The nurse is caring for a child with athetoid cerebral palsy. Which of the following assessment findings should she expect to see?
headache, vomiting and drowsiness
Involuntary purposeless movements that interfere with motion
intellectual disability including an IQ less than 70
a history of febrile seizures
The Correct Answer is B
Athetoid cerebral palsy is a non-progressive motor disorder caused by damage to the basal ganglia, particularly the extrapyramidal system, leading to impaired regulation of muscle tone and involuntary movement control. It results in fluctuating tone, poor postural control, and abnormal involuntary motor activity.
Rationale:
A. Headache, vomiting, and drowsiness are indicative of increased intracranial pressure rather than cerebral palsy. These symptoms suggest acute neurological deterioration such as hydrocephalus or intracranial hemorrhage. They are not characteristic of a chronic, non-progressive motor disorder like athetoid cerebral palsy.
B. Athetoid cerebral palsy is defined by involuntary movements due to basal ganglia dysfunction, resulting in slow, writhing, purposeless motions that worsen with voluntary activity. These movements interfere with coordinated motor function, speech, and feeding, and are hallmark features of extrapyramidal motor pathway injury.
C. Intellectual disability may coexist with cerebral palsy but is not defining for athetoid type. Cognitive impairment varies widely depending on extent of cortical involvement. Therefore, an IQ below 70 is not a specific or expected feature of athetoid cerebral palsy presentation.
D. Febrile seizures are common in early childhood due to immature thermoregulation of cortical neurons but are not directly associated with cerebral palsy. Cerebral palsy results from perinatal or early brain injury, not recurrent fever-induced seizure activity characteristic of febrile seizure disorders.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"dropdown-group-1":"D","dropdown-group-2":"C","dropdown-group-3":"B","dropdown-group-4":"A"}
Explanation
Pediatric musculoskeletal disorders involve abnormalities of bone integrity, joint inflammation, neuromuscular degeneration, and spinal alignment. Accurate assessment requires recognition of characteristic clinical manifestations, disease-specific progression patterns, and functional impairment affecting mobility, posture, growth, and systemic inflammatory response in children.
Rationale:
Osteomyelitis: This is a bacterial bone infection commonly associated with trauma, fractures, or orthopedic devices such as traction. Fever, localized pain, and inflammation occur due to medullary infection and progressive inflammatory destruction within bone tissue.
Juvenile Rheumatoid Arthritis: It causes chronic synovial inflammation leading to joint pain, stiffness, swelling, and decreased mobility. Persistent autoimmune activity damages cartilage and periarticular structures, especially in weight-bearing and large joints during childhood.
Duchenne Muscular Dystrophy: This is an X-linked disorder characterized by progressive muscle degeneration caused by dystrophin deficiency. Children develop pseudohypertrophy of calf muscles, clumsiness, frequent falls, waddling gait, and progressive motor weakness.
Scoliosis: This is a lateral spinal curvature causing postural asymmetry and vertebral rotation. Unequal shoulder or hip height becomes more visible during the forward-bending test, which is commonly used for early musculoskeletal screening in school-aged children.
Correct Answer is D
Explanation
A Milwaukee brace is a cervicothoracolumbosacral orthosis used in the management of adolescent scoliosis to halt curve progression during skeletal growth. It applies corrective pressure to the trunk while allowing growth modulation, requiring prolonged daily wear with proper skin protection to prevent breakdown and ensure alignment correction.
Rationale:
A. Wearing the brace only during sleep is incorrect because therapeutic effectiveness depends on prolonged daily wear, typically 18–23 hours per day. Limiting use to sleep provides insufficient corrective pressure, allowing continued spinal curvature progression during active growth phases.
B. Using the brace only as needed for back pain is inappropriate because the Milwaukee brace is not an analgesic device but a structural correction orthosis. Intermittent use fails to maintain continuous spinal alignment forces required to prevent worsening of scoliosis.
C. Wearing the brace directly against the skin increases risk of skin irritation and pressure injury, especially over bony prominences. Continuous friction and moisture accumulation can lead to breakdown, discomfort, and reduced compliance with long-term brace therapy.
D. The brace should be worn over a fitted t-shirt to protect the skin from direct contact with rigid plastic components, reducing friction and pressure injury risk. A snug cotton layer also improves comfort, enhances adherence, and allows early detection of skin breakdown during routine inspection.
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