Which assessment findings should the nurse note in a school-age child with Duchenne muscular dystrophy (DMD)? (Select all that apply)
Waddling gait
Kyphosis
Lordosis
Scoliosis
Gower sign
Correct Answer : A,B,C,D,E
The correct answer is
A. Waddling gait
B. Kyphosis
C. Lordosis
D. Scoliosis
E. Gower sign
Choice A reason
Waddling gait: Children with Duchenne muscular dystrophy (DMD) often exhibit a waddling gait due to progressive muscle weakness, particularly in the pelvic girdle muscles. This gait pattern is a compensatory mechanism to maintain balance and mobility despite weakened muscles. The waddling gait is one of the early signs of DMD and typically becomes noticeable between the ages of 2 and 6 years.
Choice B Reason
Kyphosis: Kyphosis, an excessive outward curvature of the spine, can develop in children with DMD as the disease progresses. Muscle weakness and imbalance, particularly in the back muscles, contribute to this spinal deformity. Kyphosis can lead to discomfort, respiratory issues, and further mobility challenges, necessitating close monitoring and intervention.
Choice C Reason
Lordosis: Lordosis, an exaggerated inward curvature of the lower spine, is another common finding in children with DMD. This condition often develops as a compensatory mechanism to maintain an upright posture despite weakened hip and thigh muscles. Lordosis can cause lower back pain and impact overall posture and gait.
Choice D Reason
Scoliosis: Scoliosis, a lateral curvature of the spine, frequently occurs in children with DMD due to progressive muscle weakness and imbalance. As the disease advances, scoliosis can become more pronounced, leading to discomfort, respiratory complications, and further functional limitations. Early detection and management are crucial to mitigate these effects.
Choice E Reason
Gower sign: The Gower sign is a classic clinical indicator of DMD. It refers to the maneuver children with DMD use to rise from the floor, involving the use of their hands to “walk” up their legs due to proximal muscle weakness. This sign is typically observed in early childhood and is a key diagnostic feature of DMD1.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason:
Rye and oats: Rye contains gluten, which must be avoided by individuals with celiac disease. Oats, while naturally gluten-free, can often be contaminated with gluten during processing. Therefore, they should be introduced cautiously and only if labeled gluten-free.
Choice B Reason:
Wheat and corn: Wheat is a major source of gluten and must be strictly avoided by those with celiac disease. Corn, on the other hand, is naturally gluten-free and safe for consumption. However, since wheat is included in this option, it is not suitable for a gluten-free diet.
Choice C Reason:
Rice and soy: Both rice and soy are naturally gluten-free and safe for individuals with celiac disease. They are excellent alternatives to gluten-containing grains and provide essential nutrients.
Choice D Reason:
Barley and millet grain: Barley contains gluten and must be avoided by those with celiac disease. Millet is naturally gluten-free and safe for consumption. However, since barley is included in this option, it is not suitable for a gluten-free diet.
Correct Answer is D
Explanation
Choice A reason:
Feeding an infant with gastroesophageal reflux formula instead of breast milk is not necessary. Breast milk is often easier for infants to digest and can be beneficial for reducing reflux symptoms. According to the American Academy of Pediatrics, breastfeeding should be continued if possible, as it has numerous health benefits for both the infant and the mother. If formula feeding is necessary, specialized formulas designed for infants with reflux can be used, but this does not mean breast milk should be avoided.
Choice B reason:
Thinning the baby’s formula with water is not recommended. This practice can dilute the essential nutrients in the formula, leading to inadequate nutrition for the infant. Instead, thickening agents such as rice cereal can be added to the formula to help reduce reflux symptoms. This approach helps the formula stay down in the stomach and reduces the likelihood of regurgitation.
Choice C reason:
Positioning the baby side-lying during sleep is not recommended for infants with gastroesophageal reflux. The American Academy of Pediatrics advises that infants should be placed on their backs to sleep to reduce the risk of sudden infant death syndrome (SIDS). Side-lying or prone positions are not safe for sleep and do not effectively reduce reflux symptoms.
Choice D reason:
Keeping the baby in an upright position after feedings is the correct approach for managing gastroesophageal reflux. This position helps prevent the stomach contents from flowing back into the esophagus, reducing the likelihood of reflux. It is recommended to hold the baby upright for at least 20-30 minutes after feeding to allow gravity to assist in keeping the stomach contents down.
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