Question 1

The nurse is working with a small child who is in Bryant's traction. During the initial assessment of the shift, the nurse will make certain that:

Accepted Answer

Bryant's traction is typically used for young children with certain fractures or orthopedic conditions, and it requires that the child's buttocks are slightly off the bed to ensure proper alignment and traction of the affected limb(s).

Question 2

The nurse is working with a client who is in cervical traction. How much should the head of the bed be elevated?

Accepted Answer

When a client is in cervical traction, the head of the bed should be elevated 20-30 degrees. This position helps to reduce pressure on the cervical spine while maintaining the effectiveness of the traction.

Question 3

The nurse is working with a child who is experiencing a complication of fractures known as compartment syndrome. Which of the following signs and symptoms is this child most likely to have?

Accepted Answer

Compartment syndrome is characterized by increased pressure within a muscle compartment of the body, leading to decreased blood flow and potential nerve damage. This results in symptoms such as paresthesia (tingling or numbness), severe pain that may not be relieved by pain medication, and severe swelling of the digits or areas below the affected compartment. Options A, B, and C do not describe the typical signs and symptoms of compartment syndrome.

Question 4

A parent of a child experiencing compartment syndrome asks the nurse to explain what this means. Which of the following is the nurse's best response?

Accepted Answer

Compartment syndrome is characterized by increased pressure within a closed muscle compartment, which can compromise circulation and lead to tissue damage. It is not related to blood shifting to interstitial spaces, cognitive processing of experiences, or blood moving from the stomach and muscles to an injury site.

Question 5

Which of the following treatments is used for compartment syndrome?

Accepted Answer

Compartment syndrome is a condition where pressure within the muscles builds to dangerous levels, preventing blood flow to and from the affected tissues. This can cause muscle and nerve damage and problems with blood flow. The primary treatment for compartment syndrome is to relieve this pressure. If the patient has a cast, it may be split to alleviate the pressure. In more severe cases, a surgical procedure known as a fasciotomy is performed to cut open the skin and fascia covering the affected compartment, thereby relieving the pressure.

Question 6

Which of the following is an early sign of compartment syndrome?

Accepted Answer

Compartment syndrome is characterized by increased pressure within a muscle compartment, leading to insufficient blood supply to the tissue. One of the earliest signs is pain that is disproportionate to the injury and not relieved by pain medications.

Question 7

The nurse is assigned to care for a child who is scheduled to have a plaster cast applied after reduction of a fracture of the radius. The nurse will prepare the child for cast application by explaining that:

Accepted Answer

When a plaster cast is applied, the chemical reaction that occurs as it dries generates heat, so the cast will indeed feel warm as it hardens. It also takes some time to dry completely, often a day or two, depending on the thickness of the cast and the ambient conditions.

Question 8

The nurse working with a child with a new cast will use which of the following techniques to work with the cast?

Accepted Answer

Handling the cast gently with the palms of the hand is recommended to avoid indenting the soft, new cast material, which could lead to pressure points against the skin and potential sores or discomfort for the child. The other options are not standard practices for managing a new cast.

Question 9

The nurse observes a child with a cast using a pencil to reach inside the cast to scratch an area that the child has been saying is itchy. The child explains that the pencil won't quite reach the place that itches. Which of the following is the nurse's best intervention?

Accepted Answer

Using a hair dryer on a cool setting to blow air into the cast is a safe method to alleviate itching without risking injury to the skin under the cast. Inserting objects like pencils, even with precautions, can cause skin injuries or infections.

Question 10

The nurse is working with a child who is in a spica hip cast. Which of the following interventions on the part of the nurse would be best to help protect the cast from urine and stool and protect the skin?

Accepted Answer

Petaling the cast involves smoothing and covering the rough edges of the cast with waterproof tape or moleskin, especially around the groin and perineum, to protect the skin and prevent the cast from getting soiled by urine or stool.

Question 11

The nurse is working with a child who is hospitalized and in traction. The parents of this child share with the nurse that the child is very angry with them at times. They share that they are hurt and frustrated by this anger because they are staying with the child and doing all they can to make the experience less traumatic. Which of the following is the nurse's best response?

Accepted Answer

The nurse explains that the child's anger is a form of displacement, where the child directs frustration about their situation towards their parents, who are perceived as safe targets.

Question 12

The nurse encourages the caregivers of a child immobilized in traction to have friends and extended family visit the child. The major rationale for this action on the part of the nurse is directed to which of the following goals?

Accepted Answer

The primary goal of encouraging visits from friends and extended family for a child immobilized in traction is to prevent social isolation and deprivation. This helps maintain the child's emotional and social well-being during a period of physical restriction.

Question 13

The nurse assesses a child's neurovascular status. The child has a long leg cast for a fracture of the humerus. The nurse finds that there is a slight decreased sensation in the foot and toes of the casted leg as compared to the baseline assessment data. The nurse realizes that this is indicative of which of the following conditions?

Accepted Answer

The slight decrease in sensation in the foot and toes of the casted leg, as compared to baseline assessment data, is indicative of neurovascular compromise. This condition requires further assessment to ensure that the cast is not too tight and compromising blood flow or nerve function, which can lead to serious complications if not addressed promptly.

Question 14

The nurse is assessing a child who has a fractured bone that has been pinned. There is caked blood and some purulent drainage in the pin area. Which of the following would be the best action for the nurse to take?

Accepted Answer

Purulent drainage indicates a possible infection, and the presence of caked blood and purulent drainage around a pinned fracture site should be reported to a physician to ensure appropriate treatment is prescribed. The physician can then provide specific orders for cleaning or treating the site, ensuring that the care is tailored to the patient's specific needs and the condition of the pin site.

Question 15

Which of the following statements best defines osteomyelitis?

Accepted Answer

Osteomyelitis is an infection of an entire bone caused by a microorganism, which is usually bacterial but may also be viral or fungal, leading to inflammation and potentially severe complications if not treated.

Question 16

Which of the following physician's orders would the nurse anticipate in cases of osteomyelitis to minimize pain and decrease the speed of infection by lymph channels?

Accepted Answer

Splinting of the limb helps to immobilize it, which can minimize pain and prevent the spread of infection through the lymphatic system by reducing movement.

Question 17

The nurse is going over discharge instructions with the caregivers of a child who has osteomyelitis and is going home on oral medications. Which of the following discharge instructions is the most important for the nurse to give the caregivers?

Accepted Answer

Osteomyelitis treatment often involves antibiotics, which can be ototoxic, making it crucial for caregivers to monitor for signs of hearing loss as a potential side effect.

Question 18

A pediatric client is diagnosed with an incomplete or partial dislocation of the articular surfaces of the joints. When the parents ask the nurse what this condition is called, the nurse accurately responds that it is referred to as ____________________.

Accepted Answer

The answer of A pediatric client is diagnosed with an...

Quiz 34: Musculoskeletal Alterations