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
Bullying, especially when prolonged, can lead to chronic stress and emotional distress, often manifesting as symptoms of depression. The consistent negative social interactions, feelings of helplessness, social isolation, and decline in academic performance are all classic indicators of major depressive disorder, characterized by persistent sadness, anhedonia, and functional impairment.
Choice B rationale
Bullying systematically erodes an individual's self-worth and confidence. The constant criticism, exclusion, and targeting by peers lead to feelings of inadequacy and shame, directly contradicting any notion of increased self-esteem. Over time, victims often internalize negative messages, resulting in a significant decrease in their overall self-perception and personal value.
Choice C rationale
Bullying typically leads to social withdrawal, not enhanced social skills. Victims often develop anxiety around social interactions due to fear of further judgment or aggression. This avoidance behavior prevents them from practicing and refining social skills, leading to a decline in their ability to engage effectively with peers and form healthy relationships.
Choice D rationale
Bullying causes significant psychological distress, including anxiety, depression, and difficulty concentrating. These factors directly interfere with cognitive functions necessary for learning, such as attention and memory. Consequently, academic performance often declines as the student struggles to focus in class and complete assignments, leading to lower grades. .
Correct Answer is ["A","B","C","D","E"]
Explanation
Choice A rationale
Calculating the estimated date of birth (EDB) is a fundamental component of the initial prenatal visit. Given the last menstrual period (LMP) was 18 weeks ago, using Naegele's rule (LMP minus 3 months plus 7 days) or a gestational wheel provides an approximate due date, crucial for planning prenatal care and monitoring fetal development.
Choice B rationale
Obtaining the client's personal and family medical history is vital for comprehensive prenatal care. This includes identifying pre-existing conditions, genetic predispositions, and potential risks that could affect the pregnancy, such as diabetes, hypertension, or a family history of chromosomal abnormalities, allowing for early intervention and personalized care.
Choice C rationale
Gathering information about prior pregnancies, including outcomes, complications, and types of deliveries, provides valuable insight into the client's obstetric history. This helps in identifying potential recurrent issues, assessing risk factors for current pregnancy complications, and tailoring a care plan based on past experiences and previous uterine healing.
Choice D rationale
Checking the client's urine with a reagent strip is a standard procedure at initial and subsequent prenatal visits. This screening tool detects proteinuria, glucosuria, ketonuria, and signs of urinary tract infections, which can impact maternal and fetal health. For example, proteinuria may indicate preeclampsia, while glucosuria suggests gestational diabetes.
Choice E rationale
Scheduling the client for prenatal laboratory testing is essential for baseline assessment and screening for various conditions. This typically includes blood type and Rh factor, complete blood count (CBC), rubella titer, hepatitis B screen, syphilis screen, HIV testing, and sometimes genetic screening tests, all crucial for managing pregnancy and fetal health.
Choice F rationale
Chorionic villus sampling (CVS) is a diagnostic procedure typically performed between 10 and 13 weeks of gestation to detect chromosomal abnormalities or genetic disorders. Given the client's last menstrual period was 18 weeks ago, this gestational age falls outside the recommended window for CVS, making it an inappropriate discussion point at this stage. .
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