Nokea
What statement best describes Duchenne (pseudohypertrophic) muscular dystrophy (DMD)?
- A. It has an autosomal dominant inheritance pattern.
- B. Onset occurs in later childhood and adolescence.
- C. It is characterized by presence of Gower sign, a waddling gait, and lordosis.
- D. Disease stabilizes during adolescence, allowing for life expectancy to approximately age 40 years.
Correct Answer: C
Rationale: DMD features Gower sign, waddling gait, and lordosis due to progressive muscle weakness starting at ages 3-5. It?s X-linked recessive, not autosomal dominant, and relentlessly progresses, leading to death by respiratory or cardiac failure, not stabilization.
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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 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.
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.
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.
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.