Question 1

What differences in the musculoskeletal system of children make their bones able to absorb more energy before breaking and to heal more quickly?

Accepted Answer

Children's bones contain more cartilage, which is more flexible than bone, and they have a stronger periosteum, the outer layer of bone tissue that aids in healing and growth. This combination allows children's bones to absorb more energy before breaking and to heal more quickly compared to adults.

Question 2

Which of the following can be caused by a fracture that disrupts or transects the epiphyseal growth plate of a child?

Accepted Answer

A fracture that disrupts or transects the epiphyseal growth plate in a child can lead to limb length discrepancy or a halt in height attainment due to premature closure of the growth plate, affecting normal bone growth.

Question 3

Where is fat stored in bones?

Accepted Answer

Fat is primarily stored in the yellow marrow of the medullary cavity of bones, serving as an energy reserve.

Question 4

Where does hematopoiesis occur in bones?

Accepted Answer

Hematopoiesis, the process of blood cell formation, occurs in the red marrow, which is found in the medullary cavity of certain bones, particularly in the proximal epiphysis of long bones and flat bones in adults.

Question 5

Growth hormone is produced in the:

Accepted Answer

Growth hormone is produced in the anterior lobe of the pituitary gland, also known as the adenohypophysis.

Question 6

The school nurse working in the middle school or high school will find that most sports injuries in older children and adolescents affect:

Accepted Answer

Most sports injuries in older children and adolescents affect soft tissues, such as muscles, ligaments, and tendons, due to the nature of physical activities and sports they engage in.

Question 7

A parent asks the nurse for advice in letting her child pursue an interest in sports. The parent asks which sports are the most dangerous. The nurse will advise this parent that most injuries in organized sports occur in which of the following sports?

Accepted Answer

Ice hockey, wrestling, and football are known for their physical contact and higher risk of injuries compared to non-contact sports or those with less physical interaction.

Question 8

Sports injuries are classified in which of the following ways?

Accepted Answer

Sports injuries are primarily classified as either acute or overuse. Acute injuries result from a sudden trauma or impact, while overuse injuries develop gradually over time due to repetitive motion or stress on a particular part of the body.

Question 9

The school nurse is seeing students who have experienced sports injuries. The nurse will talk with the students about ways to prevent sports injuries and will advise them that a major way to prevent sports injuries is:

Accepted Answer

Adequate conditioning, including warm-ups and cooldowns, is essential for preventing sports injuries as it prepares the body for physical activity and helps to reduce the risk of strains and sprains.

Question 10

The nurse gets a telephone call from a parent who wants to know what to do for her child who just twisted an ankle, which is beginning to swell and hurt. The nurse will advise the parent to do which of the following?

Accepted Answer

Elevating the leg and using an ice pack for the ankle, alternating 30 minutes on and 15 minutes off, is the recommended initial treatment for a twisted ankle to reduce swelling and pain. This approach follows the RICE protocol (Rest, Ice, Compression, Elevation), which is widely accepted for acute soft tissue injuries.

Question 11

You are the school nurse assessing the neurovascular status of a child who had a sports injury. You check the skin color, capillary refill, skin temperature, and pulses of distal extremities. You report the capillary refill as within the normal range if it is less than:

Accepted Answer

Capillary refill time is considered within the normal range if it is less than 3 seconds. This assessment helps determine the adequacy of blood circulation to the extremities.

Question 12

A parent brings a 3-year-old child to the clinic with a complaint of a painful elbow. The pediatrician orders an X-ray, which reveals the child has a dislocated elbow. The pediatrician or the office nurse will:

Accepted Answer

This scenario describes a common injury in young children known as "nursemaid's elbow," which often occurs when a child's arm is pulled. It is not typically associated with abuse, and educating the family about avoiding pulling the child's arm is appropriate.

Question 13

The nurse arrives for the shift report and finds out that one of his assigned clients has a compound or open fracture and is going to surgery sometime during the shift. The nurse knows that this type of fracture involves:

Accepted Answer

A compound or open fracture is characterized by a broken bone that protrudes through the skin, creating an open wound. This increases the risk of infection and requires prompt surgical intervention.

Question 14

A parent asks the nurse to explain what the pediatrician meant by greenstickfracture. The nurse will explain that a greenstick fracture is one in which the bone has:

Accepted Answer

A greenstick fracture is characterized by a break on one side of the bone, while the other side remains intact but may bend. This type of fracture is common in children due to the flexibility of their bones.

Question 15

Injuries of the growth plate can be classified with the Salter-Harris system. Which of the following classifications have the best prognosis?

Accepted Answer

Salter-Harris types I and II injuries have the best prognosis because they involve less disruption to the growth plate. Type I injuries are through the growth plate without affecting the bone, and Type II injuries involve the growth plate and a portion of the metaphysis but still have a good healing potential with proper treatment.

Question 16

The school nurse assessing a child who has fallen off the swings at school is looking for signs and symptoms of a fracture. The nurse suspects that the bone is fractured, because the child is complaining of pain and tenderness of the lower arm, there is some swelling of the lower arm, and there is decreased range of motion and crepitus. Which of the following best describes crepitus?

Accepted Answer

Crepitus refers to a grating sound or sensation produced by the friction between bone and cartilage or the fractured parts of a bone. This is a common sign in cases of bone fracture, where the broken ends of the bone rub against each other during movement.

Question 17

The nurse is doing discharge planning with the family of an African-American child who is going home after open reduction of a fracture. Which of the following is important for the nurse to ask the caregivers before telling them about the best foods to serve the child to facilitate healing?

Accepted Answer

Lactose intolerance is more common in African-American populations, and since dairy products are a primary source of calcium important for bone healing, it's crucial to know if the child is lactose intolerant to suggest appropriate dietary options.

Question 18

The school nurse asks a child who has returned to school after an open reduction of a fracture to describe what she has eaten in the past 24 hours in order to see if the family is following the instructions regarding foods that will assist in bone healing. Which of the following reports by the child would indicate that the child and her family are following discharge instructions?

Accepted Answer

C) "cheeseburger, broccoli, peaches, and milk" indicates a diet that supports bone healing due to the presence of calcium in cheese and milk, vitamin C in peaches, and other nutrients in broccoli that are essential for bone health.

Question 19

Which of the following explains why synthetic casts are not recommended for young children or serious fractures?

Accepted Answer

Synthetic casts do not mold as well as plaster casts, making them less suitable for young children or serious fractures where a precise fit is crucial for proper healing and support.

Question 20

The nurse is assigned to a child who is in Buck's extension traction. When the nurse does the initial assessment and looks at the traction setup, the nurse will make certain that the:

Accepted Answer

Buck's extension traction is designed to apply force in a straight line to the affected limb without the weights touching the floor, ensuring ropes and pulleys hang freely to maintain proper traction.

Quiz 34: Musculoskeletal Alterations