Pediatrics NUR 335 Exam Questions

Correct Answer: C) They typically last more than 12 months and cause activity limitations

Chronic health conditions are generally defined as those that last longer than 12 months and lead to some limitations in usual activities, which can affect an individual’s ability to function in daily life.

Why Other Options are Wrong:

A: Conditions lasting less than 12 months are typically considered acute, not chronic.

B: Chronic conditions often impact daily activities and functionality.

D: Chronic conditions often require long-term management and care to control symptoms or prevent progression.

Summary:

Chronic health conditions last more than 12 months and often result in limitations to an individual’s normal activities.

Correct Answer: C) A scissors gait

A scissors gait is a classic feature of spastic cerebral palsy, particularly in cases where the spasticity affects the muscles of the legs. In this gait, the legs cross over one another as the individual walks, resembling the action of scissors. This is due to tight adductors (inner thigh muscles) and a lack of coordination between the legs.

Spastic cerebral palsy is characterized by increased muscle tone (hypertonia) and exaggerated reflexes. The damage to the central nervous system (CNS) in spastic CP leads to abnormal muscle contraction patterns, resulting in stiffness and jerky movements.

Why Other Options are Wrong:

A) Athetoid movements:

Athetoid movements are characteristic of athetoid cerebral palsy, not spastic cerebral palsy. Athetoid CP involves involuntary, slow, writhing movements (often affecting the hands and feet). These movements are not a feature of spastic CP.

B) Intention tremor:

Intention tremor is typically associated with cerebellar damage, leading to tremors that occur during purposeful movement (e.g., reaching for an object). It is not characteristic of spastic cerebral palsy, which is more associated with hypertonia and stiffness rather than tremors.

D) A wide-based gait:

A wide-based gait is more commonly seen in individuals with ataxia or cerebellar disorders. It is characterized by a broad stance and difficulty maintaining balance. This is not typical of spastic CP, where the gait is more stiff and restricted due to muscle tightness.

Summary:

Spastic cerebral palsy, which occurs in over 70% of CP cases, is defined by muscle stiffness and exaggerated reflexes. A scissors gait, where the legs cross while walking, is a classic sign of spastic CP due to hypertonia in the leg muscles. The other options, such as athetoid movements, intention tremors, and a wide-based gait, are associated with different types of cerebral palsy or other neurological disorders.

Correct answer: C) Translocation

Translocation is a structural chromosomal abnormality in which a portion of a chromosome breaks off and attaches to another chromosome, causing rearrangement.

Why Other Options are Wrong:

A: Trisomy refers to a numerical abnormality where there is an extra chromosome.

B: Monosomy is a numerical abnormality where one chromosome is missing.

D: Down syndrome is a condition caused by trisomy 21, which is a numerical abnormality, not a structural one.

Summary:

Structural abnormalities involve changes to the structure of chromosomes, such as translocation, whereas trisomy and monosomy are numerical abnormalities.

Correct Answer: D. Applying increased stimulation.

D. Applying increased stimulation:

Motor development in children can be positively influenced by age-appropriate physical and environmental stimulation. This includes activities such as tummy time, allowing babies to practice reaching, grasping, and crawling, and providing a variety of toys and opportunities for movement.

Active engagement and encouragement of physical activities can help stimulate motor development and assist children in meeting developmental milestones more effectively.

Increased stimulation refers to providing opportunities for children to move, explore, and develop motor skills in a supportive and engaging environment. For example, encouraging play that involves standing, walking, or using fine motor skills can help boost physical development.

Why the other options are incorrect:

A. Spacing out recommended vaccinations rather than using multiple, simultaneous vaccinations:

The practice of spacing out vaccinations has no direct impact on motor development. Vaccines are crucial for preventing infectious diseases and do not interfere with or promote motor skills development. The focus of vaccination is on health protection rather than stimulating physical development.

B. Reading to the child at bedtime:

While reading to children at bedtime is critical for language development, cognitive growth, and bonding, it is not specifically related to motor development. Motor development requires physical movement and interaction with the environment, which is different from the cognitive stimulation provided by reading.

C. Nothing (children should be allowed to reach milestones at their own pace):

While it is true that children develop at different rates, there are also many ways to encourage and stimulate motor development through interactive and physically engaging activities. Simply allowing children to reach milestones on their own, without any encouragement or stimulation, may delay development in some cases. It’s important to create opportunities for children to practice motor skills in a supportive way.

Summary:

To stimulate children's motor development, providing appropriate physical activities and stimulation (option D) is key. Encouraging play and movement helps develop both gross and fine motor skills, supporting overall growth and readiness to meet developmental milestones.

Correct Answer: b) It results in localized changes in vertebral bodies, leading to back pain and kyphosis.

Scheuermann disease is an osteochondrosis affecting the vertebral bodies and causing back pain and kyphosis. The disease typically leads to localized changes in the vertebrae, and kyphosis (excessive curvature of the spine) is a key characteristic. Back pain often accompanies these changes, particularly in adolescents.

Why Other Options are Wrong:

a) It causes a lateral curvature of the spine, most often in the thoracic region, with a Cobb angle greater than 40 degrees:

This description refers to scoliosis, not Scheuermann disease. Scheuermann disease causes kyphosis (forward curvature), not lateral curvature.

c) It is an inflammatory condition that causes painful swelling in the lower back and is usually seen in adolescents:

This is incorrect because Scheuermann disease is non-inflammatory and does not cause swelling. It involves changes in the vertebral bodies and leads to kyphosis, not inflammation.

d) It involves pain and swelling in the sacral region with a flat back posture and is more common in girls:

This is incorrect because Scheuermann disease typically affects the thoracic or thoracolumbar spine, leading to kyphosis, not a flat back posture. The condition is more common in boys, not girls.

Summary:

Scheuermann disease is a type of osteochondrosis that primarily affects the vertebral bodies and leads to back pain and kyphosis. The condition causes localized changes in the vertebrae, often resulting in a forward curvature of the spine (kyphosis). It is commonly diagnosed in adolescents, with symptoms worsening during periods of rapid growth. The condition typically does not involve swelling or inflammation, making it distinct from other spine disorders.

Correct answer : C) Banding

Banding is a technique used in karyotyping to create visible patterns on chromosomes. These patterns help identify structural changes or abnormalities.

Why Other Options are Wrong:

A: Chromosomal microarray analysis detects genetic copy number variations but does not rely on visual banding patterns.

B: Fluorescent in situ hybridization (FISH) uses fluorescent probes to target specific chromosome regions, but it does not involve banding.

D: Chromosomal analysis (karyotyping) involves examining the entire chromosome set, which can include banding as a part of the process, but the term "banding" specifically refers to the visual technique itself.

Summary:

Banding is a technique used during chromosomal analysis to visualize structural chromosomal abnormalities. The other techniques, such as FISH and chromosomal microarray, serve different purposes in the diagnosis of chromosomal abnormalities.

Correct Answer c: "We will increase our child's intake of high-fiber foods, such as whole grains and legumes."

During an exacerbation of Crohn's disease, the primary goal is to reduce inflammation in the gastrointestinal tract. Foods high in fiber, such as whole grains, fruits, and vegetables, can be difficult to digest and may irritate the inflamed gut, leading to further discomfort and worsening of symptoms like diarrhea, cramping, and bloating. Therefore, high-fiber foods are typically avoided during exacerbations to minimize irritation and give the digestive system time to heal.

Why the Other Statements Are Correct:

A) "We will avoid giving our child any dairy products during an exacerbation."

Correct: Many children with Crohn's disease develop lactose intolerance, especially during periods of active inflammation. Dairy products can lead to gas, bloating, and diarrhea, so they are often avoided during exacerbations.

"We will make sure our child eats plenty of fruits and vegetables during an exacerbation."

Correct (with caution): While fruits and vegetables are generally beneficial, they need to be prepared in a way that is easier on the digestive system during an exacerbation. For example, they should be peeled, cooked, and blended to reduce fiber content. Raw, fibrous vegetables should be avoided, but well-prepared fruits and vegetables can still be included in moderation.

"We will encourage our child to drink plenty of fluids, especially water."

Correct: Staying hydrated is crucial during an exacerbation of Crohn's disease, especially if the child is experiencing diarrhea or vomiting, which can lead to dehydration. Water, along with electrolyte solutions, helps maintain fluid balance and supports recovery.

Summary:

For a child with Crohn's disease during an exacerbation, it is important to avoid high-fiber foods, including whole grains and legumes, as they may irritate the inflamed gastrointestinal tract. Instead, focus on foods that are easier to digest, and be mindful of dairy products and hydration. The correct dietary adjustments help manage symptoms and support the healing process during flare-ups.

Correct Answer: Constipation with foul-smelling, ribbon-like stool.

Hirschsprung's disease is a congenital condition caused by the absence of ganglion cells in the distal colon, leading to impaired peristalsis and obstruction.

The stool cannot pass effectively, resulting in chronic constipation and ribbon-like stools due to the narrowed segment of the colon. The stool may also be foul-smelling due to prolonged retention in the bowel.

Why Other Options are Wrong

"Currant jelly" stool: This describes stool associated with intussusception, not Hirschsprung's disease. It results from bowel telescoping, leading to mucosal injury and blood mixing with mucus.

Passage of foul-smelling, fatty stools: This describes steatorrhea, commonly seen in cystic fibrosis due to fat malabsorption, not Hirschsprung's disease.

Mucoid, bloody diarrhea: This could indicate infectious gastroenteritis or inflammatory bowel disease, not Hirschsprung's disease.

Summary:

In an infant with Hirschsprung's disease, the nurse would expect constipation with foul-smelling, ribbon-like stool due to the lack of proper bowel motility and obstruction of stool passage.

Correct answer: C) Mumps is an acute, contagious, systemic viral disease, usually causing painful enlargement of the salivary glands, most commonly the parotids. Mumps is indeed an acute viral infection that causes swelling of the salivary glands, especially the parotid glands, which are located near the jaw and ears. It is contagious and can involve other systems, though it primarily affects the salivary glands.

Why Other Options are Wrong:

A) Mumps is a bacterial infection that causes painful swelling of the lymph nodes:

This is incorrect. Mumps is a viral infection, not bacterial. The swelling in mumps occurs in the salivary glands, particularly the parotids, not lymph nodes.

B) Mumps is a viral infection that primarily affects the respiratory system and causes a persistent cough:

This is incorrect. While mumps is viral, it does not primarily affect the respiratory system, and a cough is not the hallmark symptom. The primary feature of mumps is the painful swelling of the parotid glands.

D) Mumps is a chronic viral infection that leads to hearing loss and cognitive impairment in children:

This is incorrect. While mumps can lead to complications such as orchitis (inflammation of the testes) and, rarely, hearing loss, it is not a chronic infection and does not typically cause cognitive impairment.

Summary:

Mumps is an acute, contagious viral infection that most commonly causes swelling of the parotid glands, with potential complications affecting other organs. It is not a bacterial infection and does not primarily affect the respiratory system.