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NR 328/ NR328 FINAL EXAM : (NEW 2025/
2026 UPDATE) PEDIATRIC NURSING GUIDE |
QUESTIONS & ANSWERS| GRADE A| 100%
CORRECT (VERIFIED SOLUTIONS)- CHAMBERLAIN
1. muscle dystrophy - ANS ✓one of a group of inherited diseases involving progressive
muscle degeneration, weakness, and atrophy
2. Duchenne Muscular Dystrophy (DMD) - ANS ✓most common form of muscular
dystrophy; affects primarily boys with onset between the ages of 3 and 5 years; the
disorder progresses rapidly so that most of these boys are unable to walk by age 12
and later need a respirator to breathe
3. Duchenne Muscular Dystrophy clinical manifestation - ANS ✓-Waddling gait
,frequent fall
-Gower sign
-Lordosis
-enlarged muscle especially calves ,thighs and upper arms ,followed by muscle atrophy
-Mental Deficiency
4. DMD (Duchenne Muscular Dystrophy) diagnostic - ANS ✓-Clinical experience
-EMG
-Muscle biopsy
-serum enzyme measurement
-Gower sign when rising from fall
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5. Duchenne Muscular Dystrophy (DMD) therapeutic management - ANS ✓-
Maintain function in unaffected muscles as long as possible
-ROM, bracing ,performance of ADLs ,surgical release of contractures PRN
-Support
6. Spina bifida - ANS ✓a congenital defect that occurs during early pregnancy when the
spinal canal fails to close completely around the spinal cord to protect it
7. neural tube defects - ANS ✓congenital deformities of the brain and spinal cord
caused by incomplete development of the neural tube, the embryonic structure that
forms the nervous system
8. spina bifida occulta - ANS ✓most common and least severe form of spina bifida
without protrusion of the spinal cord or meninges
9. spinal bifida cystica - ANS ✓meninges and spinal cord protruding through the absent
vertebral arch and having the appearance of a cyst
10. meningocele spina bifida - ANS ✓involves an extensive spinal opening with an
exposed pouch of cerebrospinal fluid and the meninges
11. Myelomeningocele (spina bifida) - ANS ✓Congenital disorder where the spinal cord
does not close before birth and the sac contain spinal fluid , meninges and nerves
**associated with hydrocephalus
***chiari malformation brain herniates down into the brain stem
urine dribbling or overflow
poor anal sphincter tone
orthopedic deformities
bowel control-incontinent
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12. Spina bifida risk factors - ANS ✓-medication/substances taken during pregnancy
-maternal malnutrition
-insufficient folic acid intake during pregnancy
Spina Bifida
13. Physical assessment - ANS ✓-protruding sac (cystica)
-port wine angioma(occulta)
-dark hair tufts (occulta)
-subcutaneous lipoma (occulta)
14. Spina bifida lab results - ANS ✓Increased Alfa FetoProtein in amniotic
fluid/maternal serum
15. spina bifida dx - ANS ✓In Uterus
* Amniocentesis
* Increase alpha-fetoprotein
*ultrasound
16. Spina Bifida-Nursing Considerations - ANS ✓*Close monitoring for latex allergy/
*infection
*Aviod bananas ,kiwi, avocados ,chestnuts
*Skin assessment/Assess sac
*repositioning
*Elimination program for urinary and *bowel
*Physical therapy
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*neurological check
*assess fontanel
*Support group for parents
A sterile moist non-adhering dressing is applied after surgery. The infant will need to be kept
in the prone or side laying position in order to minimize pressure on the sac and to decrease
the level of trauma at the site. Need to be alert to skin breakdown due to leaking of urine and
stool since diaper is usually not closed.
17. spina bifida pre-op - ANS ✓place in prone position,
keep sac free from stool and urine,
cover sac with moist sterile dressing,
position on abdomen with legs abducted,
measure head circumference every 8 hours,
check fontanel,
asess neuro function,
monitor for signs of infection,
empty bladder using Crede method or catheterization if needed
give iv antibiotics
18. Spina bifida Post Op care - ANS ✓general care same as pre op
prevent pressure or contamination
NR 328
NR
NR 328/ NR328 FINAL EXAM : (NEW 2025/
2026 UPDATE) PEDIATRIC NURSING GUIDE |
QUESTIONS & ANSWERS| GRADE A| 100%
CORRECT (VERIFIED SOLUTIONS)- CHAMBERLAIN
1. muscle dystrophy - ANS ✓one of a group of inherited diseases involving progressive
muscle degeneration, weakness, and atrophy
2. Duchenne Muscular Dystrophy (DMD) - ANS ✓most common form of muscular
dystrophy; affects primarily boys with onset between the ages of 3 and 5 years; the
disorder progresses rapidly so that most of these boys are unable to walk by age 12
and later need a respirator to breathe
3. Duchenne Muscular Dystrophy clinical manifestation - ANS ✓-Waddling gait
,frequent fall
-Gower sign
-Lordosis
-enlarged muscle especially calves ,thighs and upper arms ,followed by muscle atrophy
-Mental Deficiency
4. DMD (Duchenne Muscular Dystrophy) diagnostic - ANS ✓-Clinical experience
-EMG
-Muscle biopsy
-serum enzyme measurement
-Gower sign when rising from fall
NR 328
, 2
NR
5. Duchenne Muscular Dystrophy (DMD) therapeutic management - ANS ✓-
Maintain function in unaffected muscles as long as possible
-ROM, bracing ,performance of ADLs ,surgical release of contractures PRN
-Support
6. Spina bifida - ANS ✓a congenital defect that occurs during early pregnancy when the
spinal canal fails to close completely around the spinal cord to protect it
7. neural tube defects - ANS ✓congenital deformities of the brain and spinal cord
caused by incomplete development of the neural tube, the embryonic structure that
forms the nervous system
8. spina bifida occulta - ANS ✓most common and least severe form of spina bifida
without protrusion of the spinal cord or meninges
9. spinal bifida cystica - ANS ✓meninges and spinal cord protruding through the absent
vertebral arch and having the appearance of a cyst
10. meningocele spina bifida - ANS ✓involves an extensive spinal opening with an
exposed pouch of cerebrospinal fluid and the meninges
11. Myelomeningocele (spina bifida) - ANS ✓Congenital disorder where the spinal cord
does not close before birth and the sac contain spinal fluid , meninges and nerves
**associated with hydrocephalus
***chiari malformation brain herniates down into the brain stem
urine dribbling or overflow
poor anal sphincter tone
orthopedic deformities
bowel control-incontinent
NR 328
, 3
NR
12. Spina bifida risk factors - ANS ✓-medication/substances taken during pregnancy
-maternal malnutrition
-insufficient folic acid intake during pregnancy
Spina Bifida
13. Physical assessment - ANS ✓-protruding sac (cystica)
-port wine angioma(occulta)
-dark hair tufts (occulta)
-subcutaneous lipoma (occulta)
14. Spina bifida lab results - ANS ✓Increased Alfa FetoProtein in amniotic
fluid/maternal serum
15. spina bifida dx - ANS ✓In Uterus
* Amniocentesis
* Increase alpha-fetoprotein
*ultrasound
16. Spina Bifida-Nursing Considerations - ANS ✓*Close monitoring for latex allergy/
*infection
*Aviod bananas ,kiwi, avocados ,chestnuts
*Skin assessment/Assess sac
*repositioning
*Elimination program for urinary and *bowel
*Physical therapy
NR 328
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NR
*neurological check
*assess fontanel
*Support group for parents
A sterile moist non-adhering dressing is applied after surgery. The infant will need to be kept
in the prone or side laying position in order to minimize pressure on the sac and to decrease
the level of trauma at the site. Need to be alert to skin breakdown due to leaking of urine and
stool since diaper is usually not closed.
17. spina bifida pre-op - ANS ✓place in prone position,
keep sac free from stool and urine,
cover sac with moist sterile dressing,
position on abdomen with legs abducted,
measure head circumference every 8 hours,
check fontanel,
asess neuro function,
monitor for signs of infection,
empty bladder using Crede method or catheterization if needed
give iv antibiotics
18. Spina bifida Post Op care - ANS ✓general care same as pre op
prevent pressure or contamination
NR 328
