Deck 31: Cardiopulmonary Assessment and Care of Patients With Neuromuscular Disease

Question 1

Diagnosis of muscular dystrophy combines:
1) physical examination.
2) laboratory testing.
3) muscle biopsy findings.
4) pulmonary function testing.

A)1, 3
B)1, 2, 4
C)2, 3, 4
D)1, 2, 3

Answer 1

1, 2, 3

Question 2

Which of the following is the leading cause of death in a patient with neuromuscular disease (NMD)?

A) Infections
B) Breathing disorders
C) Cardiac disorders
D) Suicide

Answer 2

Breathing disorders

Question 3

The respiratory therapist can prevent increases in intracranial pressure (ICP) by:

A) the administration of albuterol q4h.
B) placing the patient in the Trendelenburg position.
C) elevating the head of the bed at least 30 degrees.
D) hypoventilating the patient.

Answer 3

the administration of albuterol q4h.

Question 4

Which of the following NMD can be diagnosed with genetic testing of the dystrophin gene?
1) Duchenne muscular dystrophy
2) Facioscapulohumeral dystrophy
3) Becker muscular dystrophy
4) Limb girdle muscular dystrophy

A)1, 3
B)1, 2, 4
C)2, 3, 4
D)1, 2, 3

Question 5

Which of the following are the two main categories of stroke?

A) Cellular damage or cellular death
B) Transient or permanent
C) Sensory or motor
D) Hemorrhagic and ischemic

Question 6

Which of the following is disease in which patients may have facial wasting, hypotonia, an arched palate with progressive weakness that begins in the distal muscles?

A) Amyotrophic lateral sclerosis
B) Duchenne muscular dystrophy
C) Myotonic dystrophy
D) Emery-Dreifuss muscular dystrophy

Question 7

You are assessing the patient-ventilator system of a patient being treated for stroke. What parameters are you most concerned with during the assessment?
1) PEEP level of 20 cm H₂O
2) Frequency of 18 breaths/min
3) MAP level of 30 mm Hg
4) Peak inspiratory pressure of 21 cm H₂O

A)1, 3
B)1, 2, 4
C)2, 3, 4
D)1, 2, 3

Question 8

Tissue plasminogen activator (TPa) should be administered within ________ of the onset of stroke symptoms.

A) 4.5 hours
B) 5.5 hours
C) 6.5 hours
D) 7.5 hours

Question 9

Which of the following is transmitted in X-linked, autosomal recessive, and autosomal dominant fashions in which patients typically exhibit muscle weakness and wasting in a scapulohumeroperoneal distribution?

A) Amyotrophic lateral sclerosis
B) Duchenne muscular dystrophy
C) Myotonic dystrophy
D) Emery-Dreifuss muscular dystrophy

Question 10

Elevation of what laboratory values suggest muscle damage?
1) Albumin
2) Aldolase
3) Immunoglobulin
4) Creatine kinase

A)1, 3
B)2, 4
C)2, 3, 4
D)1, 2, 3

Question 11

You are assisting the physician with the assessment of a patient that is thought to have ALS. What clinical cues should you be most aware of?
1) Sialorrhea
2) Muscle biopsy results
3) Tongue fasciculations
4) Nerve conduction study results

A)1, 3
B)1, 2, 4
C)2, 3, 4
D)1, 2, 3

Question 12

The use of hands and arms to "walk up" their own body from a squatting position is referred to as:

A) limb-girdle's sign.
B) Gower's sign.
C) Lou Gehrig's sign.
D) leg amyotrophic diplegia.

Question 13

Which of the following is a progressive neurologic disorder characterized by degeneration of upper and lower motor neurons?

A) Amyotrophic lateral sclerosis
B) Duchenne muscular dystrophy
C) Myotonic dystrophy
D) Emery-Dreifuss muscular dystrophy

Question 14

Which of the following is early sign of disease seen in an infant with Duchenne muscular dystrophy?

A) Pseudohypertrophy
B) Hypotonia
C) Muscle wasting of the thighs
D) Gower's sign

Question 15

You are treating a patient with a proximal distribution of weakness. Which of the following NMD is most likely?

A) Amyotrophic lateral sclerosis
B) Facioscapulohumeral dystrophy
C) Limb girdle muscular dystrophy
D) Emery-Dreifuss muscular dystrophy

Question 16

Management of a traumatic spinal cord injury below the level of C5 involves:
1) prompt assessment to prevent addition injury.
2) immediate intubation.
3) anticoagulation therapy.
4) intravenous fluid resuscitation.

A)1, 3
B)2, 4
C)1, 3, 4
D)1, 2, 3

Question 17

Which of the following areas involved in a stroke will cause sensory and motor impairment of the lower extremities?

A) Strokes of the anterior circulation
B) Strokes of the midbrain
C) Strokes of the posterior cerebral artery
D) Strokes of the pons

Question 18

General management and care of a patient with neuromuscular disease includes:
1) nutritional assessment.
2) gastrostomy tube placement.
3) mechanical ventilation.
4) weekly nerve conduction studies.

A)1, 3
B)1, 2
C)2, 3, 4
D)1, 2, 3

Question 19

Cervical nerves _______ through _______ innervate the diaphragm.

A) C1; C7
B) C1; C2
C) C3; C5
D) C5; C7