Question 1

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

Accepted Answer

The child's buttocks resting on the bed in balanced Bryant traction indicates that the traction is not applied correctly, potentially compromising circulation and healing, requiring immediate correction.

Question 2

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

Accepted Answer

Impaired color, sensitivity, and movement to lower extremities could indicate neurological compromise and requires immediate nursing action to prevent further damage. The adolescent's surgeon and health care provider should be notified immediately.

Question 3

The father of a school-age child who requires hospital admission for intravenous antibiotics to treat osteomyelitis states, "I don't understand why normal antibiotics can't be used." Which should the nurse include in the response to the father?

Accepted Answer

Osteomyelitis is an infection of the bone that is difficult to treat with oral antibiotics. Blood flow to bones is limited, and parenteral administration is necessary to get appropriate blood levels of the antibiotics to the infected area. Intravenous antibiotics are needed to ensure the infection is cleared from the bone.

Question 4

Which assessment 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?

Accepted Answer

Duchenne muscular dystrophy often presents with pseudohypertrophy of calf muscles, making the child appear more muscular despite the underlying muscle weakness.

Question 5

Which clinical manifestations should the nurse expect when assessing a pediatric client who is diagnosed with congenital hip dysplasia (CHD)? Select all that apply.

Accepted Answer

The answer of Which clinical manifestations should the nurse expect...

Question 6

Which are appropriate interventions for the nurse to include in the plan of care for a child who is receiving traction? Select all that apply.

Accepted Answer

The answer of Which are appropriate interventions for the nurse...

Question 7

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

Accepted Answer

Applying ice to the affected area is an appropriate action for a child with an ankle injury. Ice can help decrease swelling and pain.

Question 8

Which clinical manifestations should the nurse expect when assessing a pediatric client who is diagnosed with Legg-Calvé-Perthes disease? Select all that apply.

Accepted Answer

The answer of Which clinical manifestations should the nurse expect...

Question 9

Which should the nurse include in the neurovascular assessment for an infant following casting of the leg for talipes equinovarus?

Accepted Answer

The answer of Which should the nurse include in the...

Question 10

Which is the priority nursing diagnosis for nurse to use when planning care for a school-age child who must wear a brace for correction of scoliosis?

Accepted Answer

Wearing a brace for scoliosis can lead to pressure points and restricted movement, increasing the risk for impaired skin integrity due to potential skin breakdown and irritation under the brace.

Question 11

Which finding, noted during the newborn admission assessment, would lead the nurse to suspect unilateral congenital hip dysplasia?

Accepted Answer

Asymmetry of the gluteal and thigh fat folds is a common finding in unilateral congenital hip dysplasia, as the affected hip may have a shallow acetabulum and lead to dislocation or subluxation of the femoral head. Lordosis, Trendelenburg sign, and telescoping of the affected limb may indicate other musculoskeletal issues but are not specific to hip dysplasia.

Question 12

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

Accepted Answer

A) Using a spirometer every 2 hours while awake helps prevent pulmonary complications, such as pneumonia, by promoting lung expansion and clearing secretions.B) Log-rolling the client every 2 hours helps prevent pressure ulcers and maintains spinal alignment after surgery.D) Increasing fruit and grains in the diet helps prevent constipation, a common problem due to reduced mobility and the use of opioid pain medications.

Question 13

A school nurse suspects that a child who fell at recess has a fractured arm. Which should the nurse consider when applying a splint to transport the child to the hospital?

Accepted Answer

Immobilizing the joints above and below the suspected fracture is necessary to prevent any further injury during transportation. A fully padded splint should be applied to prevent skin damage, and the splint should not be applied too tightly to allow for any swelling. The arm should be positioned in a comfortable position within the splint.

Question 14

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

Accepted Answer

Compartment syndrome is characterized by increased pressure within a muscle compartment, leading to ischemia and nerve damage. Prolonged capillary refill time (C), pain not relieved by pain medication (D), and paresthesia of the affected area (E) are all indicative of compartment syndrome. A pink, warm extremity (A) and a present dorsalis pedis pulse (B) are not typically associated with compartment syndrome.

Question 15

Which parental statement would cause the nurse to include further education related to the care required for a child who is diagnosed with congenital clubfoot?

Accepted Answer

The statement "We're happy this is the only cast our baby will need" suggests that the parents may not fully understand the ongoing care and management required for a child with congenital clubfoot. The nurse should provide further education to ensure the parents are prepared for the long-term care of their child's condition.

Question 16

An infant returns to the unit following surgical correction of bilateral congenital clubfeet. The infant has bilateral long-leg casts. The nurse notes that the toes on both feet are edematous, but there is color, sensitivity, and movement to them. Which action by the nurse is the priority?

Accepted Answer

Elevating the legs on pillows will help reduce the edema by promoting venous return. Applying a warm, moist pack or encouraging movement of the toes may not necessarily help with edema reduction. Unless there are other concerning signs or symptoms, there may not be a need to call the surgical provider at this time.

Question 17

The nurse is providing care to a child who is diagnosed with Legg-Calvé-Perthes disease. Which parental statement regarding the child's care required further teaching from the nurse?

Accepted Answer

Legg-Calvé-Perthes disease can take several months to years to heal properly. Six weeks is not a sufficient timeframe for healing. Therefore, the statement regarding the length of treatment requires further clarification.

Question 18

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

Accepted Answer

Trunk and extremity support during everyday care is the priority teaching topic for the family of an infant diagnosed with osteogenesis imperfecta. This is because infants with this condition have fragile bones and are prone to fractures, even with mild trauma. Providing adequate support during everyday care can help prevent fractures and minimize the risk of injury. Cast care, postoperative spinal surgery care, and traction care may be relevant at some point, but they are not the priority teaching topic in this situation.

Question 19

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

Accepted Answer

During a scoliosis screening, the nurse should monitor for prominent scapula, a one-sided rib hump, and uneven shoulders and hips, as these are all indicative of possible scoliosis. Lordosis and pain are not necessarily specific to scoliosis and may have other causes.

Question 20

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?

Accepted Answer

Checking for red areas under the straps is important to prevent skin irritation and ensure proper fit and comfort for the infant.

Quiz 56: The Child With Alterations in Musculoskeletal Function