A school nurse is observing a child with ADHD who frequently leaves their seat, talks excessively, and interrupts peers.
What is the most appropriate intervention?

Choice A rationale

This statement incorrectly defines both terms. Multigravida refers to a woman who has experienced multiple pregnancies, while primigravida specifically denotes a woman who is pregnant for the very first time, regardless of the outcome of any previous pregnancies.

Choice B rationale

This statement is incorrect as there is a distinct difference between multigravida and primigravida based on the number of prior pregnancies. These terms are fundamental in obstetrics for assessing maternal risk factors and guiding clinical management.

Choice C rationale

This statement is incorrect. Multigravida refers to a woman who has been pregnant more than once, not someone who has never been pregnant. Nulligravida is the term for a woman who has never been pregnant. Primigravida, in contrast, specifically describes a woman in her first pregnancy.

Choice D rationale

This statement correctly differentiates the terms. Multigravida is a woman who has experienced two or more pregnancies, regardless of whether they resulted in a live birth. Primigravida refers exclusively to a woman who is currently pregnant for the first time. These classifications are critical for anticipating potential complications and providing appropriate care.

Choice A rationale

While wheelchairs offer mobility assistance, their continuous use can lead to muscle atrophy and further deconditioning in individuals with Duchenne Muscular Dystrophy. Promoting some level of independent movement, even with assistive devices, is crucial for maintaining existing muscle function and delaying disease progression. Over-reliance on a wheelchair might prematurely reduce weight-bearing activities vital for bone health and circulation.

Choice B rationale

Regular physical therapy, specifically focusing on strengthening exercises adapted for Duchenne Muscular Dystrophy, is paramount. This helps maintain existing muscle strength, slow the progression of muscle weakness, improve joint flexibility, and enhance overall functional mobility. Tailored exercises can also address compensatory movements and improve balance, thereby reducing the risk of falls and promoting ambulation for as long as possible.

Choice C rationale

While calcium and vitamin D are essential for bone health, their direct impact on improving muscle strength in the context of Duchenne Muscular Dystrophy is limited. DMD is a genetic disorder characterized by the absence of dystrophin, a protein vital for muscle fiber integrity. Supplementation may support bone density, but it does not address the underlying muscular dystrophy pathology or directly enhance muscle contractility.

Choice D rationale

Limiting physical activity excessively in Duchenne Muscular Dystrophy can lead to disuse atrophy, contractures, and a more rapid decline in mobility. A balanced approach is necessary, encouraging appropriate levels of activity to maintain muscle function without causing excessive fatigue or injury. Over-restriction can negatively impact both physical and psychological well-being, accelerating the progression of immobility.