Question 1

A 10-year-old child has had a sunken chest since birth,but has recently been noted to have activity intolerance when playing.Which diagnostic testing does the nurse teach the child and parents about?

Accepted Answer

A)  Chest x-ray 
B)  Chromosome analysis 
C)  ECG and echocardiogram 
D)  Pulmonary function studies 
E)  Ultrasound of the chest

Question 2

A 15-year-old boy is brought to the emergency room by his parents following an injury to his arm that occurred during football practice.The x-ray shows a diagonal line that coils around the bone.Based on this x-ray,which type of fracture does the nurse prepare to teach the family about?

Accepted Answer

A)  Greenstick 
B)  Oblique 
C)  Spiral 
D)  Transverse

Question 3

A nurse is completing a Pediatric Fall Risk Assessment on a child.The child has had no falls in the last 3 months,had surgery to repair a femur fracture on admission,is learning to use crutches,has a saline lock,is oriented to own ability,and is on narcotics.This child's fall risk score is ____________________.

Accepted Answer

The answer of A nurse is completing a Pediatric Fall...

Question 4

A nurse is teaching part of a babysitting class to teenagers.Which information about fractures does the nurse include in the lesson?

Accepted Answer

A)  Approximately 10% to 15% of childhood injuries are fractures. 
B)  Bicycle crashes account for many fractures . 
C)  Girls rarely have stress fractures from sports. 
D)  New bone growth is complete in 6 weeks. 
E)  Some fractures can interrupt normal growth.

Question 5

A child is going home with a distractor in place after surgery to repair syndactyly.Which discharge teaching is most important?

Accepted Answer

A)  Clean around the pin sites twice a day with soap and water. 
B)  Don't pull the pins; they will gradually fall out on their own. 
C)  Perform range-of-motion exercises to the affected fingers daily. 
D)  Turn the screw with the Allen wrench twice a day for a week.

Question 6

An 8-year-old girl has a third-degree sprain of the ankle.Based on this diagnosis,which teaching points will the nurse include in the teaching plan for this patient and family?

Accepted Answer

A)  The ligament is only stretched and the affected joint is stable. 
B)  The patient cannot bear weight or use the extremity. 
C)  There is severe pain over the joint, making an exam difficult. 
D)  There is full range of motion and weight bearing. 
E)  Sprains and strains are unusual in a child this age.

Question 7

A nurse is caring for a patient with juvenile arthritis during an exacerbation.The child weighs 95 lb (43 kg).The physician orders sulfasalazine (Azulfidine)to be given in two divided doses per day.The safe dose range for a single dose of this drug for this child is ____________________ mg per dose.

Accepted Answer

The answer of A nurse is caring for a patient...

Question 8

An infant hospitalized with multiple fractures has just been diagnosed with osteogenesis imperfecta.The nurse finds the parents crying.Which response by the nurse is the most appropriate?

Accepted Answer

A)  "I know how you feel. I would be upset to find this out too." 
B)  "There is medicine that can allow her to live a normal life." 
C)  "Would you like me to help you with holding your baby?" 
D)  "You are actually lucky; many of these babies die at birth."

Question 9

A home health-care nurse is visiting a child with Duchenne's muscular dystrophy (MD).The child has a new cough,poor appetite,fatigue,and a reddened area on his coccyx from sitting in his wheelchair all day.What intervention by the nurse takes priority?

Accepted Answer

A)  Assess the child for his favorite high-protein foods. 
B)  Develop a protocol for changing positions more often. 
C)  Encourage the family to allow the child plenty of rest. 
D)  Notify the health-care provider and request antibiotics.

Question 10

The nurse is providing care to a pediatric patient who suffered an ankle sprain.Which interventions are appropriate to include in the patient's plan of care?

Accepted Answer

A)  Apply an Ace wrap to apply pressure and reduce swelling of the joint. 
B)  Apply heat to the extremity for the first 48 hours at 15-minute intervals. 
C)  Elevate and move the affected joint to reduce swelling and stiffness. 
D)  Immediately perform range-of-motion exercises on the extremity. 
E)  Place ice on the injury for 15 minutes at a time for the first 1 to 2 days.

Question 11

The student nurse studying the anatomy of the musculoskeletal system understands that bones are classified by their size and shape.How does the student classify the pelvis?

Accepted Answer

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

Question 12

A nurse is caring for a patient in Crutchfield tongs.Which assessment finding requires immediate notification to the health-care provider?

Accepted Answer

A)  Altered mental status 
B)  Crusted drainage at pin sites 
C)  Irritability and pain 
D)  WBCs of 98,000/mm3

Question 13

A child who has been limping for several weeks is brought to the clinic and undergoes radiological studies.The results show osteonecrosis.Which information does the nurse plan to teach the parents about their child's condition?

Accepted Answer

A)  Non-weight-bearing status and mobility limitations 
B)  Overcorrection with serial casting for 2-3 years 
C)  Surgical correction with the Z-plasty technique 
D)  Wearing and caring for a Browne splint

Question 14

A pediatrician asks a patient with a knee injury to squat.Which disorder is this patient suspected of having?

Accepted Answer

A)  Juvenile arthritis 
B)  Muscular dystrophy 
C)  Osgood-Schlatter disease 
D)  Osteomyelitis

Question 15

The parents of a 3-year old cannot understand how their child has developed osteoporosis,stating "We didn't think children could get this disease." Which assessment by the nurse is most important?

Accepted Answer

A)  Attainment of developmental milestones 
B)  Dietary intake of calcium 
C)  Height and weight 
D)  Labor and birth history

Question 16

A woman who wishes to become pregnant again consults with the nurse about preventing her child from being born with clubfoot.She has two other children,both treated for this disorder.Which information does the nurse provide about preventing clubfoot?

Accepted Answer

A)  Avoid secondhand cigarette smoke while pregnant 
B)  Fetal positioning in utero cannot be controlled 
C)  Getting enough folic acid early in pregnancy is advisable. 
D)  The disorder is genetic so no prevention is available.

Question 17

A child has been hospitalized with an acute-grade IV slipped femoral capital epiphysis (SFCE)and is on bedrest awaiting surgical correction.A new nurse places the following interventions on the child's care plan.Which intervention leads the experienced nurse to intervene?

Accepted Answer

A)  Consult child-life therapist for diversionary activities. 
B)  Perform range-of-motion exercises to both lower extremities. 
C)  Reinforce teaching on crutch-walking postoperatively. 
D)  Teach child and family about non-weight-bearing status.

Question 18

An adolescent expresses frustration over how long his football injury to a tendon is taking to heal.Which response by the nurse is the most appropriate?

Accepted Answer

A)  "I'll ask the doctor to check for a tendon infection." 
B)  "Often these injuries never fully heal and return to normal." 
C)  "Tendons have a poor blood supply, so healing is slow." 
D)  "You have to be more compliant with immobilization."

Question 19

A child has been hospitalized with suspected osteomyelitis.The child's white blood cell count (WBC)is 22,000/mm³ and his C-reactive protein is 15 mg/dL.Which conclusion by the nurse is appropriate based on these laboratory values?

Accepted Answer

A)  The child has an infection somewhere. 
B)  The child has osteomyelitis. 
C)  The child is immunocompromised. 
D)  These tests are not related to the condition.

Question 20

The nurse is providing care to a pediatric patient admitted for a workup of bone deformity.The latest laboratory values indicate calcium at 6.6 mg/dL and phosphorus at 2.1 mg/dL.Which condition does the nurse correlate with these values?

Accepted Answer

A)  Muscular dystrophy 
B)  Osgood-Schlatter disease 
C)  Rickets 
D)  Scoliosis

Exam 29: Caring for the Child With a Musculoskeletal Condition