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Chapter 54: Neuromuscular or Muscular Dysfunction
Perry: Maternal Child Care Nursing in Canada, 2nd Canadian Edition
MULTIPLE CHOICE
1. Which set of symptoms are characteristic of spastic cerebral palsy?
a. Hypertonicity and poor control of posture, balance, and coordinated motion
b. Athetosis and dystonic movements
c. Wide-based gait and poor performance of rapid, repetitive movements
d. Tremors and lack of active movement
ANS: A
Hypertonicity, poor control of posture, balance, and coordinated motion are part of the
classification of spastic cerebral palsy. Athetosis and dystonic movements are part of the
classification of dyskinetic/athetoid cerebral palsy. Wide-based gait and poor performance of
rapid, repetitive movements are part of the classification of ataxic cerebral palsy. Tremors and
lack of active movement may indicate other neurological disorders.
DIF: Cognitive Level: Comprehension REF: p. 1755 | Box 54-1
OBJ: Nursing Process: Assessment
2. The parents of a child with cerebral palsy ask the nurse if any drugs can decrease their child’s
spasticity. What knowledge is the basis of the nurses’ response?
a. Anticonvulsant medications are sometimes useful for controlling spasticity.
b. Medications that would be useful in reducing spasticity are too toxic for use in
children.
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c. Many different medications can be highly effective in controlling spasticity.
d. A pump can be implanted that delivers medication into the intrathecal space to
decrease spasticity.
ANS: D
Baclofen given intrathecally is best suited for children with severe spasticity that interferes
with activities of daily living and ambulation. Anticonvulsant medications are used when
seizures occur in children with cerebral palsy. The intrathecal route decreases the adverse
effects of the drugs that reduce spasticity. Few medications are presently available for the
control of spasticity.
DIF: Cognitive Level: Analysis REF: p. 1758
OBJ: Nursing Process: Implementation
3. What term is used for a hernial protrusion of a saclike cyst of meninges, spinal fluid, and a
portion of the spinal cord with its nerves through a defect in the vertebral column?
a. Rachischisis
b. Encephalocele
c. Meningocele
d. Myelomeningocele
ANS: D
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A myelomeningocele is a visible defect with an external, saclike protrusion containing
meninges, spinal fluid, and nerves. Rachischisis is a fissure in the spinal column that leaves
the meninges and spinal cord exposed. Encephalocele is a herniation of the brain and
meninges through a defect in the skull, producing a fluid-filled sac. Meningocele is a hernial
protrusion of a saclike cyst of meninges with spinal fluid but no neural elements.
DIF: Cognitive Level: Comprehension REF: p. 1761 | Box 54-4
OBJ: Nursing Process: Assessment
4. Which problem is most often associated with a myelomeningocele?
a. Hydrocephalus
b. Craniosynostosis
c. Biliary atresia
d. Esophageal atresia
ANS: A
Hydrocephalus is a frequently associated anomaly in 80 to 90% of children with
myelomeningocele. Craniosynostosis is the premature closing of the cranial sutures and is not
associated with myelomeningocele. Biliary and esophageal atresias are not associated with
myelomeningocele.
DIF: Cognitive Level: Comprehension REF: p. 1763
OBJ: Nursing Process: Assessment
5. What is the most common problem for children born with a myelomeningocele?
a. Neurogenic bladder
b. Cognitive impairment
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c. Respiratory compromise
d. Cranioschisis
ANS: A
Myelomeningocele is one of the most common causes of neuropathic (neurogenic) bladder
dysfunction among children. Risk of cognitive impairment is minimized through early
intervention and management of hydrocephalus. Respiratory compromise is not a common
problem in myelomeningocele. Cranioschisis is a skull defect through which various tissues
protrude and is not associated with myelomeningocele.
DIF: Cognitive Level: Comprehension REF: p. 1764 OBJ: Nursing Process: Diagnosis
6. Which supplement is recommended to prevent neural tube defects?
a. Vitamin A throughout pregnancy
b. Multivitamin preparations as soon as pregnancy is suspected
c. Folic acid for all women of child-bearing age
d. Folic acid during the first and second trimesters of pregnancy
ANS: C
The widespread use of folic acid among women of childbearing age is expected to decrease
the incidence of spina bifida significantly. Vitamin A does not have a relation to the
prevention of spina bifida. Folic acid supplementation is recommended for the preconception
period and during the pregnancy, but only 42% of women actually follow these guidelines.
DIF: Cognitive Level: Analysis REF: p. 1765
TESTBANKSELLER.COM
Chapter 54: Neuromuscular or Muscular Dysfunction
Perry: Maternal Child Care Nursing in Canada, 2nd Canadian Edition
MULTIPLE CHOICE
1. Which set of symptoms are characteristic of spastic cerebral palsy?
a. Hypertonicity and poor control of posture, balance, and coordinated motion
b. Athetosis and dystonic movements
c. Wide-based gait and poor performance of rapid, repetitive movements
d. Tremors and lack of active movement
ANS: A
Hypertonicity, poor control of posture, balance, and coordinated motion are part of the
classification of spastic cerebral palsy. Athetosis and dystonic movements are part of the
classification of dyskinetic/athetoid cerebral palsy. Wide-based gait and poor performance of
rapid, repetitive movements are part of the classification of ataxic cerebral palsy. Tremors and
lack of active movement may indicate other neurological disorders.
DIF: Cognitive Level: Comprehension REF: p. 1755 | Box 54-1
OBJ: Nursing Process: Assessment
2. The parents of a child with cerebral palsy ask the nurse if any drugs can decrease their child’s
spasticity. What knowledge is the basis of the nurses’ response?
a. Anticonvulsant medications are sometimes useful for controlling spasticity.
b. Medications that would be useful in reducing spasticity are too toxic for use in
children.
TESTBANKSELLER.COM
c. Many different medications can be highly effective in controlling spasticity.
d. A pump can be implanted that delivers medication into the intrathecal space to
decrease spasticity.
ANS: D
Baclofen given intrathecally is best suited for children with severe spasticity that interferes
with activities of daily living and ambulation. Anticonvulsant medications are used when
seizures occur in children with cerebral palsy. The intrathecal route decreases the adverse
effects of the drugs that reduce spasticity. Few medications are presently available for the
control of spasticity.
DIF: Cognitive Level: Analysis REF: p. 1758
OBJ: Nursing Process: Implementation
3. What term is used for a hernial protrusion of a saclike cyst of meninges, spinal fluid, and a
portion of the spinal cord with its nerves through a defect in the vertebral column?
a. Rachischisis
b. Encephalocele
c. Meningocele
d. Myelomeningocele
ANS: D
TESTBANKSELLER.COM
, TESTBANKSELLER.COM
A myelomeningocele is a visible defect with an external, saclike protrusion containing
meninges, spinal fluid, and nerves. Rachischisis is a fissure in the spinal column that leaves
the meninges and spinal cord exposed. Encephalocele is a herniation of the brain and
meninges through a defect in the skull, producing a fluid-filled sac. Meningocele is a hernial
protrusion of a saclike cyst of meninges with spinal fluid but no neural elements.
DIF: Cognitive Level: Comprehension REF: p. 1761 | Box 54-4
OBJ: Nursing Process: Assessment
4. Which problem is most often associated with a myelomeningocele?
a. Hydrocephalus
b. Craniosynostosis
c. Biliary atresia
d. Esophageal atresia
ANS: A
Hydrocephalus is a frequently associated anomaly in 80 to 90% of children with
myelomeningocele. Craniosynostosis is the premature closing of the cranial sutures and is not
associated with myelomeningocele. Biliary and esophageal atresias are not associated with
myelomeningocele.
DIF: Cognitive Level: Comprehension REF: p. 1763
OBJ: Nursing Process: Assessment
5. What is the most common problem for children born with a myelomeningocele?
a. Neurogenic bladder
b. Cognitive impairment
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c. Respiratory compromise
d. Cranioschisis
ANS: A
Myelomeningocele is one of the most common causes of neuropathic (neurogenic) bladder
dysfunction among children. Risk of cognitive impairment is minimized through early
intervention and management of hydrocephalus. Respiratory compromise is not a common
problem in myelomeningocele. Cranioschisis is a skull defect through which various tissues
protrude and is not associated with myelomeningocele.
DIF: Cognitive Level: Comprehension REF: p. 1764 OBJ: Nursing Process: Diagnosis
6. Which supplement is recommended to prevent neural tube defects?
a. Vitamin A throughout pregnancy
b. Multivitamin preparations as soon as pregnancy is suspected
c. Folic acid for all women of child-bearing age
d. Folic acid during the first and second trimesters of pregnancy
ANS: C
The widespread use of folic acid among women of childbearing age is expected to decrease
the incidence of spina bifida significantly. Vitamin A does not have a relation to the
prevention of spina bifida. Folic acid supplementation is recommended for the preconception
period and during the pregnancy, but only 42% of women actually follow these guidelines.
DIF: Cognitive Level: Analysis REF: p. 1765
TESTBANKSELLER.COM
