What does a positive Gowers sign indicate in a pediatric patient?
Juvenile Idiopathic Arthritis.
Multiple sclerosis.
Osteosarcoma.
Muscular dystrophy, Duchenne muscular dystrophy.
The Correct Answer is D
Choice A rationale
Juvenile Idiopathic Arthritis is a chronic autoimmune inflammatory condition affecting joints in children, often leading to pain, swelling, and stiffness. It does not primarily affect proximal muscle strength or neuromuscular coordination in a way that would manifest as a Gowers sign. The underlying pathology involves synovial inflammation rather than primary muscle weakness.
Choice B rationale
Multiple Sclerosis is a demyelinating disease of the central nervous system, predominantly affecting adults, though rare in children. While it can cause muscle weakness and gait disturbances due to impaired nerve conduction, a positive Gowers sign is not a characteristic or primary indicator of this condition. Its presentation is typically varied and includes sensory deficits, visual disturbances, and ataxia.
Choice C rationale
Osteosarcoma is a malignant bone tumor, primarily affecting long bones, common in adolescents. Its primary manifestations include localized pain, swelling, and sometimes a palpable mass. It causes structural damage to the bone and surrounding tissues but does not directly lead to the proximal muscle weakness and compensatory maneuvers seen with a Gowers sign.
Choice D rationale
Muscular dystrophy, particularly Duchenne muscular dystrophy (DMD), is a genetic disorder characterized by progressive degeneration of muscle fibers, leading to increasing muscle weakness. The Gowers sign is a classic indicator of proximal muscle weakness, where the child uses their hands to "walk up" their legs to stand from a seated position, due to weakness of the gluteal and quadriceps muscles. This sign is highly specific to conditions like DMD where progressive proximal muscle weakness is a hallmark.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Ensuring the car seat is securely installed and properly buckled is paramount for infant safety. Correct installation prevents excessive movement of the car seat during a collision, and proper buckling ensures the infant is restrained effectively, reducing the risk of ejection or injury from impact forces.
Choice B rationale
Using an expired car seat or one that has been involved in a previous accident is highly dangerous. Over time, materials degrade, and the structural integrity of a car seat can be compromised after an accident, even if there are no visible signs of damage. Expired seats may not meet current safety standards.
Choice C rationale
Always placing the car seat in the front seat, facing forward, is incorrect and extremely dangerous. The front passenger airbag can deploy with significant force, causing severe or fatal injuries to an infant in a car seat. Infants and young children should always be in the back seat to mitigate this risk.
Choice D rationale
Placing the car seat in the middle of the back seat, facing forward, is incorrect for infants. Infants should always be in a rear-facing car seat until they meet the maximum height or weight limits for their rear-facing car seat, typically around 2 years of age or older. The middle back seat is generally safest for placement due to optimal crash protection.
Correct Answer is D
Explanation
Choice A rationale
An alpha-fetoprotein (AFP) test is a blood test that measures the levels of AFP in the maternal serum. This test does not require any specific dietary restrictions, such as fasting. Therefore, advising the client to abstain from food or drink for 8 hours before the test is not based on physiological necessity for accurate AFP measurement.
Choice B rationale
Test results are influenced by various factors, including gestational age, multiple pregnancies, and certain fetal anomalies. While chronic illnesses can impact overall health, they do not directly determine the outcome of an AFP screening test, which primarily assesses the risk of neural tube defects or chromosomal abnormalities.
Choice C rationale
An AFP test is a simple blood draw and is not an invasive procedure. Therefore, there is no physiological need for bed rest following the test. Clients can resume their normal activities immediately after the blood sample is collected, as there are no associated post-procedure complications requiring immobility.
Choice D rationale
The AFP test is a screening tool, meaning it identifies individuals who may be at an increased risk for certain conditions, such as neural tube defects or Down syndrome. It does not provide a definitive diagnosis. Abnormal screening results necessitate further diagnostic testing, such as amniocentesis or high-resolution ultrasound, for confirmation.
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