What does a positive Gowers sign indicate in a pediatric patient?

Juvenile Idiopathic Arthritis.

Multiple sclerosis.

Osteosarcoma.

Muscular dystrophy, Duchenne muscular dystrophy.

Answer and Explanation

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.

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Correct Answer is D

Explanation

Choice A rationale

This statement incorrectly defines both terms. Multigravida refers to a woman who has experienced multiple pregnancies, while primigravida specifically denotes a woman who is pregnant for the very first time, regardless of the outcome of any previous pregnancies.

Choice B rationale

This statement is incorrect as there is a distinct difference between multigravida and primigravida based on the number of prior pregnancies. These terms are fundamental in obstetrics for assessing maternal risk factors and guiding clinical management.

Choice C rationale

This statement is incorrect. Multigravida refers to a woman who has been pregnant more than once, not someone who has never been pregnant. Nulligravida is the term for a woman who has never been pregnant. Primigravida, in contrast, specifically describes a woman in her first pregnancy.

Choice D rationale

This statement correctly differentiates the terms. Multigravida is a woman who has experienced two or more pregnancies, regardless of whether they resulted in a live birth. Primigravida refers exclusively to a woman who is currently pregnant for the first time. These classifications are critical for anticipating potential complications and providing appropriate care.

A. "A gain of about 25 to 35 pounds is best for you and for your baby.”. B. "The recommendation for you is about 15 to 25 pounds.”. C. "You should gain 11 to 20 pounds.”. D. "It really doesn't matter exactly how much weight you gain, as long as your diet is healthy.”.

Correct Answer is B

Explanation

Choice A rationale

A weight gain of 25 to 35 pounds is the general recommendation for women who begin pregnancy with a normal body mass index (BMI) of 18.5 to 24.9. Since the client has a BMI of 26.5, she falls into the overweight category, and her recommended weight gain range is different to optimize maternal and fetal outcomes.

Choice B rationale

For pregnant individuals who are classified as overweight, defined by a BMI of 25.0 to 29.9, the recommended total weight gain during pregnancy is 15 to 25 pounds (approximately 6.8 to 11.3 kg). This guideline aims to minimize risks such as gestational diabetes, preeclampsia, and macrosomia while ensuring adequate fetal growth.

Choice C rationale

A weight gain of 11 to 20 pounds is the recommendation for pregnant individuals who are classified as obese, with a BMI of 30.0 or greater. This client's BMI of 26.5 places her in the overweight category, not obese, necessitating a different target range for gestational weight gain to promote healthy outcomes.

Choice D rationale

While a healthy diet is crucial during pregnancy, the exact amount of weight gained does matter for both maternal and fetal health outcomes. Excessive or insufficient weight gain can lead to various complications, including gestational diabetes, preeclampsia, preterm birth, and abnormal fetal growth, thus specific weight gain targets are important.

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What does a positive Gowers sign indicate in a pediatric patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

What is the difference between multigravida and primigravida?

Correct Answer is D

Explanation

A nurse is reinforcing teaching with a client who is pregnant and has a body mass index (BMI) of 26.5. She asks the nurse how much weight she should gain over the course of her pregnancy. Which of the following statements is an appropriate response by the nurse?

Correct Answer is B

Explanation

A practical nurse is reinforcing education with a client on the benefits of support during labor. Which of the following benefits should the nurse include in their teaching reinforcement? (Select All that Apply.)

A child is diagnosed with osteosarcoma. What is the primary treatment for this condition?

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The nurse is providing care for a child with Duchenne muscular dystrophy. What characteristic manifestation should the nurse expect to observe?

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