Question 1

Identify one or more choices that best complete the statement or answer the question.
-The family of an infant is present in the hospital when the diagnosis of osteogenesis imperfecta is given to the infant. The nurse is responsible for care of the infant and family. Which hospital care is appropriate? Select all that apply.

Accepted Answer

- A) Avoiding excessive force when monitoring blood pressure is crucial to prevent fractures in an infant with osteogenesis imperfecta, a condition characterized by fragile bones.- C) Teaching the parents how to gently handle the infant is essential to prevent injuries and fractures.- D) Informing ancillary staff about handling precautions ensures that everyone involved in the care of the infant is aware of the need for gentle handling to prevent harm.

Question 2

The nurse is providing care to a 7-year-old child who has been diagnosed with avascular necrosis. The patient's guardians ask the nurse what to expect due to this diagnosis. Which would be appropriate information to provide to the parents?

Accepted Answer

A

Question 3

A school-aged child is refusing to use her right hand to write or type in the classroom. The child states that her wrist hurts. There is no apparent deformity, but the wrist is swollen. The child reports crashing her bike and landing on her hand 2 days prior. If fractured, which type of fracture does the child likely suffer from?

Accepted Answer

Given the child's age, the mechanism of injury (falling onto an outstretched hand), and the symptoms (swelling and pain without obvious deformity), a Torus fracture is most likely. This type of fracture is common in children due to their softer, more pliable bones. It occurs when the bone compresses upon impact, causing a buckle or bulge rather than a complete break.

Question 4

The nurse is caring for a 13-year-old patient diagnosed with adolescent idiopathic scoliosis. The curve in her back was treated by spinal fusion with rod insertion. Which is the priority nursing intervention in the postoperative period?

Accepted Answer

Maintaining oxygen saturation within normal limits is crucial after any surgery, especially one involving the spine, to ensure adequate oxygenation to all body tissues, including the spinal cord and brain. This is essential for preventing complications such as hypoxia, which can lead to further systemic issues.

Question 5

The nurse is preparing to complete assessments on children in a homeless shelter. Which assessment will assist the nurse to identify possible musculoskeletal conditions each child?

Accepted Answer

Motor development patterns are crucial for identifying possible musculoskeletal conditions in children, as they can reveal abnormalities in muscle strength, coordination, and skeletal alignment.

Question 6

An 11-year-old child who had been treated for a broken leg is having his cast removed. After removal, the child asks the nurse about playing basketball for his local league. Which should be included in the response to the child?

Accepted Answer

After a cast is removed, the affected limb is usually weaker and less flexible due to immobilization. It's important to allow time for the muscles and bones to regain strength and for the child to adapt to movements again. A period of 4 weeks is a reasonable time to allow for recovery and gradual return to physical activities like basketball, reducing the risk of reinjury. Choices B, C, and D do not provide adequate time for recovery or consider the long-term impact and rehabilitation process.

Question 7

The nurse is providing care to a preschool-aged child who has been placed in a hip Spica cast for treatment of a femur fracture. The child is given narcotic pain medication for the first 48 hours before being sent home. When providing discharge instructions to the child's parents, which is the most important?

Accepted Answer

Ensuring the cast is not too tight around the abdomen is crucial to prevent complications such as impaired circulation and breathing difficulties, which can be life-threatening.

Question 8

A 12-year-old girl is noted to walk with an uneven gait, and her shoulders appear uneven. The left shoulder sits lower than the right shoulder, and her waist appears to be tilted from side to side. Which condition is the girl most likely experiencing?

Accepted Answer

The description of an uneven gait, uneven shoulders, and a tilted waist is characteristic of scoliosis, a condition where the spine curves sideways.

Question 9

A 3-year-old, well-known to the nursing staff, is admitted to the hospital frequently for fracture treatment secondary to osteogenesis imperfecta. It is known by staff and parents that the child is fragile. The nurse develops a long-term care plan to review with the parents. Which is the priority intervention for this child's plan of care?

Accepted Answer

Teaching methods to prevent falls and injury is the priority intervention for a child with osteogenesis imperfecta (OI) because the condition makes bones more fragile and susceptible to fractures. Preventing injuries is crucial for managing OI effectively.

Question 10

A 4-year-old who had a broken arm is preparing to have the cast removed after 4 weeks. The child's parent states, "I had a cast on my arm a lot longer than that for it to heal. Are you sure the cast has been on long enough?" Which is the best response to the parent?

Accepted Answer

Children's bones do indeed heal faster than adults', which often results in shorter durations for wearing casts. This is due to their more active bone remodeling and growth processes.

Question 11

The mother of a 6-week-old patient calls the physician's office and reports her infant is irritable, running a fever, holds his hip in an "unusual" position, and was recently given antibiotics for an ear infection. Which response by the nurse is most appropriate?

Accepted Answer

The symptoms described, especially the unusual hip position combined with irritability and fever in an infant, could indicate a serious condition such as septic arthritis or osteomyelitis. Immediate medical evaluation is necessary to rule out these or other serious conditions.

Question 12

A teenaged patient arrives in the emergency department where the physician diagnoses a dislocated shoulder. It is the patient's first dislocation. Which should the nurse prepare for treatment of the dislocation?

Accepted Answer

Sedative medication is often used to relax the patient and facilitate the reduction of a dislocated shoulder.

Question 13

The nurse is providing care for a 14-year-old patient who is within the first 24 hours postoperative for scoliosis treatment. Which intervention, if performed, would demonstrate appropriate care measures?

Accepted Answer

Repositioning the patient every 2 to 4 hours is crucial in preventing pressure ulcers and promoting circulation, especially after a major surgery like scoliosis treatment. This is a standard postoperative care measure for patients who are bedridden or have limited mobility.

Question 14

Identify one or more choices that best complete the statement or answer the question.
-A 14-year-old student reports to the school nurse that he has a persistent pain and soreness in his legs. The student is part of the football team. There is no evidence of injury to the student. Which information should the nurse provide to the student? Select all that apply.

Accepted Answer

The nurse should advise the student to do stretching exercises before being active (B) to prevent muscle strains and improve flexibility, ensure that shoes and equipment fit properly and are stable (D) to prevent injuries caused by improper gear, and learn proper body mechanics for the activities (E) to reduce the risk of injury and strain by using correct techniques during physical activities.

Question 15

The nurse is caring for a child who reports he has pain in his ankle after "twisting" it during play. Which would be the most appropriate follow-up assessment to this report?

Accepted Answer

Swelling and deformity of the ankle joint are direct indicators of potential injury following a twisting motion, such as a sprain or fracture, making it the most appropriate follow-up assessment.

Question 16

The mother of a 3-month-old returns for a visit with the physician who is caring for the infant's hip dysplasia. However, the nurse notes that upon arrival, the infant is not wearing the prescribed Pavlick harness. The mother indicates she thought the infant was uncomfortable so she removed it. Which is the best response by the nurse?

Accepted Answer

The answer of The mother of a 3-month-old returns for...

Question 17

A 2-year-old child is being evaluated for a musculoskeletal disorder. The child's laboratory results indicate hypophosphatemia, a normal erythrocyte sedimentation rate, and negative rheumatoid factor. Which disorder is the child likely experiencing?

Accepted Answer

Genu varum (bowlegs) can be associated with conditions like rickets, which is characterized by hypophosphatemia due to vitamin D deficiency or phosphate metabolism disorders, fitting the child's lab results. Juvenile arthritis, septic arthritis, and avascular necrosis typically present with other specific clinical and laboratory findings not mentioned here.

Question 18

The child is visiting the clinic for a pre-sports-participation physical. Which should be included as part of the patient education to prevent musculoskeletal injury during participation?

Accepted Answer

Performing stretching exercises before play helps to warm up the muscles and increase flexibility, reducing the risk of musculoskeletal injuries during sports activities.

Question 19

A child is being treated with a hip Spica cast and preparing to be discharged home. Which statement by the parents demonstrates effective education and readiness to care for the child?

Accepted Answer

Placing the absorbent part of the diaper toward the skin helps prevent moisture from causing skin irritation under the cast, which is crucial for maintaining skin integrity.

Question 20

The nurse is caring for a child in the emergency department. The child's arm is abnormally positioned, and the child is holding the arm near that area and is crying with pain. The child's parents explain that the child fell off the bicycle when riding on the streets of this subdivision. Which is the priority care to provide to the child?

Accepted Answer

Protecting the child from further injury is the priority to prevent exacerbation of the current injury and to ensure the child's safety. Immediate measures should focus on preventing additional harm before addressing pain and discomfort.

Quiz 20: Musculoskeletal Disorders