Deck 24: The Child with a Musculoskeletal Condition

Question 1

The nurse who is checking for capillary refill on a child in Bryant's traction will record adequate perfusion if the toe regains color in _____ seconds.

A) 3
B) 4
C) 5
D) 6

Answer 1

3

Question 2

A 6-year-old sustained a fractured femur and was put in Russell traction 2 days ago.She screams in pain when she raises herself onto the bedpan.The nursing diagnosis that takes highest priority for this child is:

A) pain resulting from tissue trauma.
B) high risk for impaired skin integrity resulting from immobility.
C) altered growth and development related to separation from family.
D) altered urinary elimination related to immobility and traction.

Answer 2

pain resulting from tissue trauma.

Question 3

The nurse caring for a child in Buck's skin traction will keep the:

A) child in high-Fowler's position.
B) child pulled up in bed.
C) child's heel on the bed surface.
D) child's feet against the foot of the bed.

Answer 3

child pulled up in bed.

Question 4

The observation that may cause the nurse to consider the possibility of child abuse when a mother says that her young child fell down the basement stairs is:

A) red, green, and yellow bruises on his body.
B) bruises are dispersed on his head, arms, and legs.
C) a broken arm last year, and the child being described as accident-prone.
D) the mother is very anxious for her son to get medical attention.

Question 5

A nurse assessing a preadolescent child for scoliosis would:

A) ask the child to bend forward at the waist, and would observe the child's back for asymmetry.
B) observe the gait while the child is walking forward heel to toe.
C) have the child flex the knees and look for uneven knee height.
D) look at the child's shoulders and hips while fully clothed.

Question 6

The nurse,assessing the neurovascular status of a child in Russell traction should report immediately the finding of:

A) skin that's warm to the touch.
B) capillary refill less than 3 seconds.
C) ability to wiggle toes.
D) bluish coloration of skin.

Question 7

The nurse caring for a child in Bryant's traction knows that the risk of serious complications will be reduced by ensuring that:

A) neurovascular checks are done frequently.
B) bandages are wrapped tightly.
C) the child is restrained from rolling over.
D) the child's buttocks are resting on the bed.

Question 8

When a 13-year-old girl is diagnosed with functional scoliosis,the nurse would explain the spinal curvature defect is usually caused by:

A) juvenile rheumatoid arthritis.
B) poor posture.
C) heredity.
D) myelomeningocele.

Question 9

The nurse assessing a child with juvenile rheumatoid arthritis notes the child's right knee and ankle are swollen,warm,and tender and with a temperature of 38.8 ° C (102° F)and abdominal pain.These findings suggest that this child has the ___________ type of juvenile rheumatoid arthritis.

A) psoriatic
B) enthesitis
C) systemic
D) acute febrile

Question 10

A child hospitalized for treatment of osteomyelitis complains that he is tired of being sick and wants to know when the antibiotic protocol will end.The nurse responds that antibiotic therapy will probably last for:

A) 2 weeks.
B) 6 weeks.
C) 2 months.
D) 3 months.

Question 11

The nurse reviewing the characteristics of Ewing's sarcoma would point out that:

A) amputation is the accepted treatment.
B) the disease is sensitive to radiation and chemotherapy.
C) metastasis is rare.
D) the disease is more prevalent among toddlers and preschoolers.

Question 12

The nurse explains that Russell traction is a type of skin traction that:

A) subluxates the tibia.
B) does not interfere with range of motion.
C) prevents the knee from flexing.
D) supplies continuous pull in two directions.

Question 13

The interventions that would be helpful in relieving morning discomfort associated with juvenile rheumatoid arthritis would be:

A) wearing splints at night to prevent extension contractures.
B) applying moist heat packs upon awakening.
C) taking a warm tub bath the evening before.
D) sleeping with two pillows under the head.

Question 14

The nurse caring for a child with Duchenne's muscular dystrophy notes a characteristic manifestation,which is that the child:

A) ambulates by holding onto furniture.
B) exhibits atrophy of the calf muscles.
C) falls frequently and is clumsy.
D) has delayed fine-motor development.

Question 15

The nurse notes as an abnormal finding on a musculoskeletal assessment of a 4-year-old that the child:

A) has inward-turned knees while standing.
B) walks on the toes.
C) appears to have flat feet.
D) swings his arms when walking.

Question 16

The nurse providing instructions to an adolescent who has been fitted with a Milwaukee brace would teach the patient to:

A) wear the brace directly against the skin.
B) wear the brace over regular clothing.
C) wear the brace over a T-shirt 23 hours a day.
D) remove the brace before sleeping.

Question 17

The nurse is providing instructions about how to treat a sprained ankle.The nurse will recognize the need for additional teaching when the mother states:

A) "Apply warm compresses to the ankle for the first 24 hours. "
B) "Put an ice pack on the ankle, alternating 30 minutes on with 30 minutes off. "
C) "Wrap the ankle in an Ace bandage for support. "
D) "Keep the leg elevated when sitting. "

Question 18

The parent of a child with osteomyelitis asks why his child is in so much pain.The nurse's response will be based on the understanding that the pain of osteomyelitis is caused by:

A) the pressure of inelastic bone.
B) purulent drainage in the bone marrow.
C) the cast applied on the extremity.
D) circulatory congestion of the skin.

Question 19

In planning teaching to parents of a child with Legg-Calvé-Perthes disease about the long-term effects of this disease,the nurse would include that:

A) there are no long-term effects.
B) the disease is self-limited and requires no long-term treatment.
C) degenerative arthritis may develop later in life.
D) there is risk of osteogenic sarcoma in adulthood.

Question 20

When caring for a child in Buck's extension,the nurse would include:

A) positioning the child with hips flexed 90 degrees at all times.
B) keeping the weights in contact with the floor.
C) checking for skin irritation from traction equipment.
D) releasing the weights on a schedule.

Question 21

The nurse explains that Bryant's traction is reserved for children who weigh less than _____ pounds.

Question 22

The nurse performing a neurovascular check on a limb in traction would report and document which finding(s)as indicative of altered circulation? Select all that apply.

A) Pulse is equal to uncasted limb.
B) Patient is aware of touch and warm and cold application.
C) Limb is cool to the touch.
D) Capillary refill is 5 seconds.
E) Distal limb can flex and extend.

Question 23

A nurse assessing welts on the body of a 2-year-old Vietnamese child should consider the skin lesions might be the result of the cultural practice of __________.

Question 24

The nurse assesses a large green bruise on the thigh of a 4-year-old to be approximately ____ days old.

A) 2
B) 4
C) 6
D) 8

Question 25

How does the pediatric skeletal system differ from that of the adult? Select all that apply.

A) Lower mineral content
B) More ossification
C) Open epiphyses
D) Less porosity
E) Greater strength

Question 26

The nurse considers what factor(s)that may trigger abuse in a parent? Select all that apply.

A) Being abused as a child
B) Low self-esteem
C) Substance abuse
D) Overwhelming responsibility
E) Knowledge deficit relative to child care
F) None of the above

Question 27

The nurse explains that the child's fracture heals more rapidly than the adult's because the child's bones:

A) are less porous than adult bone.
B) are covered by a thicker periosteum.
C) are not affected by bone overgrowth.
D) have faster callus formation.

Question 28

On entering the room of a child in Buck's traction the nurse makes all of the following observations.The observation that requires nursing intervention is the:

A) child's heels are placed firmly against the foot of the bed.
B) head of bed is elevated 20 degrees.
C) weights are hanging freely.
D) ropes are on pulleys.

Question 29

The nurse recognizes the signs of ____________________ syndrome in a child in "90-90" traction when the toes are pale and edematous and have a very slow capillary refill.

Question 30

The child with Duchenne's muscular dystrophy must push on his legs and "walk up the leg" in order to rise to a standing position.The nurse recognizes this characteristic behavior as _______________ maneuver.

Question 31

The nurse reminds the adolescent boy with Ewing's sarcoma that he is prohibited from vigorous weight-bearing activities during treatment with radiation to reduce the risk of a(n)_______________ fracture.

Question 32

The nurse demonstrates which similarities among all traction devices? Select all that apply.

A) Pull the limb into extension
B) Decrease muscle spasm
C) Reduce pain
D) Align two bone fragments
E) Immobilize the limb