The nurse is reviewing the record of a child with increased intracranial pressure and notes that the child has exhibited signs of decerebrate posturing. On assessment of the child, the nurse expects to note which characteristic of this type of posturing?
Adduction of the arms at the shoulders
Abnormal flexion of the upper extremities and extension and adduction of lower extremities
Flaccid paralysis of all extremities
Rigid extension and pronation of the arms and legs
The Correct Answer is D
D. This is the correct characteristic of decerebrate posturing. Decerebrate posturing is characterized by rigid extension and pronation (turning inward) of the arms and legs. It indicates severe neurological dysfunction and increased intracranial pressure, often involving damage to the brainstem.
A. This characteristic is not associated with decerebrate posturing. Adduction refers to movement toward the midline of the body, which is not typically observed in decerebrate posturing.
B. This description is not characteristic of decerebrate posturing. Decerebrate posturing involves extension, not flexion, of the upper extremities, along with extension and pronation (not adduction) of the lower extremities.
C. Flaccid paralysis refers to the absence of muscle tone and movement, which is not characteristic of decerebrate posturing. Decerebrate posturing involves increased muscle tone and abnormal, rigid extension of the arms and legs.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
D. An oxygen saturation level of 85% is significantly below the normal range and indicates hypoxemia (low blood oxygen levels). This finding is concerning, especially in a child with cystic fibrosis, which can lead to respiratory complications such as airway obstruction, infection, or mucus plugging.
A. A blood glucose level of 140 mg/dL is within the normal range for children, so this finding would not typically require immediate reporting to the provider.
B. A serum sodium level of 156 mEq/L is significantly elevated and above the normal range. However, hypoxia is the priority.
C. A red blood cell (RBC) count of 3.2 million/µL falls within the normal range for children, so this finding would not typically require immediate reporting to the provider.
Correct Answer is C
Explanation
C. Cerebral palsy is a chronic condition that affects muscle control and movement. It is caused by damage to or abnormal development of the parts of the brain that control movement, balance, and posture. This damage can occur before, during, or shortly after birth, and it results in difficulties with muscle coordination, balance, and motor skills.
A. Cerebral palsy is not caused by an infectious agent; it is a non-progressive neurological disorder that affects movement, posture, and muscle coordination. It is primarily caused by abnormal development or damage to the brain before, during, or shortly after birth, rather than by an infectious disease.
B. Cerebral palsy is not caused by inflammation of the brain due to a viral illness. While viral illnesses can lead to complications, such as encephalitis (inflammation of the brain), cerebral palsy itself is not caused by inflammation but rather by neurological damage or abnormal development.
D. Cerebral palsy primarily affects movement and muscle control but it does not necessarily result in intellectual disability. Intellectual disability can occur in some cases of cerebral palsy, but it is not a defining characteristic of the condition.
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