Which of the following findings may lead a nurse to suspect spina bifida?
High levels of cerebrospinal fluid (CSF)
Increased intracranial pressure (ICP)
Indications of infection
Presence of a small dimple and a tuft of hair over the lower lumbar region.
The Correct Answer is D
A. High levels of cerebrospinal fluid (CSF): Spina bifida is a neural tube defect involving incomplete closure of the vertebral column rather than abnormal CSF production. Elevated CSF levels are not a defining feature and are not used as a screening indicator. CSF abnormalities are more relevant to hydrocephalus assessment.
B. Increased intracranial pressure (ICP): Elevated ICP may occur secondary to associated conditions such as hydrocephalus, but it is not an initial or direct sign of spina bifida. The defect itself is identified by spinal and cutaneous findings. ICP changes develop later if complications arise.
C. Indications of infection: Infection is a potential complication if neural tissue is exposed, but it is not an initial indicator prompting suspicion of spina bifida. Early recognition relies on visible spinal or skin markers. Infection suggests a secondary problem rather than the congenital defect.
D. Presence of a small dimple and a tuft of hair over the lower lumbar region: Cutaneous stigmata such as a sacral dimple, hair tuft, or discoloration are classic indicators of underlying spinal dysraphism. These findings warrant further evaluation for spina bifida occulta. They are key clues during newborn and infant assessment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Presence of proteinuria and elevated blood urea nitrogen (BUN) levels: Renal involvement is common in pediatric SLE, often manifesting as lupus nephritis. Proteinuria and elevated BUN indicate impaired kidney function, which is a frequent and serious complication of the disease.
B. Increased energy: Children with SLE more commonly experience fatigue and malaise due to systemic inflammation, rather than increased energy levels.
C. Weight gain: While weight changes may occur secondary to corticosteroid therapy, spontaneous weight gain is not a typical manifestation of SLE itself.
D. Mania: Neuropsychiatric symptoms in SLE can occur, but mania is uncommon in pediatric clients. Cognitive impairment, headaches, or mood changes are more typical neurological manifestations.
Correct Answer is C
Explanation
A. Eye Movement Desensitization and Reprocessing (EMDR): EMDR is primarily used for trauma-related disorders such as post-traumatic stress disorder. While parental stress is significant, EMDR targets unresolved traumatic memories rather than ongoing caregiver burden. It is not the most appropriate first-line intervention for caregiver stress related to chronic childhood conditions.
B. Acceptance and Commitment Therapy (ACT): ACT focuses on psychological flexibility and values-based coping and can be beneficial for chronic stress. However, evidence supporting its routine use for parental burnout in caregivers of children with autism is less established than other therapies. It is typically adjunctive rather than first-line.
C. Cognitive-Behavioral Therapy (CBT): CBT is well-supported for reducing caregiver stress, anxiety, and depression by helping parents identify and reframe maladaptive thought patterns. It provides practical coping strategies, problem-solving skills, and stress-management techniques. This approach directly targets the emotional and cognitive burden described by the parents.
D. Play Therapy and Art Therapy: These therapies are primarily designed for children to express emotions and improve communication skills. While helpful for pediatric clients, they are not intended to address parental stress or burnout. Their focus does not align with the parents’ coping needs.
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