The nurse is providing care for a child with Duchenne muscular dystrophy.
What characteristic manifestation should the nurse expect to observe?
Lateral curvature of the spine.
Joint inflammation.
Progressive muscle weakness.
Bone deformities.
The Correct Answer is C
Choice A rationale
Lateral curvature of the spine, known as scoliosis, can occur in Duchenne muscular dystrophy (DMD) as a secondary complication due to progressive muscle weakness affecting the spinal support. However, it is not the primary or initial characteristic manifestation of the disease. The fundamental pathology of DMD is direct muscle fiber degeneration leading to weakness.
Choice B rationale
Joint inflammation is characteristic of inflammatory arthropathies, such as juvenile idiopathic arthritis. Duchenne muscular dystrophy is a primary myopathy, a disorder of muscle tissue itself, not a condition primarily involving inflammation of the joints. While secondary musculoskeletal issues can arise, joint inflammation is not a hallmark feature of the disease.
Choice C rationale
Duchenne muscular dystrophy is an X-linked recessive disorder characterized by the absence of dystrophin, a crucial protein for maintaining muscle fiber integrity. This leads to progressive degeneration of skeletal muscle fibers, resulting in escalating muscle weakness. This weakness typically manifests in early childhood, starting in the proximal muscles and gradually spreading, leading to loss of ambulation.
Choice D rationale
While severe muscle weakness in Duchenne muscular dystrophy can indirectly lead to some skeletal deformities over time, such as contractures and kyphoscoliosis, these are typically secondary consequences rather than primary manifestations. The direct and defining characteristic of the disease is the progressive degeneration and weakness of the muscles themselves.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
This statement is incorrect as caloric needs increase during pregnancy to support fetal growth, placental development, and increased maternal metabolic demands. Inadequate caloric intake can lead to poor fetal outcomes, including low birth weight and impaired development.
Choice B rationale
While caloric needs do increase, an additional 500 calories is generally too high for the average pregnancy. The recommended increase is typically lower, focusing on nutrient-dense foods to ensure sufficient energy for both mother and fetus.
Choice C rationale
Doubling caloric intake is excessive and can lead to excessive maternal weight gain, increasing risks for gestational diabetes, preeclampsia, and delivery complications. The concept of "eating for two" is a common misconception that often leads to overconsumption.
Choice D rationale
During the second and third trimesters, the average pregnant woman requires an additional 300 calories per day above her pre-pregnancy needs. This increase provides adequate energy for rapid fetal growth, development, and maternal physiological changes, such as increased blood volume and uterine expansion.
Correct Answer is A
Explanation
Choice A rationale
Staphylococcus aureus is the most prevalent bacterial pathogen responsible for osteomyelitis, a bone infection. This bacterium possesses virulence factors such as adhesins, which enable it to adhere to bone tissue, and various toxins that contribute to tissue damage and inflammation. It can enter the bone through direct inoculation, contiguous spread, or hematogenous dissemination.
Choice B rationale
Haemophilus influenzae can cause invasive infections, including meningitis and epiglottitis, particularly in unvaccinated children. While it can cause localized infections, it is not a common cause of osteomyelitis. Its primary colonization sites and mechanisms of infection are generally distinct from those leading to bone infections.
Choice C rationale
Escherichia coli is a common inhabitant of the gastrointestinal tract and a frequent cause of urinary tract infections and sepsis, particularly in neonates. While it can cause osteomyelitis, especially in specific populations such as neonates or individuals with compromised immune systems, it is significantly less common than Staphylococcus aureus as an overall cause.
Choice D rationale
Streptococcus pneumoniae is a leading cause of bacterial pneumonia, otitis media, and meningitis. While it can cause invasive infections and has been implicated in rare cases of osteomyelitis, it does not possess the same propensity for bone tissue colonization as Staphylococcus aureus, making it a much less common etiologic agent for bone infections.
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