Exam 1 Questions Flashcards

Question

Which of the following is a key characteristic of deep partial-thickness burns? * A. Involves the reticular dermis * B. Painful and presents with blisters * C. Insensitive to light touch but responds to deep pressure * D. Heals without the need for grafting

Answer 1

Correct Answer: C Rationale: * Deep partial-thickness burns extend into the reticular dermis, spare some structures, and are typically insensitive to light touch while retaining deep pressure sensation. * Healing may require grafting.

Answer 2

Correct Answer: B Rationale: * Splinting and positioning aim to prevent contractures, maintain ROM, and protect vulnerable structures. * Increasing circulation is not a primary goal of these interventions.

Answer 3

Correct Answer: D Rationale: * Full-thickness burns can cause significant swelling and tight eschar, potentially compromising circulation or breathing, requiring escharotomy.

Answer 4

Correct Answer: B Rationale: * Pressure garments help reduce hypertrophic scarring by applying consistent pressure, aiding in scar flattening and maturation.

Answer 5

Correct Answer: C Rationale: * According to the pediatric Rule of Nines, each arm accounts for 9% (4.5% anterior + 4.5% posterior) and the anterior trunk accounts for 18%, totaling 27% TBSA.

Answer 6

Correct Answer: A Rationale: * To prevent contractures, the neck should be positioned in extension, avoiding the typical contracture position of flexion.

Answer 7

Correct Answer: C Rationale: * Z-plasty is a surgical intervention, while the other options are non-invasive scar management techniques.

Answer 8

Correct Answer: D Rationale: * Postural drainage and percussion are effective for mobilizing secretions in pediatric burn patients with pulmonary complications.

Answer 9

Correct Answer: A Rationale: * DMD is an X-linked recessive disorder, meaning it primarily affects males. Females are usually carriers.

Answer 10

Correct Answer: B Rationale: * Pseudohypertrophy of the calves, caused by fat and fibrotic tissue replacing muscle, is a classic sign of DMD.

Answer 11

Correct Answer: A Rationale: * SMA involves progressive muscle weakness and absent or significantly decreased deep tendon reflexes due to degeneration of the anterior horn cells.

Answer 12

Correct Answer: C Rationale: * Children with DMD typically lose ambulation between 10-12 years of age if untreated.

Answer 13

Correct Answer: D Rationale: * Submaximal aerobic exercises like swimming and cycling are beneficial for overall conditioning and cardiovascular health without causing muscle damage.

Answer 14

Correct Answer: B Rationale: * SMA Type 1, also known as Werdnig-Hoffmann disease, is the most severe type and presents with profound muscle weakness and loss of motor milestones early in life.

Answer 15

Correct Answer: B Rationale: * Stretching is aimed at maintaining joint mobility and preventing contractures in children with progressive neuromuscular disorders.

Answer 16

Correct Answer: C Rationale: * CMT is characterized by peripheral nerve involvement, leading to foot deformities such as pes cavus (high arches) and hammer toes (curled toes).

Answer 17

Correct Answer: B Rationale: * Spinraza (nusinersen) is a drug used to treat SMA by improving the survival motor neuron (SMN) protein levels.

Answer 18

Correct Answer: B Rationale: * Gower's sign is a classic feature of DMD, where children use their hands to push off their thighs due to proximal muscle weakness.

Answer 19

Correct Answer: B Rationale: * RDS is caused by a deficiency in pulmonary surfactant, leading to airless alveoli, inelastic lungs, and difficulty breathing.

Answer 20

Correct Answer: B Rationale: * BPD is a chronic respiratory disorder characterized by persistent symptoms, scarring of lung tissue, and dependence on supplemental oxygen beyond 1 month.

Answer 21

Correct Answer: B Rationale: * Cystic fibrosis leads to the retention of thick, poorly hydrated mucus in the airways, causing obstruction and frequent infections.

Answer 22

Correct Answer: C Rationale: * Postural drainage and percussion are effective techniques for mobilizing mucus in the lungs, a key goal in managing cystic fibrosis.

Answer 23

Correct Answer: A Rationale: * Recent skin grafts or open wounds are contraindications for HFCWO due to the potential for disrupting healing.

Answer 24

Correct Answer: B Rationale: * Administering bronchodilators is the immediate priority in severe asthma attacks to relieve bronchospasm and improve breathing.

Answer 25

Correct Answer: B Rationale: * Swimming is a low-impact aerobic exercise that enhances cardiovascular endurance and promotes controlled breathing, making it ideal for pulmonary conditions.

Answer 26

Correct Answer: C Rationale: Grunting on expiration is a key initial symptom of RDS, helping to maintain positive airway pressure in neonates with insufficient surfactant.

Answer 27

Correct Answer: A Rationale: Pulmonary hypertension is a serious complication of BPD, resulting from chronic hypoxemia and vascular changes in the lungs.

Answer 28

Correct Answer: B Rationale: Sitting upright encourages rib cage expansion, promotes diaphragmatic breathing, and reduces reliance on accessory muscles in asthma management.

Answer 29

Correct Answer: B Rationale: * Spastic cerebral palsy is characterized by increased resistance to passive movement that worsens with increased velocity, resulting from damage to the motor cortex.

Answer 30

Correct Answer: C Rationale: Ataxic cerebral palsy, associated with cerebellar damage, involves poor balance, wide-based gait, tremors, and difficulties with coordinated movements.

Answer 31

Correct Answer: B Rationale: Diplegic cerebral palsy primarily affects the lower extremities, with lesser involvement of the upper extremities. It is commonly seen in premature infants.

Answer 32

Correct Answer: A Rationale: GMFCS Level I indicates that the individual can walk in the community without assistive devices, though they may have some limitations in advanced motor skills.

Answer 33

Correct Answer: D Rationale: Hypermobile joints are not typical in cerebral palsy. Instead, musculoskeletal complications often include hip subluxation, scoliosis, and leg length discrepancy.

Answer 34

Correct Answer: B Rationale: Spasticity in the hip adductors leads to scissoring gait, characterized by crossing of the legs during ambulation.

Answer 35

Correct Answer: B Rationale: PBWSTT is effective in promoting reciprocal stepping patterns, improving gait mechanics, and activating central pattern generators in children with cerebral palsy.

Answer 36

Correct Answer: B Rationale: SDR involves cutting sensory nerve rootlets to reduce spasticity in children with cerebral palsy, improving functional mobility and comfort.

Answer 37

Correct Answer: B Rationale: Dyskinetic cerebral palsy is characterized by uncontrolled, involuntary movements due to damage to the basal ganglia.

Answer 38

Correct Answer: B Rationale: Children with hemiplegic cerebral palsy often exhibit shoulder retraction, elbow flexion, wrist flexion, and ulnar deviation due to spasticity.

Answer 39

Correct Answer: B Rationale: VSD involves a left-to-right shunt due to higher pressure in the left ventricle, causing blood to flow abnormally into the right ventricle.

Answer 40

Correct Answer: B Rationale: Pulmonary stenosis is one of the four defining features of Tetralogy of Fallot, along with VSD, overriding aorta, and right ventricular hypertrophy.

Answer 41

Correct Answer: B Rationale: 'Tet spells,' characterized by cyanosis and difficulty breathing, are classic in Tetralogy of Fallot due to reduced pulmonary blood flow.

Answer 42

Correct Answer: A Rationale: PDA produces a continuous, machine-like murmur due to abnormal blood flow between the aorta and pulmonary artery.

Answer 43

Correct Answer: C Rationale: Prostaglandins are administered to maintain ductus arteriosus patency in defects requiring mixed blood flow, such as transposition of the great arteries.

Answer 44

Correct Answer: B Rationale: Coarctation of the aorta causes strong pulses and hypertension in the upper extremities and weak pulses in the lower extremities due to narrowing of the aorta.

Answer 45

Correct Answer: A Rationale: During a 'Tet spell,' the knee-chest position and supplemental oxygen improve oxygenation by increasing systemic vascular resistance and decreasing right-to-left shunting.

Answer 46

Correct Answer: B Rationale: Poor weight gain, tachypnea, and feeding difficulties are hallmark symptoms of CHF in children due to impaired cardiac output.

Answer 47

Correct Answer: B Rationale: In TGA, the systemic and pulmonary circulations are parallel, requiring mixing of blood through defects like ASD or PDA for survival.

Answer 48

Correct Answer: B Rationale: Echocardiography is the gold standard for diagnosing congenital heart defects due to its ability to visualize cardiac structures and blood flow.

Answer 49

Correct Answer: B Rationale: Shaken baby syndrome is the leading cause of TBI in children under 2, characterized by repetitive acceleration-deceleration forces causing brain injury.

Answer 50

Correct Answer: B Rationale: A GCS score of 9-12 indicates moderate TBI, with potential for confusion, lethargy, or altered consciousness.

Answer 51

Correct Answer: B Rationale: Diffuse axonal injury involves widespread tearing or shearing of axons due to rotational forces, leading to disrupted neural communication.

Answer 52

Correct Answer: C Rationale: Secondary injuries such as increased ICP, hypoxia, or ischemia worsen the primary damage sustained during the initial trauma.

Answer 53

Correct Answer: B Rationale: Level IV is characterized by confused-agitated behavior, with restlessness, inappropriate responses, and difficulty with attention.

Answer 54

Correct Answer: B Rationale: Proper positioning helps maintain ICP below 20 mmHg, reducing the risk of secondary brain injury.

Answer 55

Correct Answer: C Rationale: Decorticate posturing results from damage to the cerebral hemispheres above the brainstem, leading to flexion in the upper extremities and extension in the lower extremities.

Answer 56

Correct Answer: C Rationale: Post-concussion syndrome involves symptoms such as dizziness, difficulty concentrating, and fatigue, which may persist for weeks or months after the injury.

Answer 57

Correct Answer: C Rationale: Physical sports should be avoided during recovery from a mild TBI, as they increase the risk of re-injury. The other options support cognitive rest.

Answer 58

Correct Answer: B Rationale: MRI is more sensitive than CT scans for detecting diffuse axonal injury, as it provides better visualization of soft tissue changes.

Answer 59

Correct Answer: A Rationale: Injuries at C1-C3 affect the phrenic nerve, which controls the diaphragm, often requiring ventilatory support.

Answer 60

Correct Answer: B Rationale: Central cord syndrome typically presents with greater motor impairment in the upper extremities due to damage to the central part of the spinal cord.

Answer 61

Correct Answer: C Rationale: Motor vehicle accidents are the leading cause of spinal cord injuries in children, particularly in older age groups.

Answer 62

Correct Answer: B Rationale: A T6 injury spares upper extremity function but results in loss of voluntary bladder control and lower extremity paralysis.

Answer 63

Correct Answer: B Rationale: Brown-Séquard syndrome results from hemisection of the spinal cord, causing ipsilateral motor loss and contralateral pain and temperature loss.

Answer 64

Correct Answer: A Rationale: Autonomic dysreflexia is characterized by severe hypertension, bradycardia, and sweating above the level of injury, often triggered by a noxious stimulus.

Answer 65

Correct Answer: B Rationale: Sitting the child upright reduces blood pressure, and identifying and resolving the noxious stimulus (e.g., bladder distension) addresses the underlying cause.

Answer 66

Correct Answer: B Rationale: The ASIA Impairment Scale is used to classify the severity of SCI, assessing motor and sensory function as well as completeness of the injury.

Answer 67

Correct Answer: B Rationale: Preservation of sensation in S4-S5 indicates an incomplete SCI, as it reflects partial preservation of function below the level of injury.

Answer 68

Correct Answer: A Rationale: Physical therapy focuses on preventing contractures, maintaining range of motion, and promoting functional mobility to maximize independence.