A child with cerebral palsy (CP) is taking baclofen, a relaxant. Which assessment finding indicates to the practical nurse (PN) that the drug is effective?
Increased appetite.
Sufficient urinary output.
Fewer temper outbursts.
Decreased muscular spasticity.
The Correct Answer is D
Rationale:
A. Increased appetite is not a direct therapeutic indicator of baclofen efficacy. While improved comfort from muscle relaxation might indirectly support better intake, the drug does not possess orexigenic properties. Nutritional status is monitored in cerebral palsy patients, but it remains unrelated to the specific pharmacological mechanism of this skeletal muscle relaxant.
B. Sufficient urinary output is a vital assessment of general physiological and renal function, yet it is not the target of baclofen therapy. Baclofen acts primarily on the central nervous system to inhibit monosynaptic and polysynaptic reflexes at the spinal level. Urinary monitoring ensures adequate drug clearance, but output levels do not reflect the medication's clinical success.
C. Fewer temper outbursts might suggest a reduction in physical discomfort, but baclofen is not an antianxiety or antipsychotic medication. Cerebral palsy may involve behavioral challenges, but the primary goal of this therapy is physical rather than psychological. Behavioral changes are subjective and do not provide a scientific measure of the drug’s specific muscle-relaxing influence.
D. Decreased muscular spasticity is the primary therapeutic goal for a client with cerebral palsy receiving baclofen. This medication functions as a gamma-aminobutyric acid (GABA) analogue, effectively reducing the transmission of excitatory signals that cause hypertonia and involuntary muscle contractions. A reduction in resistance to passive movement confirms that the drug is achieving its intended neuromuscular effect.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Feeling sad or having a depressed mood is a common symptom of depression. Asking the client if they often feel sad can help the practical nurse (PN) assess for depression.
While recent stresses (A), sleep changes (B), and dietary habits (C) may also be relevant to the client's situation, asking if the client often feels sad is the most important question for the PN to ask in order to further assess for depression.
Correct Answer is C
Explanation
For a child with heart failure, the greatest priority for the practical nurse (PN) is to conserve the child's energy. Clustered care activities and rest periods will help to conserve the child's energy and minimize the workload on the heart.
Monitoring therapeutic levels of phenytoin (A) is not relevant to the care of a child with heart failure. Increasing fluid intake (B) is not a priority intervention for a child with heart failure, as excessive fluid intake can worsen heart failure. Restricting intake of foods high in sugar (D) may be necessary for a child with heart failure, but it is not the greatest priority for the PN to address.
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