Perry/Hockenberry chapter 49. Neuromuscular or Muscular Dysfunction
A 15-year-old is admitted to the intensive care unit (ICU) with a spinal cord injury. The MOST appropriate nursing interventions for this adolescent are: (Select all that apply.)A. monitoring neurologic status. B. administering corticosteroids. C. monitoring for respiratory complications. D. discussing long-term care issues with the family. E. monitoring and maintaining hemodynamic status.
ABCE
A woman who is 6 weeks pregnant tells the nurse that she is worried that the baby might have spina bifida because of family history. The nurse's best response is:A. there is no genetic basis for the defectB. prenatal detection is not possible yetC. chromosome studies done on amniotic fluid can diagnose the defect prenatallyD. The concentration of alpha-fetoprotein in amniotic fluid can indicate the presence of the defect prenatally.
D
A neural tube defect that is not visible externally in the lumbosacral area would be called:A. meningoceleB. mylomeningoceleC. spina vifida cysticaD. spina bifida occulta
D
What most accurately describes bowel function in children born with a myelomeningocele?o Incontinence cannot be prevented. o Enemas and laxatives are contraindicated. o Some degree of fecal continence can usually be achieved. o Colostomy is usually required by the time the child reaches adolescence.
. o Some degree of fecal continence can usually be achieved.
A neural tube defect that is not visible externally in the lumbosacral area would be called:o meningocele. o myelomeningocele. o spina bifida cystica. o spina bifida occulta.
. o spina bifida occulta.
1. Spastic cerebral palsy is characterized by what presentation?a. Hypertonicity and poor control of posture, balance, and coordinated motionb. Athetosis and dystonic movementsc. Wide-based gait and poor performance of rapid, repetitive movementsd. Tremors and lack of active movement
A
11. A young boy has just been diagnosed with pseudohypertrophic muscular dystrophy. The management plan should include whichintervention?a. Recommending genetic counselingb. Explaining that the disease is easily treatedc. Suggesting ways to limit the use of musclesd. Assisting the family in finding a nursing facility to provide his care
A
3. What is the most common problem for children born with a myelomeningocele?a. Neurogenic bladderb. Intellectual impairmentc. Respiratory compromised. Cranioschisis
A
4. Which problem is most often associated with myelomeningocele?a. Hydrocephalusb. Craniosynostosisc. Biliary atresiad. Esophageal atresia
A
9. Latex allergy is suspected in a child with spina bifida. What intervention should be included in the child's plan of care?a. Avoiding using any latex productb. Using only nonallergenic latex productsc. Administering medication for long-term desensitizationd. Teaching the family about long-term management of asthma
A
A 6 yoa girl born with a myelomeningocele has a neurognic bladder disorder. Her parents have been performing clean intermittent catheterization. The nurse's most appropriate action is to:A. teach the child to do self-cathB. Teach the child appropriate bladder controlC. continue having parents do cathD. encourage the family to consider urinary diversion
A
A young boy has just been diagnosed with pseudohypertrophic (Duchenne's) muscular dystrophy. The management plan should include:a. Recommending genetic counseling.b. Explaining that the disease is easily treated.c. Suggesting ways to limit the use of muscles.d. Assisting the family in finding a nursing facility to provide his care.
A
Latex allergy is suspected in a child with spina bifida. Appropriate nursing interventions include:a. Avoiding using any latex product.b. Using only nonallergenic latex products.c. Administering medication for long-term desensitization.d. Teaching the family about long-term management of asthma.
A
Spastic cerebral palsy is characterized by:A. Hypertonicity and poor control of posture, balance, and coordinated motion B. Athetosis and dystonic movementsC. Wide-based gait and poor performance of rapid, repetitive movements D. Tremors and lack of active movement
A
Spastic cerebral palsy is characterized by:a. Hypertonicity and poor control of posture, balance, and coordinated motion.b. Athetosis and dystonic movements.c. Wide-based gait and poor performance of rapid, repetitive movements.d. Tremors and lack of active movement.
A
The most common problem of children born with a myelomeningocele is:A. Neurogenic bladder B. Intellectual impairment C. Respiratory compromise D. Cranioschisis
A
The most common problem of children born with a myelomeningocele is:a.Neurogenic bladder.b. Intellectual impairment.c. Respiratory compromise.d. Cranioschisis.
A
Which problem is most often associated with myelomeningocele?A. Hydrocephalus B. Craniosynostosis C. Biliary atresia D. Esophageal atresia
A
Which problem is most often associated with myelomeningocele?a. Hydrocephalusc. Biliary atresiab. Craniosynotosisd. Esophageal atresia
A
The nurse in the neonatal intensive care unit is caring for an infant with myelomeningocele scheduled for surgical repair in the morning. Which early signs of infection should the nurse monitor on this infant (Select all that apply)?a. Temperature instabilityb. Irritabilityc. Lethargyd. Bradycardiae. Hypertension
ABC
How much folic acid is recommended for women of childbearing age?A. 0.1mgB. 0.4mgC. 1.5mgD. 2mg
B
How much folic acid is recommended for women of childbearing age?a. 0.1 mgb. 0.4 mgc. 1.5 mgd. 2 mg
B
Which statement is most accurate in describing tetanus?A. Acute infectious disease caused by an exotoxin produced by an anaerobic gram-positive bacillus B. Inflammatory disease that causes extreme, localized muscle spasm C. Acute infection that causes meningeal inflammation resulting in symptoms of generalized muscle spasm D. Disease affecting the salivary gland with resultant stiffness of the jaw
A
The nurse is admitting a school-age child with suspected Guillain-Barré syndrome (GBS). Which nursing intervention is a priority in the care for this child?a. Monitoring intake and outputb. Assessing respiratory effortsc. Placing on a telemetry monitord. Obtaining laboratory studies
B
4. The nurse is caring for an infant with myelomeningocele who is scheduled for surgical repair in the morning. Which early signs ofinfection should the nurse monitor on this infant? (Select all that apply.)a. Temperature instabilityb. Irritabilityc. Lethargyd. Bradycardiae. Hypertension
ABC
The nurse in the neonatal intensive care unit is caring for an infant with myelomeningocele scheduled for surgical repair in the morning. Which early signs of infection should the nurse monitor on this infant (Select all that apply)?A. Temperature instability B. Irritability C. Lethargy D. BradycardiaE. Hypertension
ABC
3. The nurse is conducting discharge teaching with parents of a preschool child with a myelomeningocele, repaired at birth, who isbeing discharged from the hospital after a urinary tract infection (UTI). Which should the nurse include in the dischargeinstructions related to management of the child's genitourinary function? (Select all that apply.)a. Continue to perform the clean intermittent catheterizations (CIC) at home.b. Administer the oxybutynin chloride as prescribed.c. Reduce fluid intake in the afternoon and evening hours.d. Monitor for signs of a recurrent UTI.e. Administer furosemide as prescribed.
ABD
The nurse is conducting discharge teaching with parents of a preschool child with myelomeningocele, repaired at birth, who is being discharged from the hospital after a urinary tract infection (UTI). Which should the nurse include in the discharge instructions related to management of the child's genitourinary function (Select all that apply)?A. Continue to perform the clean intermittent catheterizations (CIC) at home B. Administer the oxybutynin chloride (Ditropan) as prescribedC. Reduce fluid intake in the afternoon and evening hoursD. Monitor for signs of a recurrent UTIE. Administer furosemide (Lasix) as prescribed
ABD
The nurse is conducting discharge teaching with parents of a preschool child with myelomeningocele, repaired at birth, who is being discharged from the hospital after a urinary tract infection (UTI). Which should the nurse include in the discharge instructions related to management of the child's genitourinary function (Select all that apply)?a. Continue to perform the clean intermittent catheterizations (CIC) at home.b. Administer the oxybutynin chloride (Ditropan) as prescribed.c. Reduce fluid intake in the afternoon and evening hours.d. Monitor for signs of a recurrent UTI.e. Administer furosemide (Lasix) as prescribed.
ABD
1. A 14 year old is in the intensive care unit after a spinal cord injury 2 days ago. Which nursing care interventions are needed for thischild? (Select all that apply.)a. Monitoring and maintaining systemic blood pressure.b. Administering corticosteroids.c. Minimizing environmental stimuli.d. Discussing long-term care issues with the family.e. Monitoring for respiratory complications.
ABE
2. Which assessment findings should the nurse note in a school-age child diagnosed with Duchenne's muscular dystrophy (DMD)?(Select all that apply.)a. Lordosisb. Gower's signc. Kyphosisd. Scoliosise. Waddling gait
ABE
20. A 14-year-old girl is in the intensive care unit after a spinal cord injury 2 days ago. Which nursing care interventions are needed for this child (Select all that apply)?A. Monitoring and maintaining systemic blood pressureB. Administering corticosteroidsC. Minimizing environmental stimuliD. Discussing long-term care issues with the familyE. Monitoring for respiratory complications
ABE
A 14-year-old girl is in the intensive care unit after a spinal cord injury 2 days ago. Which nursing care interventions are needed for this child (Select all that apply)?a. Monitoring and maintaining systemic blood pressure.b. Administering corticosteroids.c. Minimizing environmental stimuli.d. Discussing long-term care issues with the family.e. Monitoring for respiratory complications.
ABE
Which assessment findings should the nurse note in a school-age child with Duchenne's muscular dystrophy (DMD) (Select all that apply)?a. Lordosisb. Gower's signc. Kyphosisd. Scoliosise. Waddling gait
ABE
The nurse is caring for a neonate born with a myelomeningocele. Surgery to repair the defect is scheduled the next day. The most appropriate way to position and feed this neonate is to place him:A. Prone and tube feedB. Prone, turn head to side, and nipple feedC. Supine in infant carrier and nipple feedD. Supine, with defect supported with rolled blankets and nipple feed
B
The nurse is caring for a neonate born with a myelomeningocele. Surgery to repair the defect is scheduled the next day. The most appropriate way to position and feed this neonate is to place him:a. Prone and tube feed.b. Prone, turn head to side, and nipple feed.c. Supine in infant carrier and nipple feed.d. Supine, with defect supported with rolled blankets, and nipple feed.
B
The nurse is caring for an infant with myelomeningocele scheduled for surgical closure in the morning. Which interventions should the nurse plan for the care of the myelomeningocele sac?A. Open to air B. Covered with a sterile, moist, nonadherent dressing C. Reinforcement of the original dress if drainage notedD. A diaper secured over the dressing
B
The nurse is caring for an infant with myelomeningocele scheduled for surgical closure in the morning. Which interventions should the nurse plan for the care of the myelomeningocele sac?a. Open to airb. Covered with a sterile, moist, nonadherent dressingc. Reinforcement of the original dressing if drainage notedd. A diaper secured over the dressing
B
What is frequently associated with infant botulism?A. Contaminated soil B. Honey and corn syrup C. Commercial infant cereals D. Improperly sterilized bottles
B
Which finding should cause the nurse to suspect a diagnosis of spastic cerebral palsy?A. Tremulous movements at rest and with activity B. Sudden jerking movement caused by stimuliC. Writhing, uncontrolled, involuntary movementsD. Clumsy, uncoordinated movements
B
Which finding should cause the nurse to suspect a diagnosis of spastic cerebral palsy?a. Tremulous movements at rest and with activityb. Sudden jerking movement caused by stimulic. Writhing, uncontrolled, involuntary movementsd.Clumsy, uncoordinated movements
B
13. Which statement best describes a myelomeningocele?a. Fissure in the spinal column that leaves the meninges and the spinal cord exposed.b. Herniation of the brain and meninges through a defect in the skull.c. Hernial protrusion of a sac-like cyst of meninges with spinal fluid but no neuralelements.d. Visible defect with an external sac-like protrusion containing meninges, spinalfluid, and nerves.
D
10. Which finding should cause the nurse to suspect a diagnosis of spastic cerebral palsy?a. Tremulous movements at rest and with activityb. Positive Babinski reflexc. Writhing, uncontrolled, involuntary movementsd. Clumsy, uncoordinated movements
B
15. Which interventions should the nurse include in the plan of care for the infant awaiting surgical closure of a myelomeningocelesac?a. Open to airb. Covered with a sterile, moist, nonadherent dressingc. Reinforcement of the original dressing if drainage notedd. A diaper secured over the dressing
B
16. The nurse is admitting a school-age child with suspected Guillain-Barré syndrome (GBS). Which nursing intervention is a priorityin the care for this child?a. Monitoring intake and outputb. Assessing respiratory effortsc. Placing on a telemetry monitord. Obtaining laboratory studies
B
6. How much folic acid is recommended for women of childbearing age?a. 0.1 mgb. 0.4 mgc. 1.5 mgd. 2 mg
B
7. The nurse is caring for a neonate born with a myelomeningocele. Surgery to repair the defect is scheduled the next day. The mostappropriate way to position and feed this neonate is to place him:a. prone and tube feed.b. prone, turn head to side, and nipple feed.c. supine in infant carrier and nipple feed.d. supine, with defect supported with rolled blankets, and nipple feed.
B
A 3-year-old male child has cerebral palsy and is currently hospitalized or orthopedic surgery. HIs mother says that he has difficulty swallowing and cannot hol a utensil to feed himslef. He is slightly underweight ofr his height. The MOST appropriate nursing action related to feeding this child is to:A. Bottle or tube-feed him specialized formula until he gains sufficient weight. B. stabilize his jaw with one hand (either from a front or side position) to facilitate swallowingC. place him in a well-supported semi-reclining position to make use of gravity flow.D. place him in a sitting position with his neck hyper-extended to make use of gravity flow.
B
A child with spina bifida has deveolped a latex allergy from numerous bladder catheterizations and surgeries. A PRIORITY nursing intervention is to:A. recommend allergy testingB. provide a latex-free environmentC. use only powder-free latex glovesD. limit use of latex products as much as possible
B
An 8-year-old child is hospitalized with infectious polyneuritis (Guillain-Barré syndrome). When explaining this disease process to the parents, the nurse should consider that:A. paralysis is progressive with little hope for recovery. B. muscle function will gradually return, and recovery is possible in most children. C. disease results from an apparently toxic reaction to certain medications. D. disease is inherited as an autosomal, sex-linked, recessive gene.
B
The pediatric clinic nurse completes an assessment on a 4-month-old infant brought in because the parents are concerned that something is "just not right" with their baby. The nurse should alert the health care provider to which assessment findings? (Select all that apply.)A. Inability to sit up without support. B. Poor head control and clenched fists. C. Inability to crawl. D. Failure to smile. E. Extreme irritability.
BDE
14. Which signs and symptoms are associated with Werdnig-Hoffmann disease?a. Spinal muscular atrophyb. Neural atrophy of musclesc. Progressive weakness and wasting of skeletal muscled. Pseudohypertrophy of certain muscle groups
C
5. A current recommendation to prevent neural tube defects is the administration of what supplement?a. Vitamin A throughout pregnancyb. Multivitamin preparations as soon as pregnancy is suspectedc. Folic acid for all women of childbearing aged. Folic acid during the first and second trimesters of pregnancy
C
A current recommendation to prevent neural tube defects is the supplementation of:A. Vitamin A throughout pregnancy B. Multivitamin preparations as soon as pregnancy is suspected C. Folic acid for all women of childbearing ageD. Folic acid during the first and second trimesters of pregnancy
C
A current recommendation to prevent neural tube defects is the supplementation of:a. Vitamin A throughout pregnancy.b. Multivitamin preparations as soon as pregnancy is suspected.c. Folic acid for all women of childbearing age.d. Folic acid during the first and second trimesters of pregnancy.
C
A home care nurse is caring for an adolescent with a T1 spinal cord injury. The adolescent suddenly becomes flushed, hypertensive, and diaphoretic. Which intervention should the nurse perform first?A. Place the adolescent in a flat right side-lying position B. Place a cool washcloth on the adolescent's forehead and continue to monitor the blood pressureC. Implement a standing prescription to empty the bladder with a sterile in-and-out catheterD. Take a full set of vital signs and notify the health care provider
C
A home care nurse is caring for an adolescent with a T1 spinal cord injury. The adolescent suddenly becomes flushed, hypertensive, and diaphoretic. Which intervention should the nurse perform first?a. Place the adolescent in a flat right side-lying position.b. Place a cool washcloth on the adolescent's forehead and continue to monitor the blood pressure.c. Implement a standing prescription to empty the bladder with a sterile in-and-out Foley catheter.d. Take a full set of vital signs and notify the health care provider.
C
The nurse is admitting a child with Werdnig-Hoffmann disease (spinal muscular atrophy type 1). Which signs and symptoms are associated with this disease?a. Spinal muscular atrophyb. Neural atrophy of musclesc. Progressive weakness and wasting of skeletal muscled. Pseudohypertrophy of certain muscle groups
C
What most accurately describes bowel function in children born with myelomemingoceleA. Incontinence cannot be preventedB. enemas and laxatives are contraindicatedc. come degree of fecal continence can usually be achieved. D. colostomy is ususally required by he time the child reaches adolescence
C
Which statementBEST describes pseudohypertrophic (Duchenne) muscular dystrophy?A. It is inherited as an autosomal dominant disorder. B. It is characterized by weakness of proximal muscles of both pelvic and shoulder girdles. C. It is characterized by muscle weakness usually beginning about 3 years old. D. Onset occurs in later childhood and adolescence
C
17. The nurse is caring for an intubated infant with botulism. Which health care provider prescriptions should the nurse clarify with thehealth care provider before implementing?a. Administer 250 mg botulism immune globulin intravenously (BIG-IV) one time.b. Provide total parenteral nutrition (TPN) at 25 mL/hr intravenously.c. Titrate oxygen to keep pulse oximetry saturations greater than 92.d. Administer gentamicin sulfate 10 mg per intravenous piggyback every 12 hours.
D
2. The parents of a child diagnosed with cerebral palsy ask the nurse if any drugs can decrease their child's spasticity. The nurse'sresponse should be based on what knowledge?a. Anticonvulsant medications are sometimes useful for controlling spasticity.b. Medications that would be useful in reducing spasticity are too toxic for use withchildren.c. Many different medications can be highly effective in controlling spasticity.d. Implantation of a pump to deliver medication into the intrathecal space todecrease spasticity has recently become available.
D
8. The nurse is talking to a parent with a child who has a latex allergy. Which statement by the parent would indicate a correctunderstanding of the teaching?a. "My child will have an allergic reaction if he comes in contact with yeastproducts."b. "My child may have an upset stomach if he eats a food made with wheat orbarley."c. "My child will probably develop an allergy to peanuts."d. "My child should not eat bananas or kiwis."
D
12. What is the most appropriate nursing response to the father of a newborn infant with myelomeningocele who asks about the causeof this condition?a. "One of the parents carries a defective gene that causes myelomeningocele."b. "A deficiency in folic acid in the father is the most likely cause."c. "Offspring of parents who have a spinal abnormality are at greater risk formyelomeningocele."d. "There may be a variety of different causes."
D
An 8 yoa female child is diagnosed with moderate cerebral palsy (CP). She recently began participation in a regular classroom for part of the day. Her mother asks the school nurse about having her daughter join the after-school Girl Scout troop. The nurse's response should be based on knowledge that:A. most activities such as GS canot be adapted for children with CP. B. after - school activities ususally result in extreme fatigue for children with CP.C. trying to participate in activities such as GS leads to lowered self-esteem in children with CP. D. after-school activities often provide children with CP opportunities for socialization and recreation
D
An important nursing intervention when caring for a child with myelomeningocele in the postoperative stage is to:A. place child on his or her side to decrease pressure on the spinal cord. B. apply a heat lamp to facilitate drying and toughening of the sacC. keep skin clean and dry to prevent irritation from diarrhea stools. D. measure had circumference and examine fontanels for signs that might indicate developing hydrocephalums
D
Cerebral palsy may result from a variety of causes. It is now know that the most common cause of cerebral palsy is:A. birth asphyxiaB. Neonatal diseasesC. cerebra traumaD. prenatal brain abnormalities
D
The major goals of therapy for children with CP include:A. reversing degenerative processes that have occurred.B. curing underlying defect causing the disorderC. preventing spread to individuals in close contact with the child.D. recognizing the disorder early and promoting optimal developmnet
D
The nurse is caring for an intubated infant with botulism in the pediatric intensive care unit. Which health care provider prescriptions should the nurse clarify with the health care provider before implementing?a. Administer 250 mg botulism immune globulin intravenously (BIG-IV) one time.b. Provide total parenteral nutrition (TPN) at 25 mL/hr intravenously.c. Titrate oxygen to keep pulse oximetry saturations greater than 92.d. Administer gentamicin sulfate (Garamycin) 10 mg per intravenous piggyback every 12 hours.
D
The nurse is preparing to admit a newborn with myelomeningocele to the neonatal intensive care nursery. Which describes this newborn's defect?A. Fissure in the spinal column that leaves the meninges and the spinal cord exposed B. Herniation of the brain and meninges through a defect in the skullC. Hernial protrusion of a saclike cyst of meninges with spinal fluid but no neural elements D. Visible defect with an external saclike protrusion containing meninges, spinal fluid, nerves
D
The nurse is preparing to admit a newborn with myelomeningocele to the neonatal intensive care nursery. Which describes this newborn's defect?a. Fissure in the spinal column that leaves the meninges and the spinal cord exposedb. Herniation of the brain and meninges through a defect in the skullc. Hernial protrusion of a saclike cyst of meninges with spinal fluid but no neural elementsd. Visible defect with an external saclike protrusion containing meninges, spinal fluid, and nerves
D
The nurse is talking to a parent with a child who has a latex allergy. Which statement by the parent would indicate a correct understanding of the teaching?a. "My child will have an allergic reaction if he comes in contact with yeast products."b. "My child may have an upset stomach if he eats a food made with wheat or barley."c. "My child will probably develop an allergy to peanuts."d. "My child should not eat bananas or kiwis."
D
The parents of a child with cerebral palsy ask the nurse if any drugs can decrease their child's spasticity. The nurse's response should be based on knowing that:A. anticonvulsant medications are sometimes useful for controlling spasticity B. Medications that would be useful in reducing spasticity are too toxic for use C. Many different medications can be highly effective in controlling spasticityD. Implantation of a pump to deliver medication into the intrathecal space to decrease spasticity has recently become available
D
The parents of a child with cerebral palsy ask the nurse if any drugs can decrease their child's spasticity. The nurse's response should be based on knowing that:a. Anticonvulsant medications are sometimes useful for controlling spasticity.b. Medications that would be useful in reducing spasticity are too toxic for use with children.c. Many different medications can be highly effective in controlling spasticity.d. Implantation of a pump to deliver medication into the intrathecal space to decrease spasticity has recently become available.
D
Therapeutic management of a child with tetanus includes the administration of:a. Nonsteroidal antiinflammatory drugs (NSAIDs) to reduce inflammation.b. Muscle stimulants to counteract muscle weakness.c. Bronchodilators to prevent respiratory complications.d. Antibiotics to control bacterial proliferation at the site of injury.
D
What is the most appropriate nursing response to the father of a newborn infant with myelomeningocele who asks about the cause of this condition?A. "One of the parents carries a defective gene that causes myelomeningocele."B. "A deficiency in folic acid in the father is the most likely cause."C. "Offspring of parents who have a spinal abnormality are at greater risk for myelomeningocele."D. "There may be no definitive cause identified."
D
What is the most appropriate nursing response to the father of a newborn infant with myelomeningocele who asks about the cause of this condition?a. "One of the parents carries a defective gene that causes myelomeningocele."b. "A deficiency in folic acid in the father is the most likely cause."c. "Offspring of parents who have a spinal abnormality are at greater risk for myelomeningocele."d. "There may be no definitive cause identified."
D
A 15-year-old is admitted to the intensive care unit (ICU) with a spinal cord injury. The MOST appropriate nursing interventions for this adolescent are: (Select all that apply.)o monitoring neurologic status. o administering corticosteroids. o monitoring for respiratory complications.o discussing long-term care issues with the family. o monitoring and maintaining hemodynamic status.
o monitoring neurologic status. o administering corticosteroids. o monitoring for respiratory complications.o monitoring and maintaining hemodynamic status.
woman who is 6 weeks' pregnant tells the nurse that she is worried that the baby might have spina bifida because of a family history. The nurse's BEST response is:o "There is no genetic basis for the defect." o "Prenatal detection is not possible yet." o "Chromosome studies done on amniotic fluid can diagnose the defect prenatally." o "The concentration of alpha-fetoprotein in amniotic fluid can indicate the presence of the defect prenatally."
o "The concentration of alpha-fetoprotein in amniotic fluid can indicate the presence of the defect prenatally."
Which statement is most accurate in describing tetanus?o Acute infectious disease caused by an exotoxin produced by an anaerobic gram-positive bacillus o Inflammatory disease that causes extreme, localized muscle spasm o Acute infection that causes meningeal inflammation resulting in symptoms of generalized muscle spasm o Disease affecting the salivary gland with resultant stiffness of the jaw
o Acute infectious disease caused by an exotoxin produced by an anaerobic gram-positive bacillus
What is frequently associated with infant botulism?o Contaminated soil o Honey and corn syrup o Commercial infant cereals o Improperly sterilized bottles
o Honey and corn syrup
Which statementBEST describes pseudohypertrophic (Duchenne) muscular dystrophy?o It is inherited as an autosomal dominant disorder. o It is characterized by weakness of proximal muscles of both pelvic and shoulder girdles. o It is characterized by muscle weakness usually beginning about 3 years old. o Onset occurs in later childhood and adolescence.
o It is characterized by muscle weakness usually beginning about 3 years old.
The pediatric clinic nurse completes an assessment on a 4-month-old infant brought in because the parents are concerned that something is "just not right" with their baby. The nurse should alert the health care provider to which assessment findings? (Select all that apply.)o Inability to sit up without support. o Poor head control and clenched fists. o Inability to crawl. o Failure to smile. o Extreme irritability.
o Poor head control and clenched fists. o Failure to smile. o Extreme irritability.
An 8-year-old female child is diagnosed with moderate cerebral palsy (CP). She recently began participation in a regular classroom for part of the day. Her mother asks the school nurse about having her daughter join the after-school Girl Scout troop. The nurse's response should be based on knowledge that:o most activities such as Girl Scouts cannot be adapted for children with CP. o after-school activities usually result in extreme fatigue for children with CP. o trying to participate in activities such as Girl Scouts leads to lowered self-esteem in children with CP. o after-school activities often provide children with CP opportunities for socialization and recreation.
o after-school activities often provide children with CP opportunities for socialization and recreation.
An important nursing intervention when caring for a child with myelomeningocele in the postoperative stage is to:o place child on his or her side to decrease pressure on the spinal cord. o apply a heat lamp to facilitate drying and toughening of the sac. o keep skin clean and dry to prevent irritation from diarrheal stools. o measure head circumference and examine fontanels for signs that might indicate developing hydrocephalus.
o measure head circumference and examine fontanels for signs that might indicate developing hydrocephalus.
An 8-year-old child is hospitalized with infectious polyneuritis (Guillain-Barré syndrome). When explaining this disease process to the parents, the nurse should consider that:o paralysis is progressive with little hope for recovery. o muscle function will gradually return, and recovery is possible in most children. o disease results from an apparently toxic reaction to certain medications. o disease is inherited as an autosomal, sex-linked, recessive gene.
o muscle function will gradually return, and recovery is possible in most children.
Cerebral palsy may result from a variety of causes. It is now known that the most common cause of cerebral palsy is:o birth asphyxia. o neonatal diseases. o cerebral trauma. o prenatal brain abnormalities.
o prenatal brain abnormalities.
A child with spina bifida has developed a latex allergy from numerous bladder catheterizations and surgeries. A PRIORITY nursing intervention is to:o recommend allergy testing. o provide a latex-free environment. o use only powder-free latex gloves. o limit use of latex products as much as possible.
o provide a latex-free environment.
The major goals of therapy for children with cerebral palsy include:o reversing degenerative processes that have occurred. o curing underlying defect causing the disorder. o preventing spread to individuals in close contact with the child. o recognizing the disorder early and promoting optimal development.
o recognizing the disorder early and promoting optimal development.
A 3-year-old male child has cerebral palsy and is currently hospitalized for orthopedic surgery. His mother says that he has difficulty swallowing and cannot hold a utensil to feed himself. He is slightly underweight for his height. The MOST appropriate nursing action related to feeding this child is to:o bottle- or tube-feed him a specialized formula until he gains sufficient weight. o stabilize his jaw with one hand (either from a front or side position) to facilitate swallowing.o place him in a well-supported, semireclining position to make use of gravity flow. o place him in a sitting position with his neck hyperextended to make use of gravity flow.
o stabilize his jaw with one hand (either from a front or side position) to facilitate swallowing.
A 6-year-old girl born with a myelomeningocele has a neurogenic bladder disorder. Her parents have been performing clean intermittent catheterization. The nurse's MOST appropriate action is to:o teach the child to do self-catheterization. o teach the child appropriate bladder control. o continue having parents do catheterization. o encourage the family to consider urinary diversion.
o teach the child to do self-catheterization.
