Deck 49: The Child With Neuromuscular or Muscular Dysfunction

Question 1

A young boy has just been diagnosed with pseudohypertrophic muscular dystrophy.The management plan should include which intervention?

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

Answer 1

Recommending genetic counseling

Question 2

A current recommendation to prevent neural tube defects is the administration of what supplement?

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

Answer 2

Folic acid for all women of childbearing age

Question 3

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."

Answer 3

"My child should not eat bananas or kiwis."

Question 4

Which assessment findings should the nurse note in a school-age child diagnosed with Duchenne's muscular dystrophy (DMD)? (Select all that apply.)

A) Lordosis
B) Gower's sign
C) Kyphosis
D) Scoliosis
E) Waddling gait

Question 5

Which interventions should the nurse include in the plan of care for the infant awaiting surgical closure of a myelomeningocele sac?

A) Open to air
B) Covered with a sterile, moist, nonadherent dressing
C) Reinforcement of the original dressing if drainage noted
D) A diaper secured over the dressing

Question 6

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 neural elements.
D) Visible defect with an external sac-like protrusion containing meninges, spinal fluid, and nerves.

Question 7

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.

Question 8

Which finding should cause the nurse to suspect a diagnosis of spastic cerebral palsy?

A) Tremulous movements at rest and with activity
B) Positive Babinski reflex
C) Writhing, uncontrolled, involuntary movements
D) Clumsy, uncoordinated movements

Question 9

Spastic cerebral palsy is characterized by what presentation?

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

Question 10

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 a variety of different causes."

Question 11

The parents of a child diagnosed with cerebral palsy ask the nurse if any drugs can decrease their child's spasticity.The nurse's response 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 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.

Question 12

The nurse is caring for an intubated infant with botulism.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 10 mg per intravenous piggyback every 12 hours.

Question 13

Which problem is most often associated with myelomeningocele?

A) Hydrocephalus
B) Craniosynostosis
C) Biliary atresia
D) Esophageal atresia

Question 14

How much folic acid is recommended for women of childbearing age?

A) 0.1 mg
B) 0.4 mg
C) 1.5 mg
D) 2 mg

Question 15

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 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.

Question 16

The nurse is conducting discharge teaching with parents of a preschool child with a 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 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.

Question 17

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 product
B) Using only nonallergenic latex products
C) Administering medication for long-term desensitization
D) Teaching the family about long-term management of asthma

Question 18

What is the most common problem for children born with a myelomeningocele?

A) Neurogenic bladder
B) Intellectual impairment
C) Respiratory compromise
D) Cranioschisis

Question 19

Which signs and symptoms are associated with Werdnig-Hoffmann disease?

A) Spinal muscular atrophy
B) Neural atrophy of muscles
C) Progressive weakness and wasting of skeletal muscle
D) Pseudohypertrophy of certain muscle groups

Question 20

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 output
B) Assessing respiratory efforts
C) Placing on a telemetry monitor
D) Obtaining laboratory studies

Question 21

The nurse is caring for an infant with myelomeningocele who is 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) Bradycardia
E) Hypertension