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.
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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.
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.
What is a major goal of therapy for children with cerebral palsy (CP)?
- A. Cure the underlying defect causing the disorder.
- B. Reverse the degenerative processes that have occurred.
- C. Prevent the spread to individuals in close contact with the child.
- D. Recognize the disorder early and promote optimum development.
Correct Answer: D
Rationale: Early recognition and promoting optimal development are key CP therapy goals, maximizing potential within physical limits. CP is permanent, not curable or reversible, and is not contagious.
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.
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.
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