Question 1

The nurse is caring for an infant with developmental dysplasia of the hip.Which clinical manifestations should the nurse expect to observe? (Select all that apply.)

Accepted Answer

A)  Positive Ortolani click
B)  Unequal gluteal folds
C)  Negative Babinski sign
D)  Trendelenburg sign
E)  Telescoping of the affected limb f. Lordosis A,B

Question 2

Four-year-old David is placed in Buck extension traction for Legg-Calvé-Perthes disease.He is crying with pain as the nurse assesses that the skin of his right foot is pale with an absence of pulse.Which action should the nurse take first?

Accepted Answer

A)  Notify the practitioner of the changes noted.
B)  Give the child medication to relieve the pain.
C)  Reposition the child and notify physician.
D)  Chart the observations and check the extremity again in 15 minutes. A

Question 3

Which is an appropriate nursing intervention when caring for a child in traction?

Accepted Answer

A)  Remove adhesive traction straps daily to prevent skin breakdown.
B)  Assess for tightness, weakness, or contractures in uninvolved joints and muscles.
C)  Provide active range-of-motion exercises to affected extremity three times a day.
D)  Keep the child in one position to maintain good alignment. B

Question 4

The nurse is taking care of an adolescent diagnosed with kyphosis.Which describes this condition?

Accepted Answer

A)  Lateral curvature of the spine
B)  Immobility of the shoulder joint
C)  Exaggerated concave lumbar curvature of the spine
D)  Increased convex angulation in the curve of the thoracic spine

Question 5

Which term is used to describe a type of fracture that does not produce a break in the skin?

Accepted Answer

A)  Simple
B)  Compound
C)  Complicated
D)  Comminuted

Question 6

The nurse is conducting a staff in-service on casts.Which is an advantage to using a fiberglass cast instead of a plaster of Paris cast?

Accepted Answer

A)  Cheaper
B)  Dries rapidly
C)  Molds closely to body parts
D)  Smooth exterior

Question 7

The nurse is preparing an adolescent with scoliosis for a Luque-rod segmental spinal instrumentation procedure.Which consideration should the nurse include?

Accepted Answer

A)  Nasogastric intubation and urinary catheter may be required.
B)  Ambulation will not be allowed for up to 3 months.
C)  Surgery eliminates the need for casting and bracing.
D)  Discomfort can be controlled with nonpharmacologic methods.

Question 8

The nurse is caring for a 12-year-old child with a left leg below the knee amputation (BKA).The child had the surgery 1 week ago.Which intervention should the nurse plan to implement for this child?

Accepted Answer

A)  Elevate the left stump on a pillow.
B)  Place ice pack on the stump.
C)  Encourage the child to use an overhead bed trapeze when repositioning.
D)  Replace the ace wrap covering the stump with a gauze dressing.

Question 9

A school nurse is conducting a staff in-service to other school nurses on idiopathic scoliosis.During which period of child development does idiopathic scoliosis become most noticeable?

Accepted Answer

A)  Newborn period
B)  When child starts to walk
C)  Preadolescent growth spurt
D)  Adolescence

Question 10

A clinic nurse is conducting a staff in-service for other clinic nurses about signs and symptoms of a rhabdomyosarcoma tumor.Which should be included in the teaching session? (Select all that apply.)

Accepted Answer

A)  Bone fractures
B)  Abdominal mass
C)  Sore throat and ear pain
D)  Headache
E)  Ecchymosis of conjunctiva

Question 11

A nurse is conducting discharge teaching for parents of an infant with osteogenesis imperfecta (OI).Further teaching is indicated if the parents make which statement?

Accepted Answer

A)  "We will be very careful handling the baby."
B)  "We will lift the baby by the buttocks when diapering."
C)  "We're glad there is a cure for this disorder."
D)  "We will schedule follow-up appointments as instructed."

Question 12

The nurse should monitor for which effect on the cardiovascular system when a child is immobilized?

Accepted Answer

A)  Venous stasis
B)  Increased vasopressor mechanism
C)  Normal distribution of blood volume
D)  Increased efficiency of orthostatic neurovascular reflexes

Question 13

A young girl has just injured her ankle at school.In addition to calling the child's parents,the most appropriate,immediate action by the school nurse is to:

Accepted Answer

A)  apply ice.
B)  observe for edema and discoloration.
C)  encourage child to assume a position of comfort.
D)  obtain parental permission for administration of acetaminophen or aspirin.

Question 14

An adolescent with a fractured femur is in Russell's traction.Surgical intervention to correct the fracture is scheduled for the morning.Nursing actions should include which action?

Accepted Answer

A)  Maintaining continuous traction until 1 hour before the scheduled surgery
B)  Maintaining continuous traction and checking position of traction frequently
C)  Releasing traction every hour to perform skin care
D)  Releasing traction once every 8 hours to check circulation

Question 15

The nurse is caring for an adolescent with osteosarcoma being admitted to undergo chemotherapy.The adolescent had a right above-the-knee amputation 2 months ago and has been experiencing "phantom limb pain." Which prescribed medication is appropriate to administer to relieve phantom limb pain?

Accepted Answer

A)  Amitriptyline (Elavil) 
B)  Hydrocodone (Vicodin) 
C)  Oxycodone (OxyContin) 
D)  Alprazolam (Xanax)

Question 16

Which can result from the bone demineralization associated with immobility?

Accepted Answer

A)  Osteoporosis
B)  Urinary retention
C)  Pooling of blood
D)  Susceptibility to infection

Question 17

An adolescent with osteosarcoma is scheduled for a leg amputation in 2 days.The nurse's approach should include which action?

Accepted Answer

A)  Answering questions with straightforward honesty
B)  Avoiding discussing the seriousness of the condition
C)  Explaining that, although the amputation is difficult, it will cure the cancer
D)  Assisting the adolescent in accepting the amputation as better than a long course of chemotherapy

Question 18

An adolescent with juvenile idiopathic arthritis (JIA)is prescribed abatacept (Orencia).Which should the nurse teach the adolescent regarding this medication? (Select all that apply.)

Accepted Answer

A)  Avoid receiving live immunizations while taking the medication.
B)  Before beginning this medication, a tuberculin screening test will be done.
C)  You will be getting a twice-a-day dose of this medication.
D)  This medication is taken orally.

Question 19

The nurse is caring for a 4-year-old child immobilized by a fractured hip.Which complication should the nurse monitor related to the child's immobilization status?

Accepted Answer

A)  Metabolic rate increases
B)  Increased joint mobility leading to contractures
C)  Bone calcium increases, releasing excess calcium into the body (hypercalcemia) 
D)  Venous stasis leading to thrombi or emboli formation

Question 20

Which should cause a nurse to suspect that an infection has developed under a cast?

Accepted Answer

A)  Complaint of paresthesia
B)  Cold toes
C)  Increased respirations
D)  "Hot spots" felt on cast surface

Exam 31: The Child with Musculoskeletal or Articular Dysfunction