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Neurologic Disorder MCQs
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Neurologic Disorder MCQs
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1. The health care provider has prescribed sulfasalazine (Azulfidine) 5 mg/kg PO per dose twicea day for a child with juvenile arthritis. The child weighs 55 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.
________
ANS:
125
The correct calculation is:
h a
55 lb/2.2 kg = 25 kg
Dose of Azulfidine is 5 mg/kg
Ta
5 mg 25 = 125 mg
e b
Chapter 34.The Child with Neuromuscular or Muscular Dysfunction
MULTIPLE CHOICE
b e
H a
1. What is the most common cause of cerebral palsy (CP)?
a. Central nervous system (CNS) diseases
b. Birth asphyxia
c. Cerebral trauma
d. Neonatal encephalopathy
ANS: D
Approximately 80% of CP is caused by unknown prenatal causes. Neonatal encephalopathy in
term and preterm infants is believed to play a significant role in the development of CP. CNS
diseases such as meningitis or encephalitis can result in CP. Birth asphyxia does contribute to
some cases of CP. Cerebral trauma, including shaken baby syndrome, can result in CP.
,DIF: Cognitive Level: Understanding REF: MCS: 1632
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
2. Spastic cerebral palsy (CP) is characterized by which clinical manifestations?
a. Athetosis, dystonic movements
b. Tremors, lack of active movement
c. Hypertonicity; poor control of posture, balance, and coordinated motion
d. Wide-based gait; poor performance of rapid, repetitive movements
h a
ANS: C
Ta
Hypertonicity and poor control of posture, balance, and coordinated motion are part of the
classification of spastic CP. Athetosis and dystonic movements are part of the classification of
dyskinetic or athetoid CP. Tremors and lack of active movement may indicate other neurologic
classification of ataxic CP.
e b
disorders. A wide-based gait and poor performance of rapid, repetitive movements are part of the
b e
DIF: Cognitive Level: Understanding REF: MCS: 1619
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
a. Ataxic
b. Spastic
H a
3. What type of cerebral palsy (CP) is the most common type?
c. Dyskinetic
d. Mixed type
ANS: B
Spastic CP is the most common clinical type. Early manifestations are usually generalized
hypotonia, or decreased tone that lasts for a few weeks or may extend for months or as long as 1
,year. It is replaced by increased stretch reflexes, increased muscle tone, and weakness. Ataxic,
dyskinetic, and mixed type are less common forms of CP.
DIF: Cognitive Level: Understanding REF: MCS: 1619
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
4. The parents of an infant with cerebral palsy (CP) ask the nurse if their child will have
a
cognitive impairment. The nurses response should be based on which knowledge?
h
a. Affected children have some degree of cognitive impairment.
b. Around 20% of affected children have normal intelligence.
c. About 45% of affected children have normal intelligence.
Ta
d. Cognitive impairment is expected if motor and sensory deficits are severe.
ANS: C
e b
Children with CP have a wide range of intelligence, and 40% to 50% are within normal limits. A
large percentage of children with CP do not have mental impairment. Many individuals who
b e
have severely limiting physical impairment have the least amount of intellectual compromise.
DIF: Cognitive Level: Applying REF: MCS: 1620
H a
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Physiological Integrity
5. Gingivitis is a common problem in children with cerebral palsy (CP). What preventive
measure should be included in the plan of care?
a. High-carbohydrate diet
b. Meticulous dental hygiene
c. Minimum use of fluoride
d. Avoidance of medications that contribute to gingivitis
, ANS: B
Meticulous oral hygiene is essential. Many children with CP have congenital enamel defects,
high-carbohydrate diets, poor nutritional intake, and difficulty closing their mouths. These,
coupled with the childs spasticity or clonic movements, make oral hygiene difficult. Children
with CP have high carbohydrate intake and retention, which contribute to dental caries. Use of
fluoride should be encouraged through fluoridated water or supplements and toothpaste. Certain
medications such as phenytoin do contribute to gingival hyperplasia. If that is the drug of choice,
then meticulous oral hygiene must be used.
DIF: Cognitive Level: Applying REF: MCS: 1621
h a
T a
TOP: Nursing Process: Implementation MSC: Client Needs: Physiological Integrity
6. What is a major goal of therapy for children with cerebral palsy (CP)?
b
a. Cure the underlying defect causing the disorder.
b. Reverse the degenerative processes that have occurred.
e
c. Prevent the spread to individuals in close contact with the child.
ANS: D
b e
d. Recognize the disorder early and promote optimum development.
a
The goals of therapy include early recognition and promotion of an optimum developmental
H
course to enable affected children to attain their potential within the limits of their dysfunction.
The disorder is permanent, and therapy is chiefly symptomatic and preventive. It is not possible
at this time to reverse the degenerative processes. CP is not contagious.
DIF: Cognitive Level: Understanding REF: MCS: 1621
TOP: Nursing Process: Implementation MSC: Client Needs: Physiological Integrity
7. The parents of a child with spastic cerebral palsy (CP) state that their child seems to have
significant pain. In addition to systemic pharmacologic management, the nurse includes which
teaching?
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