Question 1

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:&#10;A)Prone and tube-feed.&#10;B)Prone, turn head to side, and nipple-feed.&#10;C)Supine in infant carrier and nipple-feed.&#10;D)Supine, with defect supported with rolled blankets, and nipple-feed.&#10;

Accepted Answer

Placing the neonate prone with the head turned to the side helps protect the myelomeningocele sac from pressure and damage. Nipple-feeding is appropriate as long as the neonate can safely swallow.

Question 2

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 which of the following?&#10;A)Anticonvulsant medications are sometimes useful for controlling spasticity.&#10;B)Medications that would be useful in reducing spasticity are too toxic for use with children.&#10;C)Many different medications can be highly effective in controlling spasticity.&#10;D)Implantation of a pump to deliver medication into the intrathecal space to decrease spasticity has recently become available.&#10;

Accepted Answer

Implantation of an intrathecal baclofen pump is a treatment option for reducing spasticity in children with cerebral palsy.

Question 3

Which of the following refers to a hernial protrusion of a saclike cyst of meninges, spinal fluid, and a portion of the spinal cord with its nerves through a defect in the vertebral column?&#10;A)Rachischisis&#10;B)Encephalocele&#10;C)Meningocele&#10;D)Myelomeningocele&#10;

Accepted Answer

Myelomeningocele is a type of spina bifida where there is a hernial protrusion of a sac-like cyst containing meninges, spinal fluid, and a portion of the spinal cord with its nerves through a defect in the vertebral column.

Question 4

A young boy has just been diagnosed with pseudohypertrophic (Duchenne) muscular dystrophy. His care should include which of the following?&#10;A)Recommend genetic counseling.&#10;B)Explain that the disease is easily treated.&#10;C)Suggest ways to limit use of muscles.&#10;D)Assist family in finding a nursing facility to provide his care.&#10;

Accepted Answer

Duchenne muscular dystrophy is a genetic disorder characterized by progressive muscle degeneration and weakness due to alterations of a protein called dystrophin that helps keep muscle cells intact. It is inherited in an X-linked recessive pattern, thus genetic counseling is recommended to discuss the risk of recurrence in future pregnancies and to provide information about the condition to the family.

Question 5

A 14-year-old girl is in the intensive care unit after a spinal cord injury 2 days ago. Nursing care for this child includes which of the following? (Select all that apply.)&#10;A)Monitoring and maintaining systemic blood pressure&#10;B)Administration of corticosteroids&#10;C)Minimizing environmental stimuli&#10;D)Discussing long-term care issues with the family&#10;E)Monitoring for respiratory complications&#10;

Accepted Answer

After a spinal cord injury, it is crucial to monitor and maintain systemic blood pressure to ensure adequate perfusion of the spinal cord and minimize secondary injury. Administration of corticosteroids can reduce inflammation and potentially improve outcomes if administered within the initial hours following the injury. Monitoring for respiratory complications is also essential due to the risk of respiratory muscle weakness or paralysis, depending on the level of the spinal injury. Discussing long-term care issues immediately after the injury might not be appropriate due to the acute phase of care and the uncertainty regarding the full extent of recovery. Minimizing environmental stimuli is not specifically indicated for spinal cord injury care and is more relevant to conditions like brain injuries where sensory overload can be a concern.

Question 6

When a child develops latex allergy, which of the following foods may also cause an allergic reaction?&#10;A)Wheat&#10;B)Yeast&#10;C)Peanuts&#10;D)Bananas&#10;

Accepted Answer

Latex allergy can be associated with certain food allergies due to a phenomenon known as cross-reactivity, where proteins in latex resemble those in certain foods. Bananas are one of the most common foods associated with latex-fruit syndrome, where individuals allergic to latex may also react to bananas.

Question 7

A recommendation to prevent neural tube defects is the supplementation of which of the following?&#10;A)Vitamin A throughout pregnancy&#10;B)Multivitamin preparations as soon as pregnancy is suspected&#10;C)Folic acid for all women of childbearing age&#10;D)Folic acid during the first and second trimesters of pregnancy&#10;

Accepted Answer

Folic acid supplementation for all women of childbearing age is recommended to prevent neural tube defects, as these defects often occur very early in pregnancy, sometimes before a woman knows she is pregnant.

Question 8

Which of the following is a progressive infantile spinal muscular atrophy and most common paralytic form of the &#34;floppy infant&#34; syndrome?&#10;A)Kugelberg-Welander disease&#10;B)Charcot-Marie-Tooth disease&#10;C)Werdnig-Hoffmann disease&#10;D)Duchenne muscular dystrophy&#10;

Accepted Answer

Werdnig-Hoffmann disease, also known as Spinal Muscular Atrophy Type I, is a progressive infantile spinal muscular atrophy and represents the most common paralytic form of the "floppy infant" syndrome.

Question 9

Which of the following clinical manifestations in an infant would be suggestive of spinal muscular atrophy (Werdnig-Hoffman disease)?&#10;A)Hyperactive deep tendon reflexes&#10;B)Hypertonicity&#10;C)Lying in the frog position&#10;D)Motor deficits on one side of body&#10;

Accepted Answer

Spinal muscular atrophy (Werdnig-Hoffman disease) is characterized by muscle weakness and hypotonia. Infants with this condition often lie in a frog-leg position due to weakness of the proximal muscles.

Question 10

Therapeutic management of a child with tetanus includes the administration of which of the following?&#10;A)NSAIDs to reduce inflammation&#10;B)Muscle stimulants to counteract muscle weakness&#10;C)Bronchodilators to prevent respiratory complications&#10;D)Antibiotics to control bacterial proliferation at site of injury&#10;

Accepted Answer

Antibiotics, such as metronidazole or penicillin, are used in the treatment of tetanus to control the proliferation of Clostridium tetani bacteria at the site of injury, which is responsible for producing the toxin that causes the disease.

Question 11

Latex allergy is suspected in a child with spina bifida. Appropriate nursing interventions include which of the following?&#10;A)Avoid using any latex product.&#10;B)Use only nonallergic latex products.&#10;C)Administer medication for long-term desensitization.&#10;D)Teach family about long-term management of asthma.&#10;

Accepted Answer

The answer of Latex allergy is suspected in a child...

Question 12

Spastic cerebral palsy is characterized by which of the following?&#10;A)Hypertonicity; poor control of posture, balance, and coordinated motion&#10;B)Athetosis; dystonic movements&#10;C)Wide-based gait; poor performance of rapid, repetitive movements&#10;D)Tremors; lack of active movement&#10;

Accepted Answer

The answer of Spastic cerebral palsy is characterized by which...

Question 13

Which of the following problems is most often associated with myelomeningocele?&#10;A)Hydrocephalus&#10;B)Craniosynostosis&#10;C)Biliary atresia&#10;D)Esophageal atresia&#10;

Accepted Answer

The answer of Which of the following problems is most...

Question 14

Of the following, the most common problem of children born with a myelomeningocele is which of the following?&#10;A)Neurogenic bladder&#10;B)Mental retardation&#10;C)Respiratory compromise&#10;D)Cranioschisis&#10;

Accepted Answer

The answer of Of the following, the most common problem...

Question 15

How much folic acid is recommended for women of childbearing age?&#10;A)0.1 mg&#10;B)0.4 mg&#10;C)1.5 mg&#10;D)2.0 mg&#10;

Accepted Answer

The answer of How much folic acid is recommended for...

Question 16

A 6-month-old infant does not smile, has poor head control, has a persistent Moro reflex, and often gags and chokes while eating. These findings are most suggestive of:&#10;A)Hypotonia.&#10;B)Cerebral palsy.&#10;C)Spinal cord injury.&#10;D)Neonatal myasthenia gravis.&#10;

Accepted Answer

The answer of A 6-month-old infant does not smile, has...

Deck 32: The Child With Neuromuscular or Muscular Dysfunction