A child with cerebral palsy (CP) is taking baclofen, a relaxant. Which assessment finding indicates to the practical nurse (PN) that the drug is effective?
Increased appetite.
Sufficient urinary output.
Fewer temper outbursts.
Decreased muscular spasticity.
The Correct Answer is D
Rationale:
A. Increased appetite is not a direct therapeutic indicator of baclofen efficacy. While improved comfort from muscle relaxation might indirectly support better intake, the drug does not possess orexigenic properties. Nutritional status is monitored in cerebral palsy patients, but it remains unrelated to the specific pharmacological mechanism of this skeletal muscle relaxant.
B. Sufficient urinary output is a vital assessment of general physiological and renal function, yet it is not the target of baclofen therapy. Baclofen acts primarily on the central nervous system to inhibit monosynaptic and polysynaptic reflexes at the spinal level. Urinary monitoring ensures adequate drug clearance, but output levels do not reflect the medication's clinical success.
C. Fewer temper outbursts might suggest a reduction in physical discomfort, but baclofen is not an antianxiety or antipsychotic medication. Cerebral palsy may involve behavioral challenges, but the primary goal of this therapy is physical rather than psychological. Behavioral changes are subjective and do not provide a scientific measure of the drug’s specific muscle-relaxing influence.
D. Decreased muscular spasticity is the primary therapeutic goal for a client with cerebral palsy receiving baclofen. This medication functions as a gamma-aminobutyric acid (GABA) analogue, effectively reducing the transmission of excitatory signals that cause hypertonia and involuntary muscle contractions. A reduction in resistance to passive movement confirms that the drug is achieving its intended neuromuscular effect.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The practical nurse (PN) should recognize that the client who is 2-weeks postpartum and presents with feelings of irritability, severe mood swings, and an irrational sense of her ability to keep her infant safe may be exhibiting symptoms of postpartum psychosis. Postpartum psychosis is a rare but serious condition that can develop after childbirth and is characterized by symptoms such as delusions, hallucinations, and severe mood swings. The client's belief that her infant is going to die and that there is nothing she can do to save her baby may indicate the presence of delusions. The PN should report these symptoms to the appropriate healthcare provider for further assessment and intervention.
Correct Answer is A
Explanation
The practical nurse (PN) should obtain information about the client's current medications, including any analgesics or antianxiety medications that may be contributing to the confusion. These medications can cause cognitive impairment and confusion, especially in older adults. It is important to assess the client's mental status and identify any potential causes of confusion, as this can indicate a change in the client's condition that requires further evaluation and intervention.
Option B is incorrect as it refers to a history of situational depression, which may not be relevant to the current situation.
Option C is also incorrect as it refers to previous falls, which may not be related to the current confusion.
Option D is incorrect as it refers to the client's history of alcohol abuse, which may be important to know but is not the most relevant information to obtain in this situation.
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