Chapter 44-Nursing Care of the Child With an Alteration in Mobility/Neuromuscular or Musculoskeletal Disorder

9. The nurse is caring for a child with a spinal cord injury and providing instruction to the parents on promoting skin integrity. Which response from the mother indicates a need for further teaching?

A) "I need to monitor his skin at least twice a week."

3. The nurse is providing postoperative care for a 14-month-old girl who has undergone a myelomeningocele repair. The girl's mother is extremely anxious and tells the nurse she is afraid she will never learn how to care for her daughter at home. Which response by the nurse would be most appropriate?

A) "I will help you become comfortable in caring for your daughter."

13. A child with Duchenne muscular dystrophy is to receive prednisone as part of his treatment plan. After teaching the child's parents about this drug, which statement by the parents indicates the need for additional teaching?

A) "We should give this drug before he eats anything."

23. The nurse is assessing a child who is suspected of having Guillain-Barré syndrome. Which assessment findings would the nurse correlate as supporting this diagnosis? Select all answers that apply.

A) Recent cytomegalovirus infection C) Numbness in the lower extremities D) Sustained clonus

11. When developing the plan of care for a child with cerebral palsy, which treatment would the nurse expect as least likely?

A) Skeletal traction

18. The nurse is assessing the neuromusculoskeletal system of a newborn. Which of the following would the nurse identify as an abnormal finding?

A) Sluggish deep tendon reflexes

2. The nurse is caring for an 8-year-old boy with myasthenia gravis and is teaching his parents about the signs of cholinergic crisis. Which of the following responses by the parents indicates a need for further teaching?

B) "He might have difficulty swallowing."

24. A child with myasthenia gravis is brought to the emergency department by his parents. The parents have noticed a sudden increase in respiratory difficulty. The nurse suspects myasthenic crisis based on which statement by the parents?

B) "He was coughing and had a slight fever yesterday and today."

8. The nurse is caring for a 2-month-old with cerebral palsy. The infant is limp and flaccid with uncontrolled, slow, worm-like, writhing, and twisting movements. Which of the following would the nurse use when documenting these observations?

B) Athetoid

14. Which of the following would the nurse include in the preoperative plan of care for an infant with myelomeningocele?

B) Covering the sac with saline-soaked non-adhesive gauze

16. The nurse is assessing a newborn who was delivered after a prolonged labor due to an abnormal presentation. The newborn sustained a cranial nerve injury. The nurse would most likely expect to assess deficits related to which cranial nerve?

B) Facial

21. A group of students are reviewing information about neuromuscular disorders. The students demonstrate understanding of the information when they identify which of the following as examples of autoimmune neuromuscular disorders? Select all answers that apply.

B) Guillain-Barré syndrome C) Myasthenia gravis E) Dermatomyositis

6. A nurse is caring for a 14-year-old girl following myelography. Which of the following would be the priority nursing action?

B) Observing for signs of meningeal irritation

10. The nurse is teaching a group of students about myelinization in a child. Which statement by the students indicates that the teaching was successful?

B) The process occurs in a head-to-toe fashion.

4. The nurse is caring for a 10-year-old with Duchenne muscular dystrophy. As part of the plan of care, the nurse focuses on maintaining his cardiopulmonary function. Which intervention would the nurse implement to best promote maximum chest expansion?

B) Upright positioning

22. A nursing instructor is preparing for a class discussion on spinal muscular atrophy (SMA). When describing type 2 SMA, which of the following would the instructor include? Select all answers that apply.

B) Weakness most severe in shoulders and hips D) Slowly progressing condition E) Genetic disease with autosomal recessive inheritance

1. The nurse is teaching the mother of a 5-year-old boy with a myelomeningocele who has developed a sensitivity to latex. Which of the following responses from his mother indicates a need for further teaching?

C) "A product's label indicates whether it is latex-free."

5. A 6-year-old boy with cerebral palsy has been admitted to the hospital for some tests. His condition is stable. The boy's mother remains with her son, but she is obviously exhausted and stressed. Which response by the nurse would be most appropriate?

C) "He's in good hands; consider going home to get some sleep."

12. A nurse is preparing a program for a group of parents about injury prevention. Which of the following would the nurse include as an important contributing factor for cervical spine injury in a child?

C) Increased mobility of the spine

17. A child with spastic cerebral palsy is to receive botulin toxin. The nurse prepares the child for administration of this drug by which route?

C) Intramuscular injection

20. A child with cerebral palsy has undergone surgery for placement of a baclofen pump. Which of the following would the nurse include when teaching the parents about caring for their child?

D) Discouraging the child from stretching or bending forward for 4 weeks

25. After teaching a class of nursing students about muscular dystrophy, the instructor determines that the teaching was successful when the students identify which type of muscular dystrophy as demonstrating an X-linked recessive pattern of inheritance?

D) Duchenne

15. Which of the following would the nurse expect to find initially in a child with Guillain-Barré syndrome?

D) Lower extremity pain

7. The nurse has developed a plan of care for a 6-year-old with muscular dystrophy. He was recently injured when he fell out of bed at home. Which intervention would the nurse suggest to prevent further injury?

D) Recommend raising the bed's side rails when a caregiver is not present.

19. The nurse is developing a teaching plan for the parents of a child with a myelomeningocele who will require clean intermittent catheterization. Which of the following would the nurse include?

D) Soaking the catheter in a vinegar and water solution to sterilize