Nokea
Spastic cerebral palsy (CP) is characterized by which clinical manifestations?
- A. Athetosis, dystonic movements
- B. Tremors, lack of active movement
- C. Hypertonicity; poor control of posture, balance, and coordinated motion
- D. Wide-based gait; poor performance of rapid, repetitive movements
Correct Answer: C
Rationale: Spastic CP features hypertonicity and poor posture, balance, and coordination control due to increased muscle tone and stretch reflexes. Athetosis and dystonia characterize dyskinetic CP, tremors suggest other disorders, and wide-based gait is typical of ataxic CP.
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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.
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.
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.
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.
The parents of a child with spastic cerebral palsy (CP) state that their child seems to have significant pain. In addition to systemic pharmacologic management, the nurse includes which teaching?
- A. Patterning
- B. Positions to reduce spasticity
- C. Stretching exercises after meals
- D. Topical analgesics for muscle spasms
Correct Answer: B
Rationale: Teaching positions to reduce spasticity, such as specific sitting or lying postures, helps manage pain in spastic CP. Patterning is ineffective, stretching requires prior analgesia, and topical analgesics are not effective for CP spasms.