A child with Duchenne muscular dystrophy is likely to experience which of the following?
Decreased risk of falls.
Rapid cognitive development.
Increased muscle strength.
Wheelchair dependence
The Correct Answer is D
Choice A rationale
Duchenne muscular dystrophy (DMD) is a progressive genetic disorder characterized by muscle degeneration and weakness. Individuals with DMD experience significant muscle weakness, particularly in the lower limbs, leading to an increased risk of falls due to impaired balance and gait instability. Decreased muscle strength directly compromises postural control.
Choice B rationale
Rapid cognitive development is not a typical characteristic of Duchenne muscular dystrophy. While DMD primarily affects skeletal muscles, some individuals may experience cognitive impairments, ranging from mild learning difficulties to more significant intellectual disabilities. The disease is linked to dystrophin deficiency in brain tissue, which can impact neurological function.
Choice C rationale
Increased muscle strength is antithetical to the pathology of Duchenne muscular dystrophy. The hallmark of DMD is progressive muscle weakness caused by the absence or malfunction of dystrophin, a protein vital for maintaining muscle fiber integrity. This leads to chronic muscle damage, inflammation, and eventual replacement of muscle tissue with fat and fibrous tissue.
Choice D rationale
Wheelchair dependence is a common and almost inevitable outcome for individuals with Duchenne muscular dystrophy. Due to the progressive muscle weakness affecting ambulation, most individuals with DMD lose the ability to walk independently between ages 7 and 13, necessitating the use of a wheelchair for mobility as the disease progresses and leg muscles deteriorate.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","D"]
Explanation
Choice A rationale
Support during labor has been shown to significantly decrease the perception of pain. Continuous presence of a supportive individual, such as a doula or partner, provides comfort, encouragement, and various coping mechanisms, which can physiologically reduce stress hormone release and enhance the body's natural pain-modulating systems, leading to a less painful experience.
Choice B rationale
A supportive presence during labor contributes to an improved overall experience for the client. The emotional, physical, and informational support provided can alleviate anxiety, empower the client, and foster a sense of control and confidence, leading to a more positive and satisfying childbirth experience, often with lasting beneficial psychological impacts.
Choice C rationale
Support during labor can contribute to better fetal outcomes by reducing maternal stress and anxiety. Lower maternal stress levels can lead to improved uterine blood flow and oxygenation to the fetus. Additionally, continuous support can lead to fewer interventions, such as operative deliveries, which are associated with potential risks to the fetus.
Choice D rationale
Research indicates that continuous support during labor is associated with improved client outcomes. This includes a reduced likelihood of medical interventions, such as epidural anesthesia, synthetic oxytocin for augmentation, and cesarean sections. Enhanced emotional well-being and reduced maternal stress hormones also contribute to a more positive physiological response during labor.
Choice E rationale
Support during labor is known to decrease, not increase, anxiety. The presence of a supportive individual provides reassurance, reduces fear of the unknown, and offers comfort. This contributes to a calm environment, which can physiologically mitigate the stress response, thereby lowering anxiety levels and promoting a more relaxed labor progression for the client.
Correct Answer is C
Explanation
Choice A rationale
Referring the child to a gastrointestinal specialist might be considered later, but it is not the priority action. Since the child shows no evidence of physical illness, the most likely cause of chronic soiling is functional or psychological. Addressing the potential underlying psychosocial factors takes precedence over pursuing further physical diagnostics immediately.
Choice B rationale
Reprimanding the child gently is an inappropriate and potentially harmful action. Encopresis is often involuntary and can be a source of significant shame and distress for the child. Reprimanding can exacerbate these feelings, leading to further withdrawal and potentially hindering therapeutic progress rather than encouraging control or behavioral change.
Choice C rationale
Reporting suspected encopresis and beginning a psychosocial evaluation is the priority nursing action. Encopresis, in the absence of physical illness, strongly suggests a psychological or behavioral component. A psychosocial evaluation is critical to identify underlying stressors, emotional issues, or developmental factors contributing to the soiling behavior, facilitating appropriate intervention.
Choice D rationale
Instructing the child to eat more fiber is an intervention for constipation, which can be a contributing factor to encopresis. However, it's not the priority action when there's no evidence of physical illness and chronic soiling is present. Without addressing potential psychological factors, dietary changes alone are unlikely to resolve the complex issue of non-organic encopresis.
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