Nursing Elites

1. The parents of a 3-year-old boy have brought him to a pediatrician for assessment of the boy's late ambulation and frequent falls. Subsequent muscle biopsy has confirmed a diagnosis of Duchenne muscular dystrophy. Which teaching point should the physician include when explaining the child's diagnosis to his parents?

• A. Your child may develop breathing difficulties as the disease progresses.
• B. Your child is likely to benefit from physical therapy and exercise.
• C. This condition can be cured with early intervention and treatment.
• D. The disease is caused by inflammation in the muscles, which leads to weakness.

Correct answer: A

Rationale: The correct teaching point that the physician should include when explaining Duchenne muscular dystrophy to the parents is that 'Your child may develop breathing difficulties as the disease progresses.' Duchenne muscular dystrophy is a progressive condition that affects muscle strength, including respiratory muscles, leading to breathing difficulties as the disease advances. Choice B is incorrect because while physical therapy and exercise can help maintain muscle function and mobility, they do not cure the condition. Choice C is incorrect because Duchenne muscular dystrophy is a genetic disorder with no known cure. Choice D is incorrect as Duchenne muscular dystrophy is primarily characterized by a lack of dystrophin protein due to genetic mutations, not inflammation in the muscles.

2. A client with a pneumothorax is receiving oxygen therapy. Which assessment finding would indicate that the treatment is effective?

• A. Increased respiratory rate
• B. Decreased oxygen saturation levels
• C. Improved breath sounds on the affected side
• D. Increased dyspnea and chest pain

Correct answer: C

Rationale: In a client with a pneumothorax receiving oxygen therapy, improved breath sounds on the affected side would indicate effective treatment. This finding suggests that the collapsed lung is re-expanding, allowing air to flow more freely in and out of the affected area. Choices A, B, and D are incorrect: Increased respiratory rate, decreased oxygen saturation levels, and increased dyspnea and chest pain are signs of ineffective treatment or worsening of the condition in a client with a pneumothorax.

3. When a Tae Kwon Do (TKD) master applies downward pressure just above the elbow joint on an attacker who immediately collapses to the ground, which reflex is applicable to this example?

• A. Golgi tendon reflex
• B. Myotatic reflex
• C. Withdrawal reflex
• D. Crossed-extensor reflex

Correct answer: A

Rationale: The Golgi tendon reflex is the correct answer. This reflex protects the muscle and tendons from excessive force by causing the muscle to relax. In this scenario, the downward pressure applied just above the elbow joint triggers the Golgi tendon reflex, resulting in the attacker's collapse. The other options are incorrect: - The myotatic reflex (also known as the stretch reflex) is responsible for contracting a muscle in response to its stretch, not relaxing it. - The withdrawal reflex is a spinal reflex that moves a body part away from a painful stimulus, not directly related to the scenario described. - The crossed-extensor reflex is a reflex that occurs on the opposite side of the body in response to a withdrawal reflex, which is not the case in this situation.

4. A patient is receiving chloroquine (Aralen) for extraintestinal amebiasis. Which of the following medications should be administered with chloroquine?

• A. Iodoquinol (Yodoxin)
• B. Metronidazole (Flagyl)
• C. Metyrosine (Demser)
• D. Carbamazepine (Tegretol)

Correct answer: B

Rationale: The correct answer is B: Metronidazole (Flagyl). When treating extraintestinal amebiasis, chloroquine is often used in combination with metronidazole to ensure the eradication of the parasite. Metronidazole helps to target the infection more effectively. Choices A, C, and D are incorrect. Iodoquinol (Yodoxin) is another antiprotozoal agent but is not typically used in combination with chloroquine for amebiasis. Metyrosine (Demser) is used in the management of pheochromocytoma, and carbamazepine (Tegretol) is an anticonvulsant and mood-stabilizing drug, neither of which are indicated for extraintestinal amebiasis.

5. Which of the following describes inflammation of the bladder lining?

• A. Incontinence
• B. Pyelonephritis
• C. Urinary calculi
• D. Cystitis

Correct answer: D

Rationale: The correct answer is D, Cystitis. Cystitis specifically refers to the inflammation of the bladder lining. Choice A, Incontinence, refers to the loss of bladder control and is not related to inflammation. Choice B, Pyelonephritis, is the inflammation of the kidney and renal pelvis, not the bladder lining. Choice C, Urinary calculi, refers to the formation of stones in the urinary tract and is not related to bladder inflammation.

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