Nokea
What functional ability should the nurse expect in a child with a spinal cord lesion at C7?
- A. Complete respiratory paralysis
- B. No voluntary function of upper extremities
- C. Inability to roll over or attain sitting position
- D. Almost complete independence within limitations of wheelchair
Correct Answer: D
Rationale: A C7 spinal cord lesion allows significant independence with wheelchair use, with some assistance for transfers and dressing. Respiratory paralysis occurs at C3 or higher, upper extremity function is preserved, and rolling over or sitting is possible.
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The parents of an infant with cerebral palsy (CP) ask the nurse if their child will have cognitive impairment. The nurses response should be based on which knowledge?
- A. Affected children have some degree of cognitive impairment.
- B. Around 20% of affected children have normal intelligence.
- C. About 45% of affected children have normal intelligence.
- D. Cognitive impairment is expected if motor and sensory deficits are severe.
Correct Answer: C
Rationale: Approximately 40% to 50% of children with CP have normal intelligence, with a wide range of cognitive outcomes. Severe physical impairment does not necessarily correlate with cognitive deficits, and many have minimal intellectual compromise.
Gingivitis is a common problem in children with cerebral palsy (CP). What preventive measure should be included in the plan of care?
- A. High-carbohydrate diet
- B. Meticulous dental hygiene
- C. Minimum use of fluoride
- D. Avoidance of medications that contribute to gingivitis
Correct Answer: B
Rationale: Meticulous dental hygiene prevents gingivitis in CP, countering enamel defects, high-carbohydrate diets, and spasticity-related oral care challenges. Fluoride use is encouraged, and medications like phenytoin may require hygiene adjustments, not avoidance.
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.
The nurse is caring for a family whose infant was just born with anencephaly. What is the most important nursing intervention?
- A. Implement measures to facilitate the attachment process.
- B. Help the family cope with the birth of an infant with a fatal defect.
- C. Prepare the family for extensive surgical procedures that will be needed.
- D. Provide emotional support so the family can adjust to the birth of an infant with problems.
Correct Answer: B
Rationale: Anencephaly, a fatal neural tube defect, requires nursing support to help families cope with grief and provide comfort measures for the infant, who may survive briefly. Attachment is encouraged but secondary, no surgical options exist, and general support is less specific.
A 4-month-old with significant head lag meets the criteria for floppy infant syndrome. A diagnosis of progressive infantile spinal muscular atrophy (Werdnig-Hoffmann disease) is made. What should be included in the nursing care for this child?
- A. Infant stimulation program
- B. Stretching exercises to decrease contractures
- C. Limited physical contact to minimize seizures
- D. Encouraging parents to have additional children
Correct Answer: A
Rationale: An infant stimulation program with frequent position changes and sensory input is vital for Werdnig-Hoffmann disease to support development. Contractures are not a concern due to muscle atrophy, sensation is normal, and genetic counseling is needed, not encouragement for more children.