Deck 35: Alterations in Musculoskeletal Function

Question 1

The nurse has completed parent education related to treatment for a child with congenital clubfoot. The nurse knows that parents need further teaching when they state:

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

Answer 1

"We're happy this is the only cast our baby will need."

Question 2

An infant returns to the unit following casting of the leg for talipes equinovarus. Standing orders include monitoring the neurovascular status. In addition to color, for what will the nurse monitor the infant's foot? Standard Text: Select all that apply.

A)Warmth
B)Capillary refill
C)Pedal pulse
D)Sensation
E)Movement of the toes

Answer 2

Warmth
Capillary refill
Sensation
Movement of the toes

Question 3

An adolescent has just returned from surgery after spinal fusion surgery. Which assessment finding would take priority at this time?

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

Answer 3

Impaired color, sensitivity, and movement to lower extremities

Question 4

The nurse has completed discharge teaching for the family of a child diagnosed with Legg-Calvé-Perthes disease. The nurse knows further teaching is needed about the condition if the family states:

A)"We're glad this will only take about six weeks to correct."
B)"We understand abduction of the affected leg is important."
C)"We know to watch for areas on the skin that the brace might rub."
D)"We understand swimming is a good sport for Legg-Calvé-Perthes."

Question 5

When assigned to the patient on complete bed rest for spinal fusion secondary to scoliosis, the nurse will want to intervene to prevent common complications of immobility. Nursing interventions will include: Standard Text: Select all that apply.

A)Encouraging use of the spirometer every two hours while the child is awake.
B)Log-rolling the patient every two 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 6

A child must wear a brace for correction of scoliosis. Which nursing diagnosis takes priority at this time?

A)Impaired gas exchange, risk for
B)Altered growth and development, risk for
C)Impaired skin integrity, risk for
D)Impaired mobility, risk for

Question 7

A school health nurse is screening for scoliosis. For what assessment findings would the nurse look? Standard Text: Select all that apply.

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

Question 8

An 18-month-old child is admitted to the hospital unit for weakness of the lower extremities. Duchenne muscular dystrophy is suspected. Which assessment finding on the admission history and physical is indicative of this disorder?

A)Infant was post-mature by almost two 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 9

A nurse is assessing a child after an open reduction of a fractured femur. Which signs indicate that compartment syndrome could be occurring? Standard Text: 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 10

Which of the following would take priority when teaching the family how to care for an infant with osteogenesis imperfecta?

A)Teaching the family how to care for an infant in a cast
B)Teaching the family that the trunk and extremities should always be supported when moving this infant
C)Teaching the family how to care for an infant postop spinal surgery
D)Teaching the family how to care for an infant in traction

Question 11

An infant has just returned from surgery for correction of bilateral congenital clubfeet. The infant has bilateral long-leg casts. The toes on both feet are edematous, but there is color, sensitivity, and movement to them. What should the nurse do first?

A)Apply a warm, moist pack to the feet.
B)Elevate the infant's legs on pillows.
C)Encourage movement of the toes.
D)Call the physician to report the edema.

Question 12

A six-year-old boy is admitted to the hospital with a diagnosis of osteomyelitis of the left femur. The plan of care includes a two-week round of intravenous antibiotics. The father questions why the child must be hospitalized and why the child cannot receive oral antibiotics. The nurse explains:

A)The antibiotic of choice is not available in oral form.
B)Blood flow to bones is limited, and parenteral administration is necessary to get appropriate blood levels.
C)Because the child is older now, it is harder to get the child to cooperate with oral antibiotics.
D)Because two weeks of therapy is necessary, the intravenous route will produce fewer side effects.

Question 13

A two-year-old child is placed in balanced Bryant's traction for a fractured right femur. Which finding by the nurse should be reported to the surgeon?

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

Question 14

A child has experienced a sprain of the right ankle. The school nurse should:

A)Leave the ankle open to the air and avoid compressing the area to allow tissue swelling as necessary.
B)Perform passive range-of-motion to the extremity.
C)Lower the extremity below the level of the heart.
D)Apply ice to the extremity.

Question 15

The nurse in the newborn nursery is doing the admission assessment on a neonate. Which assessment finding would lead the nurse to suspect unilateral congenital hip dysplasia?

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

Question 16

While at recess, a child falls and hurts his arm. The school nurse is called and suspects a fractured arm. The nurse will apply a splint before transporting the child to the hospital. The nurse will ensure that:

A)The splint is applied firmly enough to prevent swelling.
B)The arm is fully extended in the splint.
C)The splint is fully padded to prevent skin damage.
D)The joints above and below the suspected fracture are immobilized.

Question 17

The nurse is teaching a family how to care for their infant in a Pavlik harness to treat congenital developmental dysplasia of the hip. Which instruction is appropriate for the nurse to include in parental education in relation to the Pavlik harness?

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 using a thin, superabsorbent, disposable diaper.