Question 1

The health care provider has prescribed neostigmine (Prostigmin) 0.04 mg/kg/per dose SC q 4 to 6 hrs PRN for a child with myasthenia gravis. The child weighs 77 lb. The nurse is preparing to administer a dose. Calculate the dose the nurse should administer in milligrams. Record your answer below using one decimal place.
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Accepted Answer

The answer of The health care provider has prescribed neostigmine...

Question 2

The health care provider has prescribed valproic acid (Depakene) 30 mg/kg/day divided bid for a child with cerebral palsy having seizures. The child weighs 22 lb. The nurse is preparing to administer the 0900 dose. Calculate the dose the nurse should administer in milligrams. Record your answer below in a whole number.
__________

Accepted Answer

The answer of The health care provider has prescribed valproic...

Question 3

What functional goal should the nurse expect for a child who has a T1 to T10 spinal cord injury? (Select all that apply.)

Accepted Answer

A child with a T1 to T10 spinal cord injury may be braced for standing, is able to drive an automobile with hand controls, and can manage adapted public transportation. The ability to use regular public transportation and ambulation with bilateral long braces using four-point or swing-through crutch gait are functional goals for individuals with a T10 to L2 injury.

Question 4

The health care provider has prescribed dantrolene sodium (Dantrium) 0.5 mg/kg PO once a day for a child with cerebral palsy. The child weighs 55 lb. Calculate the dose the nurse should administer in milligrams. Record your answer below using one decimal place.
________

Accepted Answer

The answer of The health care provider has prescribed dantrolene...

Question 5

The nurse is teaching the family with a child with cerebral palsy (CP) strategies to prevent constipation. What should the nurse include in the teaching session? (Select all that apply.)

Accepted Answer

A variety of factors, including decreased mobility, decreased fluid intake, a fear of toileting, poor positioning on the toilet, and lack of fiber intake may be responsible for constipation for a child with CP. Stool softeners, laxatives, and a bowel management program may be required to prevent chronic constipation. The child should be placed on the toilet or encouraged to have a bowel movement at the same time each day. Dairy products can cause constipation.

Question 6

What functional goal should the nurse expect for a child who has a C7 spinal cord injury? (Select all that apply.)

Accepted Answer

A child with a C7 spinal cord injury can expect to be completely independent within the limitations of a wheelchair, can roll over in bed, sit up in bed, and eat independently, and will require some assistance in transfer and lower extremity dressing. The ability to drive an automobile with hand controls is a functional goal for a T1 to T10 spinal cord injury. Ambulation with bilateral long braces using four-point or swing-through crutch gait is a functional goal for a T10 to L2 injury.

Question 7

The nurse is preparing to admit a 2-year-old child with spina bifida occulta. What clinical manifestations of spina bifida occulta should the nurse expect to observe? (Select all that apply.)

Accepted Answer

Clinical manifestations of spina bifida occulta include dark tufts of hair; skin depression or dimple; port-wine angiomatous nevi; and soft, subcutaneous lipomas. Bladder and sphincter paralysis are present with spina bifida cystica but not occulta.

Question 8

What findings should the nurse expect to observe in a 7-month-old infant with Werdnig-Hoffman disease? (Select all that apply.)

Accepted Answer

Clinical manifestations of Werdnig-Hoffman disease in an infant include absent deep tendon reflexes, abnormal tongue movements, and failure to thrive. Scoliosis, prominent pectus excavatum, and significant leg involvement are findings observed in a child with intermediate spinal muscular atrophy.

Question 9

What are some of the associated disabilities seen with cerebral palsy? (Select all that apply.)

Accepted Answer

Some of the disabilities associated with CP are visual impairment, hearing impairment, behavioral problems, communication and speech difficulties, seizures, and intellectual impairment. Additional sensory deficits such as hypersensitivity, hyposensitivity, and balance difficulties may occur in children with CP.

Question 10

The nurse is preparing to admit a 5-year-old with spina bifida cystica that was below the second lumbar vertebra. What clinical manifestations of spina bifida cystica below the second lumbar vertebra should the nurse expect to observe? (Select all that apply.)

Accepted Answer

The clinical manifestations of spina bifida cystica below the second lumbar vertebra include lack of bowel control, flaccid, partial paralysis of lower extremities, and overflow incontinence with constant dribbling of urine. No motor impairment occurs with spina bifida cystica that was below the third lumbar vertebra, and soft, subcutaneous lipomas occur with spina bifida occulta.

Question 11

The nurse is preparing to admit a 7-year-old child with ataxic cerebral palsy. What clinical manifestations of ataxic cerebral palsy should the nurse expect to observe? (Select all that apply.)

Accepted Answer

Clinical manifestations of ataxic cerebral palsy include a wide-based gait; rapid, repetitive movements performed poorly; and disintegration of movements of the upper extremities when the child reaches for objects. Slow, twisting movements of the trunk are seen with dyskinetic cerebral palsy, and hypertonicity with poor control of posture, balance, and coordinated motion are seen with spastic cerebral palsy.

Question 12

The nurse is caring for a child with myasthenia gravis (MG). What health care prescription should the nurse verify before administering?

Accepted Answer

Avoid aminoglycoside antibiotics such as gentamicin because they potentiate MG symptoms. Cefizox, Claforan, and Rocephin are cephalosporin antibiotics.

Question 13

The nurse is preparing to admit a 5-year-old child with a lower motor neuron syndrome. What clinical manifestations of a lower motor neuron syndrome should the nurse expect to observe? (Select all that apply.)

Accepted Answer

Clinical manifestations of a lower motor neuron syndrome include loss of hair, skin and tissue changes, and marked atrophy of atonic muscle. Babinski reflex present and hyperreflexia with tendon reflexes exaggerated are manifestations of an upper motor neuron syndrome.

Question 14

The health care provider has prescribed diazepam (Valium) 0.8 mg/kg/day PO divided q 6 hours for a child with cerebral palsy. The child weighs 110 lb. The nurse is preparing to administer the 1200 dose. Calculate the dose the nurse should administer in milligrams. Record your answer below in a whole number.
_______

Accepted Answer

The answer of The health care provider has prescribed diazepam...

Question 15

The health care provider has prescribed carbamazepine (Tegretol) 20 mg/kg/day divided bid for a child with cerebral palsy having seizures. The child weighs 44 lb. The nurse is preparing to administer the 0900 dose. Calculate the dose the nurse should administer in milligrams. Record your answer below in a whole number.
_________

Accepted Answer

The answer of The health care provider has prescribed carbamazepine...

Question 16

The nurse is preparing to admit a 10-year-old child with Duchenne muscular dystrophy. What clinical features of Duchenne muscular dystrophy should the nurse recognize? (Select all that apply.)

Accepted Answer

Clinical features of Duchenne muscular dystrophy include calf muscle hypertrophy; progressive muscular weakness; wasting and contractures; loss of independent ambulation by 9 to 12 years of age; and slowly progressive, generalized weakness during adolescence. The onset is early, not late, usually between 3 and 5 years of age.

Question 17

The health care provider has prescribed oxybutynin (Ditropan) 0.2 mg/kg/day divided bid for a child with myelomeningocele. The child weighs 33 lb. The nurse is preparing to administer the 0900 dose. Calculate the dose the nurse should administer in milligrams. Record your answer below using one decimal place.
_______

Accepted Answer

The answer of The health care provider has prescribed oxybutynin...

Question 18

The nurse is preparing to admit a 7-year-old child with an upper motor neuron syndrome. What clinical manifestations of an upper motor neuron syndrome should the nurse expect to observe? (Select all that apply.)

Accepted Answer

Clinical manifestations of an upper motor neuron syndrome include Babinski reflex present, no wasting of muscle mass, and hyperreflexia with tendon reflexes exaggerated. No flexor spasms and marked atrophy of atonic muscle are manifestations of a lower motor neuron syndrome.

Question 19

The health care provider has prescribed gabapentin (Neurontin) 30 mg/kg/day divided q 8 hours for a child with cerebral palsy having seizures. The child weighs 110 lb. The nurse is preparing to administer the 1200 dose. Calculate the dose the nurse should administer in milligrams. Record your answer below in a whole number.
_________

Accepted Answer

The answer of The health care provider has prescribed gabapentin...

Quiz 35: The Child with Neuromuscular or Muscular Dysfunction