Question 1

The nurse is assessing a child who is suspected of having Guillain-Barré syndrome. Which assessment findings would the nurse correlate as supporting this diagnosis? Select all answers that apply.

Accepted Answer

The answer of The nurse is assessing a child who...

Question 2

A child with myasthenia gravis is brought to the emergency department by his parents. The parents have noticed a sudden increase in respiratory difficulty. The nurse suspects myasthenic crisis based on which statement by the parents?

Accepted Answer

Myasthenic crisis can be triggered by infection, leading to increased weakness and respiratory difficulty. The parents' statement about coughing and fever suggests an infection, which could precipitate a myasthenic crisis.

Question 3

After teaching a class of nursing students about muscular dystrophy, the instructor determines that the teaching was successful when the students identify which type of muscular dystrophy as demonstrating an X-linked recessive pattern of inheritance?

Accepted Answer

Duchenne muscular dystrophy is known for its X-linked recessive pattern of inheritance, meaning it primarily affects males, while females can be carriers.

Question 4

An 8-year-old girl was diagnosed with a closed fracture of the radius at approximately 2 p.m. The fracture was reduced in the emergency department and her arm placed in a cast. At 11 p.m. her mother brings her back to the emergency department due to unrelenting pain that has not been relieved by the prescribed narcotics. Which action would be the priority?

Accepted Answer

Notifying the doctor immediately is the priority action in this scenario because the child's unrelenting pain, despite narcotic administration, could indicate a complication such as compartment syndrome, especially following a fracture reduction and cast application. Immediate medical evaluation is necessary to prevent further injury.

Question 5

The nurse is caring for an active 14-year-old boy who has recently been diagnosed with scoliosis. He is dismayed that a "jock" like himself could have this condition, and is afraid it will impact his spot on the water polo team. Which response by the nurse would best address the boy's concerns?

Accepted Answer

C) This response directly addresses the boy's concerns about his athletic performance and provides a positive role model, showing that scoliosis does not necessarily limit athletic achievements.

Question 6

The nurse is caring for a female infant with torticollis and is providing instructions to the parents about how to help their daughter. Which statement by the parents indicates a need for further teaching?

Accepted Answer

The correct management of torticollis involves gentle stretching exercises to improve the range of motion, which should be done regularly, not just every other day. The statement about applying firm pressure and stretching every other day indicates a misunderstanding of the recommended frequency and intensity of the exercises.

Question 7

The nurse is caring for a 10-year-old in traction. While performing a skin assessment, the nurse notices that the skin over the calcaneus appears slightly red and irritated. Which action would the nurse do first?

Accepted Answer

Repositioning the child's foot on a pressure-reducing device is the first action to relieve pressure and prevent further skin breakdown.

Question 8

The nurse is caring for a 14-month-old boy with rickets who was recently adopted from overseas. His condition was likely a result of a diet very low in milk products. The nurse is providing teaching regarding treatment. Which response by the parents indicates a need for further teaching?

Accepted Answer

The answer of The nurse is caring for a 14-month-old...

Question 9

The nurse is caring for a 13-year-old boy in traction prior to surgery for slipped capital femoral epiphysis. He has been in an acute care setting for 2 weeks and will require an additional 10 days in the hospital. He is complaining that he feels isolated and is resisting further treatment. Which response by the nurse would be most appropriate?

Accepted Answer

Option C is the most appropriate response because it acknowledges the patient's feelings of isolation and offers constructive suggestions to help alleviate boredom and improve his hospital stay experience. It also encourages patient involvement in care planning, which can increase his cooperation and sense of control over his situation.

Question 10

A nurse is caring for a 10-year-old girl following joint fluid aspiration. The nurse would expect to perform which of the following immediately after the procedure?

Accepted Answer

Applying cold therapy and a pressure dressing to the site after joint fluid aspiration helps reduce swelling and bleeding. Cold therapy decreases inflammation, and a pressure dressing helps prevent fluid accumulation at the aspiration site.

Question 11

The nurse is caring for a 2-year-old girl in a bilateral brace with tibia vara. Her parents are upset by their toddler's limited mobility. Which response by the nurse would be most appropriate?

Accepted Answer

C) This response is most appropriate because it acknowledges the parents' feelings, offers support, and suggests collaboration to address the child's needs, which is a positive and constructive approach.

Question 12

The nurse is conducting a physical examination of a child with suspected developmental dysplasia of the hip. Which of the following findings would help confirm this diagnosis?

Accepted Answer

The "clunk" heard with Barlow (which identifies a dislocatable hip by adducting and applying gentle pressure to the knee, pushing the femoral head posteriorly) and Ortolani maneuvers (which reduces a dislocated hip by abducting and lifting the thigh, applying anterior force to the femur) is a classic sign of developmental dysplasia of the hip (DDH). This indicates that the femoral head is moving in and out of the acetabulum, which is not normal.

Question 13

The nurse is caring for an infant with osteogenesis imperfecta and is providing instruction on how to reduce the risk of injury. Which response from the mother indicates a need for further teaching?

Accepted Answer

Lifting an infant with osteogenesis imperfecta from under the armpits can put undue stress on the fragile bones, increasing the risk of fractures. The correct method involves supporting the baby's head, neck, and bottom to distribute weight more evenly and reduce the risk of injury.

Question 14

The nurse is developing a teaching plan for a child who is to have his cast removed. Which of the following would the nurse most likely include?

Accepted Answer

Soaking the area in warm water every day helps to gently remove dead skin and soothe the area without causing irritation or damage.

Question 15

When teaching a group of students about the skeletal development in children, which of the following would the instructor include?

Accepted Answer

B is correct because children's bones are more flexible and have a greater capacity to bend due to the presence of more collagen in their bone matrix compared to adults. This flexibility can result in bones bending rather than breaking when subjected to force. Choices A, C, and D are incorrect: A) The growth plate, or epiphyseal plate, is not made up of the epiphysis but is located between the epiphysis and the diaphysis of long bones and is responsible for longitudinal growth; C) An infant's skeleton is not fully ossified at birth, with much of the skeleton initially present as cartilage that gradually ossifies; D) Children's bones actually have a thicker periosteum and a rich blood supply, which contributes to their strong healing capacity.

Question 16

A nurse is assessing a child with suspected osteomyelitis. Which finding would help support this suspicion?

Accepted Answer

Swelling and point tenderness are common signs of osteomyelitis, indicating inflammation and infection within the bone.

Question 17

The school nurse is presenting a class to a group of students about common overuse disorders. Which of the following would the school nurse include?

Accepted Answer

Osgood-Schlatter disease is a common overuse disorder affecting the knee area, often seen in adolescents who are very active in sports. It is caused by repetitive stress or tension on the growth plate at the top of the tibia, where the patellar tendon attaches.

Question 18

The nurse is assessing a child with a possible fracture. Which of the following would the nurse identify as the most reliable indicator?

Accepted Answer

Point tenderness is the most reliable indicator of a fracture. When a specific point on a bone is significantly more tender than surrounding areas, it suggests a localized injury such as a fracture. Other options, while potentially indicative of a fracture, are less specific and can be present in various injuries.

Question 19

Which of the following would the nurse be least likely to assess in a 6-year-old with septic arthritis of the hip?

Accepted Answer

Septic arthritis typically results in significant pain, leading to a decreased range of motion in the affected joint. Therefore, a child with septic arthritis of the hip would be unlikely to have a full range of motion of the hip, making option D the least likely assessment finding.

Question 20

An 8-year-old boy with a fractured forearm is to have a fiberglass cast applied. Which of the following would the nurse include when teaching the child about the cast?

Accepted Answer

The child initially may experience a very warm feeling inside the cast.

Quiz 44: Nursing Care of the Child With an Alteration in Mobility/Neuromuscular or Musculoskeletal Disorder