Chapter 40: The Child with Neuromuscular or Muscular Dysfunction

Chapter 40: The Child with Neuromuscular or Muscular Dysfunction

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Cerebral palsy (CP) may result from a variety of causes. It is now known that the most common cause of CP is which of the following?

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: Comprehension     REF:   p. 1692

TOP:   Nursing Process: Assessment

MSC:  Client Needs: Physiological Integrity: Physiologic Adaptation

 

2. Spastic cerebral palsy (CP) is characterized by which of the following?

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

 

 

ANS:  C

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 disorders. Wide-based gait and poor performance of rapid, repetitive movements are part of the classification of ataxic CP.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 1693

TOP:   Nursing Process: Assessment

MSC:  Client Needs: Physiological Integrity: Physiologic Adaptation

 

3. Which of the following is the most common type of cerebral palsy (CP)?

a.	Ataxic
b.	Spastic
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 a 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: Comprehension     REF:   p. 1693

TOP:   Nursing Process: Assessment

MSC:  Client Needs: Physiological Integrity: Physiologic Adaptation

 

4. The parents of an infant with cerebral palsy (CP) ask the nurse if their child will have cognitive impairment. The nurse’s response should be based on which of the following?

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.
d.	Cognitive impairment is expected if motor and sensory deficits are severe.

 

 

ANS:  C

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 have severely limiting physical impairment have the least amount of intellectual compromise.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 1694

TOP:   Nursing Process: Assessment

MSC:  Client Needs: Physiological Integrity: Physiologic Adaptation