Deck 58: The Child With Alterations in Musculoskeletal Function

Question 1

The nurse in the newborn nursery is doing the admission assessment on a neonate.Which area in the accompanying picture is an abnormal finding indicating that the neonate might have congenital hip dysplasia?

Answer 1

A

Question 2

A 12-year-old boy with Duchenne muscular dystrophy is being seen in the clinic for a routine health visit.An appropriate nursing diagnosis for this client would be:

A)Risk for impaired mobility related to hypertrophy of muscles and possible loss of ability to ambulate.
B)Risk for infection related to altered immune system.
C)Risk for impaired skin integrity related to paresthesia to lower extremities.
D)Risk for altered comfort related to effects of muscular dystrophy disease.

Answer 2

Risk for impaired mobility related to hypertrophy of muscles and possible loss of ability to ambulate.

Question 3

A child has just returned from spinal fusion surgery.The nurse should check for signs of:

A)Increased intracranial pressure.
B)Seizure activity.
C)Impaired pupillary response during neurological checks.
D)Impaired color,sensitivity,and movement to lower extremities.

Answer 3

Impaired color,sensitivity,and movement to lower extremities.

Question 4

The nurse is caring for a child in Bryant's skin traction.An appropriate nursing intervention for this child would be to:

A)Remove the adhesive traction straps daily to prevent skin breakdown.
B)Check the traction frequently to ensure that proper alignment is maintained.
C)Position the child prone to maintain good alignment.
D)Move the child as infrequently as possible to maintain traction.

Question 5

A child has experienced a sprain of the right ankle.The school nurse should:

A)Apply ice to the extremity.
B)Apply a warm,moist pack to the extremity.
C)Perform passive range-of-motion to the extremity.
D)Lower the extremity below the level of the heart.

Question 6

An infant has just returned from surgery for correction of bilateral congenital clubfeet.The infant has bilateral long leg casts.The toes on both feet appear edematous,but there is color,sensitivity,and movement to them.The nurse should:

A)Call the physician to report the edema.
B)Elevate the legs on pillows.
C)Apply a warm,moist pack to the feet.
D)Encourage movement of toes.

Question 7

Care for an infant with osteogenesis imperfecta should include:

A)Support of the trunk and extremities when moving.
B)Traction care.
C)Cast care.
D)Postop spinal surgery care.

Question 8

A child has been admitted to the hospital with osteomyelitis.The nurse would expect to administer which intravenous antibiotic for this child?

A)Ampicillin or penicillin
B)Vancomycin or clindamycin
C)Gentamicin or tobramycin
D)Rifampin

Question 9

A nurse notes a blue sclera during a newborn assessment.The infant should be checked for:

A)Marfan syndrome.
B)Achondroplasia.
C)Osteogenesis imperfecta.
D)Muscular dystrophy.

Question 10

A school health nurse is screening for scoliosis.For what assessment findings would the nurse look? Select all that apply.

A)Uneven shoulders and hips
B)A one-sided rib hump
C)Prominent scapula
D)Lordosis
E)Pain

Question 11

The nurse is teaching a family how to care for an infant in a Pavlik harness to treat congenital developmental dysplasia of the hip.The nurse will include in the parental education instructions to:

A)Apply lotion or powder to minimize skin irritation.
B)Put clothing over the harness for maximum effectiveness of the device.
C)Check at least two or three times a day for red areas under the straps.
D)Place the diaper over the harness,preferably using a thin,superabsorbent disposable diaper.

Question 12

A child must wear a brace for correction of scoliosis.The nursing diagnosis that should be included in this child's plan of care is:

A)Risk for impaired skin integrity.
B)Risk for altered growth and development.
C)Risk for impaired mobility.
D)Risk for impaired gas exchange.

Question 13

The nurse has completed discharge teaching for the family of a child diagnosed with Legg-Calvé-Perthes disease.The nurse knows further teaching is needed about the condition if the family states:

A)"We're glad this will only take about 6 weeks to correct."
B)"We understand swimming is a good sport for Legg-Calvé-Perthes disease."
C)"We know to watch for areas on the skin that the brace might rub."
D)"We understand abduction of the affected leg is important."

Question 14

A nurse is assessing a child after an open reduction of a fractured femur.A sign that compartment syndrome could be occurring would be:

A)A pink,warm extremity.
B)Pain relieved by pain medication.
C)Dorsalis pedis pulse present.
D)Prolonged capillary refill time with loss of paresthesia.

Question 15

The nurse has completed parent education related to treatment for a child with congenital clubfoot.The nurse knows that parents need further teaching when they state:

A)"We're happy this is the only cast our baby will need."
B)"We'll watch for any swelling of the feet while the casts are on."
C)"We'll keep the casts dry."
D)"We're getting a special car seat to accommodate the casts."