The nurse is working with a child who has a diagnosis of Duchenne muscular dystrophy. While assessing the motor development of a 6-year- old child, the nurse is most likely to find Gower's sign. This is evident when the child:

Demonstrates cog-wheeling in arm movements and in walking and shows a characteristic shuffling gait when walking

Walks flat footed with a duck-like walk, although the child will not walk unless someone insists and makes the child walk

Uses a series of maneuvers and walks the hands up the legs in order to rise from a sitting to a standing position

Grabs onto furniture or people in order to get from any position to a standing position

Answer and Explanation

The Correct Answer is C

Rationale:

A. Demonstrates cog-wheeling in arm movements and in walking and shows a characteristic shuffling gait when walking: Cog-wheeling and shuffling gait are more characteristic of Parkinson’s disease and are not associated with Duchenne muscular dystrophy or Gower’s sign.

B. Walks flat footed with a duck-like walk, although the child will not walk unless someone insists and makes the child walk: A waddling gait can occur in Duchenne muscular dystrophy, but reluctance to walk unless prompted is not a defining feature of Gower’s sign.

C. Uses a series of maneuvers and walks the hands up the legs in order to rise from a sitting to a standing position: This is the hallmark of Gower’s sign. It occurs due to proximal muscle weakness, especially in the hips and thighs, forcing the child to push on their own legs to stand.

D. Grabs onto furniture or people in order to get from any position to a standing position: While this suggests difficulty rising, reliance on external support does not describe Gower’s sign, which specifically involves using one’s own body for leverage.

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Free Nursing Study Resources

Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"A"}

Explanation

Rationale for Correct Choices:
• Weak: Weak pedal pulses are typical because the narrowed aortic segment reduces blood flow to the lower extremities. This is a key clinical finding that often leads to suspicion of coarctation in children.

• Strong: Brachial pulses are typically strong or bounding because the narrowing occurs after the vessels to the upper body branch off, allowing normal or increased perfusion to the arms.

Rationale for Incorrect Choices:
• Absent: Completely absent pedal pulses are uncommon in coarctation of the aorta unless the narrowing is extremely severe or there is complete arterial obstruction. Most clients will have diminished but still palpable pedal pulses.

• Bounding: Bounding pedal pulses would indicate increased blood flow to the lower extremities, which is not seen in coarctation of the aorta. Instead, bounding pulses are usually found in the upper extremities in this condition.

• Weak: Weak brachial pulses would suggest reduced blood flow to the upper extremities, which is inconsistent with the anatomy of coarctation where the narrowing is distal to these branches.

• Thready: Thready pulses indicate low stroke volume or shock states, which are not characteristic of compensated coarctation. In coarctation, upper extremity pulses remain strong unless severe heart failure develops.

A. Offer a complex carbohydrate snack B. Give 10 to 15 grams of a simple carbohydrate. C. Administer glucagon intramuscularly. D. Administer a sliding-scale dose of insulin.

Correct Answer is B

Explanation

Rationale:

A. Offer a complex carbohydrate snack: Complex carbohydrates take longer to digest and raise blood glucose more slowly. In early hypoglycemia, immediate action with simple carbohydrates is preferred to quickly raise blood glucose.

B. Give 10 to 15 grams of a simple carbohydrate: Simple carbohydrates, such as glucose tablets or juice, provide rapid absorption and quick elevation of blood glucose, which is essential in treating mild to moderate hypoglycemia promptly to prevent progression.

C. Administer glucagon intramuscularly: Glucagon is reserved for severe hypoglycemia when the patient is unconscious or unable to swallow. Since the child is coherent and able to communicate, oral glucose administration is the first-line treatment.

D. Administer a sliding-scale dose of insulin: Insulin lowers blood glucose and would worsen hypoglycemia. It is contraindicated when the blood sugar is low and the patient shows symptoms of hypoglycemia.

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The nurse is working with a child who has a diagnosis of Duchenne muscular dystrophy. While assessing the motor development of a 6-year- old child, the nurse is most likely to find Gower's sign. This is evident when the child:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A child with coarctation of the aorta will have dropdown pedal pulses and dropdown brachial pulses.

Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"A"}

Explanation

A child with diabetes reports that he is feeling a little shaky. Further assessment reveals that the child is coherent but with some slight tremors and sweating. A fingerstick blood glucose level is 70 mg/dL. What would the nurse do next?

Correct Answer is B

Explanation

The nurse is caring for a child with multiple injuries following a motor vehicle accident. According to the QUESTT pain assessment, what are the two first steps the nurse should take in evaluating the child's pain? dropdown and dropdown.

Classify the following congenital cardiac defects as cyanotic defects or cyanotic defects.

A 9-month-old is two hours post-cardiac catheterization for a PDA closure. What post-operative interventions would be appropriate for nurse to perform? Select all that apply.

The nurse is caring for a child who has just returned from the operating room after a tonsillectomy. What symptom would the nurse monitor for which would be an early indication of bleeding?