Correct Answer: C
Rationale: Honey ingestion is a known risk factor for infant botulism in children under 1 year, supporting the diagnosis given symptoms like constipation and weakness. Breastfeeding and formula have minimal risk, and bottle sterilization issues are unrelated to botulism.
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.
An adolescent with a spinal cord injury is admitted to a rehabilitation center. Her parents describe her as being angry, hostile, and uncooperative. The nurse should recognize that this is suggestive of which psychosocial state?
- A. Normal phase of adolescent development
- B. Severe depression that will require long-term counseling
- C. Normal response to her situation that can be redirected in a healthy way
- D. Denial response to her situation that makes rehabilitative efforts more difficult
Correct Answer: C
Rationale: Anger, hostility, and uncooperativeness in a spinal cord injury adolescent reflect a normal response to disrupted independence, which can be redirected positively during rehabilitation. This isn?t typical adolescent behavior, severe depression, or denial, but an adaptive phase.
The nurse is caring for a 4-year-old child with cerebral palsy (CP). The child, developmentally, is at an infant stage. Appropriate developmental stimulation for this child should be what?
- A. Playing pat-a-cake with the child
- B. None so the child does not become overstimulated
- C. Putting a colorful mobile with music on the bed
- D. Giving the child a coloring book and crayons
Correct Answer: C
Rationale: A colorful mobile with music provides sensory stimulation appropriate for an infant developmental stage, supporting sensory input needs in CP. Pat-a-cake and coloring are too advanced, and avoiding stimulation neglects developmental needs.