Deck 35: Child With a Musculoskeletal Condition

Question 1

Which data does the licensed practical nurse (LPN)report to the charge nurse for an infant suspected of having unilateral congenital hip dysplasia?

A) Lordosis
B) Trendelenburg sign
C) Telescoping of the affected limb
D) Asymmetry of the gluteal and thigh fat folds

Answer 1

Asymmetry of the gluteal and thigh fat folds

Question 2

Which information should the nurse include in a teaching session for the parents of a child with a leg cast?

A) Apply warm compresses to the leg for the first 24 hours after the injury.
B) Provide a well-balanced diet consisting mostly of carbohydrates.
C) Elevate the casted extremity on pillows for at least the first 24 hours.
D) Apply cold packs to the leg 24 hours after the injury.

Answer 2

Elevate the casted extremity on pillows for at least the first 24 hours.

Question 3

The nurse performs a neuromuscular assessment of a child who is in Russell's traction.Which assessment findings indicate the need for further intervention? (Select all that apply.)

A) A pain rating of 6 on an age-appropriate numeric pain rating scale
B) The child feels the distal part of the extremity when touched by the nurse.
C) The child does not have a significant amount of edema in the extremity.
D) The child has a capillary refill time of more than 3 seconds.
E) The child's toes are cold and appear dusky.

Answer 3

A pain rating of 6 on an age-appropriate numeric pain rating scale
The child has a capillary refill time of more than 3 seconds.
The child's toes are cold and appear dusky.

Question 4

Which clinical data noted by the nurse during the shift assessment indicate the pediatric client may be experiencing compartment syndrome? (Select all that apply.)

A) Pink,warm extremity
B) Dorsalis pedis pulse present
C) Prolonged capillary refill time
D) Pain not relieved by pain medication
E) Paresthesia of the leg

Question 5

Which data obtained by the nurse during the health history portion of the assessment process support the current diagnosis of Duchenne muscular dystrophy (MD)for an 18-month-old child?

A) The child was postmature by almost 2 weeks.
B) The child seems very muscular.
C) The child walked early and without support at 10 months.
D) The child's older sister developed scoliosis in the fourth grade.

Question 6

Which interventions should the nurse include in the plan of care for an adolescent patient who is on complete bedrest after spinal fusion surgery secondary to scoliosis to prevent complications associated with immobility? (Select all that apply.)

A) Encouraging use of the spirometer every 2 hours while the patient is awake
B) Log rolling the patient every 2 hours while awake
C) Increasing intake of milk to maintain bone calcium
D) Increasing fruit and grains in the diet
E) Limiting fluid intake to reduce the need to void

Question 7

Which assessment finding requires an immediate nursing action when providing care to an adolescent who is postoperative for spinal fusion surgery?

A) Sleeps when not bothered but arouses easily with stimuli
B) Impaired color,sensitivity,and movement of lower extremities
C) Nausea relieved by antiemetics
D) Pain relieved by analgesics

Question 8

Which parental statement causes the nurse to include further education related to the care of a child who is diagnosed with congenital clubfoot?

A) "We'll keep the casts dry."
B) "We're happy this is the only cast our baby will need."
C) "We're getting a special car seat to accommodate the casts."
D) "We'll watch for any swelling of the feet while the casts are on."

Question 9

Which nursing action is appropriate when providing care for a child who is in a spica cast to decrease the risk for cast syndrome?

A) Discouraging frequent repositioning
B) Encouraging increased fluids and dietary fiber
C) Drying the cast using a hair dryer
D) Telling the parents the cast can be immersed in water

Question 10

Which clinical manifestations should the nurse monitor for when conducting a scoliosis screening for a school-aged child? (Select all that apply.)

A) Lordosis
B) Prominent scapula
C) Pain
D) A one-sided rib hump
E) Uneven shoulders and hips

Question 11

To prevent rickets,which calcium requirement should the nurse include in a teaching session for the parents of a later school-aged child?

A) 500 mg
B) 800 mg
C) 1300 mg
D) 1500 mg

Question 12

The nurse is providing care to a child who is diagnosed with Legg-Calvé-Perthes disease.Which parental statement regarding the child's care indicates correct understanding of the information provided?

A) "We're glad this will take only about 6 weeks to correct."
B) "We understand adduction of the affected leg is important."
C) "We know that surgical correction is the only medical intervention needed."
D) "We will encourage our child to swim in the pool for exercise."

Question 13

The nurse is assisting in the assessment process for a school-aged patient who reports groin pain all week.When assessing the right hip,the nurse finds that the hip does not fully rotate internally,and abduction is limited.On the basis of these data,which condition might the nurse suspect?

A) Osgood-Schlatter disease
B) Left hip and femur fracture
C) Legg-Calvé-Perthes disease
D) Slipped capital femoral epiphysis

Question 14

Which parental statement indicates correct understanding regarding a type IV fracture of the femur?

A) "The break will not affect my child's growth and long-term development."
B) "The break requires open reduction and internal fixation."
C) "The break results in premature closure of the epiphyseal plate."
D) "The break will not impact my child's circulation."

Question 15

Which action by the nurse is appropriate for a child who presents in the emergency department with an ankle injury?

A) Avoiding compression of the area to allow tissue swelling as necessary
B) Performing passive range of motion (ROM)to the extremity
C) Lowering the extremity below the level of the heart
D) Applying ice to the extremity

Question 16

Which should the nurse include in a teaching session for the parents of an infant who will be placed in a Pavlik harness for the treatment of congenital developmental dysplasia?

A) Apply lotion or powder to minimize skin irritation.
B) Check at least two or three times a day for red areas under the straps.
C) Put clothing over the harness for maximum effectiveness of the device.
D) Place a diaper over the harness,preferably a thin,superabsorbent,disposable diaper.

Question 17

Which assessment finding for a toddler-aged child in balanced Bryant traction for a fractured right femur requires immediate action by the nurse?

A) The child keeps trying to turn and lie on his belly.
B) The ropes are unequal in length.
C) The child's buttocks are resting on the bed.
D) The compression bandage wrapping the legs is wrinkled.

Question 18

Which bone is a common location for musculoskeletal disorders during childhood?

A) Flat
B) Long
C) Short
D) Irregular

Question 19

Which topic is the priority for the nurse who is teaching the family of an infant diagnosed with osteogenesis imperfecta?

A) Cast care
B) Traction care
C) Postoperative spinal surgery care
D) Trunk and extremity support during everyday care

Question 20

Which imaging test should the nurse anticipate for a patient whose provider wants to visualize hard and soft tissue along with bone marrow,without the use of radiation?

A) Bone scan
B) Fluoroscopy
C) Computed tomography
D) Magnetic resonance imaging