Question 1

A child hospitalized for treatment of osteomyelitis complains that he is tired of being sick and wants to know when the antibiotic protocol will end. The nurse responds that antibiotic therapy will probably last for:

Accepted Answer

A)   2 weeks
B)   6 weeks
C)   2 months
D)   3 months B

Question 2

The nurse reminds the adolescent boy with Ewing's sarcoma that he is prohibited from vigorous weight-bearing during treatment with radiation to reduce the risk of a ____________________ fracture.

Accepted Answer

pathological
Explanation: The bone has lost its integrity because of the cancer and the following radiation. Excessive or vigorous weight bearing can cause a pathological fracture of the compromised bone.

Question 3

The nurse demonstrates how all traction devices: Select all that apply.

Accepted Answer

A)   Pull the limb into extension
B)   Decrease muscle spasm
C)   Reduce pain
D)   Align two bone fragments
E)   Immobilize the limb A, B, D, E

Question 4

In planning teaching to parents of a child with Legg-Calvé-Perthes disease about the long-term effects of this disease, the nurse would include that:

Accepted Answer

A)   There are no long-term effects.
B)   The disease is self-limiting, resolving itself in a year.
C)   Degenerative arthritis may develop later in life.
D)   There is risk of osteogenic sarcoma in adulthood.

Question 5

The nurse assessing a child with juvenile rheumatoid arthritis notes the child's right knee and ankle are swollen, warm, and tender. This finding is suggestive of the _____ type of juvenile rheumatoid arthritis.

Accepted Answer

A)   Pauciarticular
B)   Polyarticular
C)   Systemic
D)   Acute febrile

Question 6

The nurse explains that Russell traction is a type of skin traction that:

Accepted Answer

A)   Subluxates the tibia
B)   Does not interfere with range of motion
C)   Prevents the knee from flexing
D)   Supplies continuous pull in two directions

Question 7

The nurse explains that Bryant's traction is reserved for children who weigh less than ____________________ pounds.

Accepted Answer

The answer of The nurse explains that Bryant's traction is...

Question 8

The nurse caring for a child in Bryant's traction knows that the risk of serious complications will be reduced by ensuring that:

Accepted Answer

A)   Neurovascular checks are done frequently
B)   Ace bandages are wrapped tightly
C)   The baby is restrained from rolling over
D)   The child's buttocks are resting on the bed

Question 9

The child with Duchenne's muscular dystrophy must push on his legs and "walk up the leg" in order to rise to a standing position. The nurse recognizes this characteristic behavior as ____________________ maneuver.

Accepted Answer

The answer of The child with Duchenne's muscular dystrophy must...

Question 10

The nurse providing instructions to an adolescent who has been fitted with a Milwaukee brace would teach the patient to:

Accepted Answer

A)   Wear the brace directly against the skin.
B)   Wear the brace over regular clothing.
C)   Wear the brace over a T-shirt 23 hours a day.
D)   Remove the brace before sleeping.

Question 11

The nurse caring for a child in Buck's skin traction will keep the:

Accepted Answer

A)   Child in high-Fowler's position
B)   Child pulled up in bed
C)   Child's heel on the bed surface
D)   Child's feet against the foot of the bed

Question 12

The nurse, assessing the neurovascular status of a child in Russell traction, should report immediately the finding of:

Accepted Answer

A)   Skin warm to the touch
B)   Capillary refill less than 30 seconds
C)   Ability to wiggle toes
D)   Bluish coloration of skin

Question 13

When caring for a child in Buck's extension, the nurse would include:

Accepted Answer

A)   Positioning the child with hips flexed 90° at all times
B)   Keeping the weights in contact with the floor
C)   Checking for skin irritation from traction equipment
D)   Releasing the weights on a schedule

Question 14

The interventions that would be helpful in relieving morning discomfort associated with juvenile rheumatoid arthritis would be:

Accepted Answer

A)   Wearing splints at night to prevent extension contractures
B)   Applying moist heat packs upon awakening
C)   Taking a warm tub bath the evening before
D)   Sleeping with two pillows under the head

Question 15

The nurse notes as an abnormal finding on a musculoskeletal assessment of a 4-year-old that the child:

Accepted Answer

A)   Has inward-turned knees while standing
B)   Walks on his toes
C)   Appears to have flat feet
D)   Swings his arms when walking

Question 16

A nurse assessing a preadolescent child for scoliosis would:

Accepted Answer

A)   Ask the child to bend forward at the waist, and would observe the child's back for asymmetry
B)   Observe the gait while the child is walking forward heel to toe
C)   Have the child flex the knees and look for uneven knee height
D)   Look at the child's shoulders and hips while fully clothed

Question 17

The nurse who is checking for capillary refill on a child in Bryant's traction will record adequate perfusion if the toe regains color in _____ seconds

Accepted Answer

A)   3
B)   4
C)   5
D)   6

Question 18

When a 13-year-old girl is diagnosed with functional scoliosis, the nurse would explain the spinal curvature defect is usually caused by:

Accepted Answer

A)   Juvenile rheumatoid arthritis
B)   Poor posture
C)   Heredity
D)   Myelomeningocele

Question 19

The nurse understands a difference in the child's skeletal system as compared to an adult's is:

Accepted Answer

A)   The child's bone is less porous than adult bone.
B)   Bone growth is not affected by fractures.
C)   Bone overgrowth in healing fractures is uncommon.
D)   Callus formation in healing fractures occurs more rapidly.

Question 20

The parent of a child with osteomyelitis asks why his child is in so much pain. The nurse's response will be based on the understanding that the pain of osteomyelitis is caused by:

Accepted Answer

A)   The pressure of inelastic bone
B)   Purulent drainage in the bone marrow
C)   The cast applied on the extremity
D)   Circulatory congestion of the skin

Exam 24: The Child With a Musculoskeletal Condition