Question 1

When does idiopathic scoliosis become most noticeable?

Accepted Answer

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

Question 2

An important nursing consideration when caring for a child with juvenile rheumatoid arthritis would be which of the following?

Accepted Answer

A)  Apply ice packs to relieve stiffness and pain.
B)  Administer acetaminophen to reduce inflammation.
C)  Teach child and family correct administration of medications.
D)  Encourage range-of-motion exercises during periods of inflammation. C

Question 3

Which of the following 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 4

Which of the following would be the most appropriate play activity for a 3-year-old child in a spica cast, considering both safety and development?

Accepted Answer

A)  Marbles
B)  Game of checkers
C)  Coloring with crayons
D)  Playing with toy telephone

Question 5

A child has just returned to the orthopedic unit after being placed in a hip spica cast. The instructions to parents for home care should include which of the following?

Accepted Answer

A)  Turn every 8 hours.
B)  Diapers should be avoided to reduce soiling of the cast.
C)  Use abduction bar between legs to aid in turning.
D)  Specially designed car seats are indicated and required.

Question 6

Immobilization causes which of the following effects on the cardiovascular system?

Accepted Answer

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

Question 7

The nurse is preparing an adolescent girl for an instrumentation procedure to treat scoliosis. Which of the following 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

Which of the following clinical manifestations of developmental dysplasia of the hip (previously called congenital hip dysplasia)  would be seen in the newborn?

Accepted Answer

A)  Positive Ortolani click
B)  Trendelenburg sign
C)  Telescoping of the affected limb
D)  Lordosis

Question 9

An adolescent is scheduled for a leg amputation in 2 days for treatment of osteosarcoma. The nurse's approach should include which of the following?

Accepted Answer

A)  Answer questions with straightforward honesty.
B)  Avoid discussing the seriousness of the condition.
C)  Explain that although the amputation is difficult, it will cure the cancer.
D)  Assist adolescent to accept the amputation as better than a long course of chemotherapy.

Question 10

A 4-year-old is newly diagnosed with Legg-Calvé-Perthes disease. Nursing considerations include which of the following?

Accepted Answer

A)  Encourage normal activity for as long as is possible.
B)  Explain the cause of the disease to the child and family.
C)  Prepare child and family for long-term, permanent disabilities.
D)  Teach family the care and management of the corrective appliance.

Question 11

The nurse is teaching a family how to care for their infant in a Pavlik harness to treat developmental dysplasia of the hip. Which of the following should be included?

Accepted Answer

A)  Apply lotion or powder to minimize skin irritation.
B)  Remove harness several times a day to prevent contractures.
C)  Necessity to return to clinic every 1 to 2 weeks.
D)  Place diaper over harness, preferably using a superabsorbent disposable diaper that is relatively thin.

Question 12

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. What should the nurse do 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.

Question 13

Which of the following would 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 D

Question 14

Which of the following terms is used to describe an abnormally increased convex angulation in the curvature of the thoracic spine?

Accepted Answer

A)  Scoliosis
B)  Ankylosis
C)  Lordosis
D)  Kyphosis

Question 15

A 7-year-old has just had a cast applied for a fractured arm with the wrist and elbow immobilized. Which of the following should be included in the home care instructions?

Accepted Answer

A)  Swelling of the fingers is to be expected.Notify a health professional if it persists more than 48 hours.
B)  The shoulder should be kept as immobile as possible to avoid pain.
C)  No restrictions of activity are indicated.
D)  Elevate casted arm when both upright and resting.

Question 16

Immobilization causes which of the following effects on metabolism?

Accepted Answer

A)  Hypocalcemia
B)  Decreased metabolic rate
C)  Positive nitrogen balance
D)  Increased production of stress hormones B

Question 17

Which of the following terms 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 18

Which of the following is a physiological effect of immobilization on children?

Accepted Answer

A)  Metabolic rate increases.
B)  Increased joint mobility can lead to contractures in a short time.
C)  Bone calcium increases, releasing excess calcium into the body (hypercalcemia) .
D)  Venous stasis can lead to thrombi and/or emboli formation.

Question 19

Osteosarcoma is the most common bone cancer in children. Where are most of the primary tumor sites?

Accepted Answer

A)  Femur
B)  Humerus
C)  Pelvis
D)  Tibia

Question 20

Kristin, age 10 years, sustained a fracture in the epiphyseal plate of her right fibula when she fell out of a tree. When discussing this injury with her parents, the nurse should consider which of the following?

Accepted Answer

A)  Healing is usually delayed in this type of fracture.
B)  Bone growth can be affected with this type of fracture.
C)  This is an unusual fracture site in young children.
D)  This type of fracture is inconsistent with a fall.

Exam 31: The Child With Musculoskeletal or Articular Dysfunction

When does idiopathic scoliosis become most noticeable?

Correct AnswerverifiedShow Answer

An important nursing consideration when caring for a child with juvenile rheumatoid arthritis would be which of the following?

Correct AnswerverifiedC

Which of the following can result from the bone demineralization associated with immobility?

Correct AnswerverifiedShow Answer

Which of the following would be the most appropriate play activity for a 3-year-old child in a spica cast, considering both safety and development?

Correct AnswerverifiedShow Answer

A child has just returned to the orthopedic unit after being placed in a hip spica cast. The instructions to parents for home care should include which of the following?

Correct AnswerverifiedShow Answer

Immobilization causes which of the following effects on the cardiovascular system?

Correct AnswerverifiedShow Answer

The nurse is preparing an adolescent girl for an instrumentation procedure to treat scoliosis. Which of the following should the nurse include?

Correct AnswerverifiedShow Answer

Which of the following clinical manifestations of developmental dysplasia of the hip (previously called congenital hip dysplasia) would be seen in the newborn?

Correct AnswerverifiedShow Answer

An adolescent is scheduled for a leg amputation in 2 days for treatment of osteosarcoma. The nurse's approach should include which of the following?

Correct AnswerverifiedShow Answer

A 4-year-old is newly diagnosed with Legg-Calvé-Perthes disease. Nursing considerations include which of the following?

Correct AnswerverifiedShow Answer

The nurse is teaching a family how to care for their infant in a Pavlik harness to treat developmental dysplasia of the hip. Which of the following should be included?

Correct AnswerverifiedShow Answer

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. What should the nurse do first?

Correct AnswerverifiedShow Answer

Which of the following would cause a nurse to suspect that an infection has developed under a cast?

Correct AnswerverifiedD

Which of the following terms is used to describe an abnormally increased convex angulation in the curvature of the thoracic spine?

Correct AnswerverifiedShow Answer

A 7-year-old has just had a cast applied for a fractured arm with the wrist and elbow immobilized. Which of the following should be included in the home care instructions?

Correct AnswerverifiedShow Answer

Immobilization causes which of the following effects on metabolism?

Correct AnswerverifiedB

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

Correct AnswerverifiedShow Answer

Which of the following is a physiological effect of immobilization on children?

Correct AnswerverifiedShow Answer

Osteosarcoma is the most common bone cancer in children. Where are most of the primary tumor sites?

Correct AnswerverifiedShow Answer

Kristin, age 10 years, sustained a fracture in the epiphyseal plate of her right fibula when she fell out of a tree. When discussing this injury with her parents, the nurse should consider which of the following?

Correct AnswerverifiedShow Answer

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D

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