The nurse is teaching a group of nursing students on the topic of Duchenne muscular dystrophy (DMD). Which of the following statements validates that learning was effective related to progressive complications of the disease?
"As DMD progresses monitoring of pulmonary function test and SpO2 assessment is critical as lung function decreases and chest wall muscles become weaker."
"It is important to monitor the child's cognitive status as DMD may cause developmental delay"
"In patients with DMD it is expected to have a decrease in serum creatine kinase due to muscle wasting"
"It is not important for a patient with DMD to be seen by a cardiologist as DMD does not affect the heart."
The Correct Answer is A
A. Duchenne muscular dystrophy is a progressive neuromuscular disorder characterized by skeletal muscle weakness that eventually affects respiratory muscles. Monitoring pulmonary function (e.g., forced vital capacity) and oxygen saturation is essential to detect declining lung function early and guide interventions such as respiratory therapy, assisted coughing, or ventilatory support. This statement reflects an accurate understanding of the progressive complications of DMD.
B. While some children with DMD may have mild cognitive delays or learning difficulties, progressive cognitive decline is not a primary complication of the disease. The main progressive complications involve the musculoskeletal, respiratory, and cardiac systems, so this statement does not best reflect the expected disease progression.
C. In DMD, serum creatine kinase (CK) levels are initially markedly elevated due to muscle breakdown. CK may decline later as muscle mass is lost, but this is not the hallmark monitoring point for progressive complications. Relying on CK alone does not guide management of pulmonary or cardiac complications.
D. DMD does affect the heart, causing cardiomyopathy and arrhythmias as the disease progresses. Cardiac monitoring is essential to manage complications and prevent morbidity and mortality. This statement reflects a dangerous misconception.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. School-aged children (ages 6–12) are in Erikson’s stage of Industry vs. Inferiority, during which they develop a sense of competence through achievement, skill mastery, and productive activities. Participating in organized sports or extracurricular activities allows children to practice skills, receive recognition, work in teams, and gain confidence, all of which support healthy psychosocial development and a sense of industry.
B. Concern with attractiveness is incorrect because this is more characteristic of the adolescent stage (Identity vs. Role Confusion), when children focus on body image, self-identity, and peer acceptance.
C. Wants to please parents is incorrect because preschool-aged children (ages 3–6) in Initiative vs. Guilt often seek parental approval. While school-aged children still value adult feedback, their primary focus shifts toward competence and peer recognition rather than parental approval alone.
D. Makes up games is incorrect because inventing games is typical of the preschool stage (Initiative vs. Guilt), when children engage in imaginative and symbolic play. School-aged children move toward structured play and rule-based activities, reflecting cognitive growth and industry development.
Correct Answer is C
Explanation
A. Changes in respiratory rate, such as irregular or slowed breathing, typically occur later in the course of increasing intracranial pressure (ICP), often indicating severe brainstem involvement. It is not the first sign.
B. Bradycardia is a component of Cushing’s triad (bradycardia, hypertension, and irregular respirations) associated with advanced ICP, not an early sign. Relying on heart rate changes alone may delay recognition of ICP.
C. Altered mental status is the earliest and most sensitive indicator of increasing ICP in children. This can include irritability, restlessness, confusion, or decreased responsiveness. Early recognition of changes in level of consciousness allows prompt intervention to prevent further neurological compromise.
D. Tachycardia is not a primary indicator of rising ICP. Heart rate changes are nonspecific and usually occur secondary to pain, anxiety, or systemic stress, rather than as an early ICP sign.
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