Deck 53: Musculoskeletal or Articular Dysfunction

Question 1

An adolescent is scheduled for a leg amputation in 2 days for treatment of osteosarcoma.How should the nurse approach this patient?

A) Answer questions with straightforward honesty.
B) Avoid discussing the seriousness of the condition.
C) Explain that,although the amputation is difficult,it will cure the cancer.
D) Assist the adolescent in accepting that the amputation as better than a long course of chemotherapy.

Answer 1

Answer questions with straightforward honesty.

Question 2

When does idiopathic scoliosis become most noticeable?

A) During the newborn period
B) When the child starts to walk
C) During the preadolescent growth spurt
D) In adolescence

Answer 2

During the preadolescent growth spurt

Question 3

What effect does immobilization have on the cardiovascular system?

A) Venous stasis
B) Increased vasopressor mechanism
C) Normal distribution of blood volume
D) Increased efficiency of orthostatic neurovascular reflexes

Answer 3

Venous stasis

Question 4

What term is used to describe an abnormally increased convex angulation in the curvature of the thoracic spine?

A) Scoliosis
B) Ankylosis
C) Lordosis
D) Kyphosis

Question 5

Why does a nurse use the palms of his hands when handling a wet cast?

A) To assess the dryness of the cast
B) To facilitate easy turning
C) To keep the patient's limb balanced
D) To avoid indenting the cast

Question 6

A young girl has just injured her ankle at school.In addition to calling the child's parents,what is the school nurse's most appropriate,immediate action?

A) Apply ice.
B) Observe the ankle for edema and discolouration.
C) Encourage the child to assume a comfortable position.
D) Obtain parental permission for administration of acetaminophen or aspirin.

Question 7

Osteosarcoma is the most common bone cancer in children.What is the most common primary tumour site?

A) Femur
B) Humerus
C) Pelvis
D) Tibia

Question 8

A child is upset because,when the cast was removed from her leg,the skin surface was caked with desquamated skin and sebaceous secretions.What should the nurse suggest to remove this material?

A) Soak in a bathtub.
B) Vigorously scrub the leg.
C) Apply powder to absorb the material.
D) Carefully pick the material off of the leg.

Question 9

What effect does immobilization have on metabolism?

A) It causes hypocalcemia.
B) It causes a decreased metabolic rate.
C) It causes a positive nitrogen balance.
D) It causes increased production of stress hormones.

Question 10

What is one advantage of using a fibreglass cast instead of a plaster one?

A) It is less expensive.
B) It dries rapidly.
C) It moulds closely to body parts.
D) It has a smooth exterior.

Question 11

What can result from the bone demineralization associated with immobility?

A) Osteoporosis
B) Urinary retention
C) Pooling of blood
D) Susceptibility to infection

Question 12

A newborn is born with mild clubfeet.What should the nurse explain to the parents when they ask how this will be corrected?

A) Traction is tried first.
B) Surgical intervention is needed.
C) Frequent,serial casting is tried first.
D) Children outgrow this condition when they learn to walk.

Question 13

Which type of traction uses skin traction on the lower leg and a padded sling under the knee?

A) Dunlop
B) Bryant
C) Russell
D) Buck extension

Question 14

What is the primary method for treating osteomyelitis?

A) Joint replacement
B) Bracing and casting
C) Intravenous antibiotic therapy
D) Long-term corticosteroid therapy

Question 15

What term is used to describe a fracture that does not produce a break in the skin?

A) Simple
B) Compound
C) Complicated
D) Comminuted

Question 16

The nurse is teaching the parents of a 7-year-old child who has just had a cast applied to a fractured arm with the wrist and elbow immobilized.What instruction should the nurse include in the discharge information?

A) Swelling of the fingers is to be expected for the next 48 hours.
B) Immobilize the shoulder to decrease pain in the arm.
C) Allow the affected limb to hang down for 1 hour each day.
D) Elevate the casted arm when resting and sitting up.

Question 17

Which is an appropriate nursing intervention when caring for a child in traction?

A) Remove adhesive traction straps daily to prevent skin breakdown.
B) Assess for tightness,weakness,or contractures in uninvolved joints and muscles.
C) Provide active range-of-motion exercises to affected extremity three times a day.
D) Keep the child in one position to maintain good alignment.

Question 18

Which should be included when the nurse is teaching a family how to care for their infant in a Pavlik harness to treat developmental dysplasia of the hip?

A) Apply lotion or powder to minimize skin irritation.
B) Remove the harness several times a day to prevent contractures.
C) Return to the clinic every week for assessment.
D) Place a diaper over the harness,preferably using a superabsorbent disposable diaper that is relatively thin.

Question 19

What sentence is most descriptive of the therapeutic management of osteosarcoma?

A) Treatment usually consists of surgery and chemotherapy.
B) Amputation of the affected extremity is rarely necessary.
C) Intensive irradiation is the primary treatment.
D) Bone marrow transplantation offers the best chance of long-term survival.

Question 20

What causes a nurse to suspect that an infection has developed under a cast?

A) Complaint of paresthesia
B) Cold toes
C) Increased respirations
D) Hot spots on the cast's surface

Question 21

The nurse is caring for an infant with developmental dysplasia of the hip.What clinical manifestation should the nurse expect to observe?

A) Positive Ortolani click
B) Lordosis
C) Negative Babinski sign
D) Telescoping of the affected limb

Question 22

What is an important nursing consideration when caring for a child with juvenile idiopathic arthritis (JIA)?

A) Apply ice packs to relieve stiffness and pain.
B) Administer acetaminophen to reduce inflammation.
C) Teach the child and family the correct administration of medications.
D) Encourage range-of-motion exercises during periods of inflammation.

Question 23

Which would the nurse expect to find when assessing a child with slipped capital femoral epiphysis? Select all that apply.Express answer with small letters followed by a comma and a space-e.g. ,a,b,c

A) Pain in the hip
B) External rotation deformity
C) Restricted internal rotation on adduction
D) Limp on the unaffected side
E) Lengthening of lower extremity
F) No change in abduction

Question 24

Which medication is usually tried first when a child is diagnosed with juvenile idiopathic arthritis (JIA)?

A) Aspirin
B) Corticosteroids
C) Cytotoxic drugs such as methotrexate
D) Nonsteroidal anti-inflammatory drugs (NSAIDs)