Nursing Care of the Child With an Alteration in Mobility/Neuromuscular or Musculoskeletal Disorder

The nurse is caring for an 8-year-old child in traction. The client has been in an acute care setting for 2 weeks and will require an additional 10 days in the hospital. The client is showing signs of regression with thumb sucking and pleas for the now tattered baby blanket. What would be the most helpful intervention? a. "Let's ask your parents to bring your friend for a visit." b. "Would you like a coloring book?" c. "You are too big to suck your thumb." d. "Do you want a book to read?"

a. "Let's ask your parents to bring your friend for a visit."

A nurse is assisting the parents of an infant who requires a Pavlik harness. The parents are apprehensive about how to care for their infant and concerned about holding and playing with the infant. How can the nurse best assist the parents? a. "Let's put you in touch with other families who have experience this." b. "The infant only needs the harness for 12 weeks." c. "The harness does not hurt the infant." d. "Do no attempt to adjust the harness yourself."

a. "Let's put you in touch with other families who have experience this."

After teaching the parents of a 6-year-old child about caring for a sprained wrist, which statement by the parents indicates the need for additional teaching? a. "We'll apply a warm moist compress to the wrist for 20 minutes at a time." b. "We can wrap the wrist in an elastic bandage to help reduce the swelling." c. "We'll make sure she keeps her arm above arm level." d. "She'll need to limit any activity that involves the wrist."

a. "We'll apply a warm moist compress to the wrist for 20 minutes at a time."

A nurse is performing a physical examination of a child with a suspected fracture. Which assessment technique would the nurse assume would not be used? a. Auscultation b. Palpation c. Inspection d. Observation

a. Auscultation

The nurse is caring for a child who fractured the arm in an accident. A cast has been applied to the child's right arm. Which action(s) should the nurse implement? Select all that apply. a. Document any signs of pain b. Check capillary refill time in both arms c. Monitor the color of the nail beds in the right hand d. Wear a protective gown when moving the child's arm e. Wear sterile gloves when removing or touching the cast

a. Document any signs of pain b. Check capillary refill time in both arms c. Monitor the color of the nail beds in the right hand

A nurse is conducting a physical examination of a 5-year-old boy with spinal muscular atrophy (SMA) type 2. What assessment findings would the nurse expect to find? a. Pectus excavatum (funnel chest) b. pseudohypertrophy of the calves c. loss of the strength in hip extension d. loss of strength in ankle dorsiflexion

a. Pectus excavatum (funnel chest)

A nurse is caring for a newborn client who is diagnosed with myelomeningocele. Which nursing intervention would protect the newborn from injury? a. Place the newborn in a prone or lateral position b. Delay the parents from holding the newborn c. Place petroleum jelly gauze on the spinal sac to keep it moist d. Place a urine collection bag on newborn for the continuous leakage

a. Place the newborn in a prone or lateral position

The nurse is caring for a 3-year-old boy with a fracture of the humerus. His chart indicates "fracture is partially through the physis extending into the metaphysis." The nurse identifies this as which Salter-Harris classification? a. Type II b. Type I c. Type IV d. Type V

a. Type II

The nurse is caring for a 10-year-old girl in traction. The girl is experiencing muscle spasms associated with the traction. What would the nurse expect to administer if ordered? a. diazepam b. opioid analgesics c. alendronate d. pamidronate

a. diazepam

The nurse is working with a group of caregivers of school-aged children discussing fractures. The nurse explains that if the fragments of fractured bone are separated, the fracture is said to be: a. Incomplete b. Complete c. Greenstick d. Spiral

b. Complete

The nurse is caring for a toddler in the emergency department who has fallen out of a grocery cart. Which area of the body should the nurse avoid moving while assessing this toddler? a. lower extremiites b. head and neck c. torso d. clavicle

b. head and neck

The nurse is providing preoperative care for a newborn with myelomeningocele. Which action is the central nursing priority? a. maintain infant's body temperature b. prevent rupture or leaking of cerebrospinal fluid c. maintain infant in prone position d. keep lesion free from fecal matter or urine

b. prevent rupture or leaking of cerebrospinal fluid

The nurse cares for an infant with myelomeningocele before surgical intervention. What action will the nurse take? a. Keep the mass uncovered and dry b. Prevent cold stress using an isolette and blankets c. Cover the sac with a saline-moistened dressing d. Change position from side to side hourly

c. Cover the sac with a saline-moistened dressing

A nurse is providing care to parents whose infant has been diagnosed with spinal muscular atrophy (SMA) type 1. The parents ask the nurse to explain what this diagnosis means for their child long term. Which statement should the nurse include in the explanation? a. This an autosomal dominant disorder that affects motor and cognitive development b. The slow progression of the disorder will allow the infant to have a fairly normal childhood c. Muscular wasting results in generalized immobility and difficulty feeding and breathing d. Intense physical therapy can aide the infant in learning to sit and walk independently

c. Muscular wasting results in generalized immobility and difficulty feeding and breathing

What will be the nurse's next action after noting dimpling and a tuft of hair located in the lumbosacral area of the preschool child during examination? a. Snip the tuft of hair off close to the skin for hygienic reasons b. Move on to other assessments without calling attention to the difference c. Record and refer the finding for follow-up to the pediatrician d. Inspect for precocious hair growth in the genital and underarm areas

c. Record and refer the finding for follow-up to the pediatrician

The nurse is caring for a child diagnosed with Legg-Calvé-Perthes disease (LCPD). What is the most important nursing intervention for the nurse to include in working with this child and his caregivers? a. The nurse should provide information when the child or caregiver requests it b. The nurse should be a contact person when the child is hospitalized c. The nurse should support the caregivers in restricting activity during the treatment d. The nurse should help the caregivers to understand and help the child to effectively use the corrective devices

d. The nurse should help the caregivers to understand and help the child to effectively use the corrective devices

In caring for a child in traction, which intervention is the highest priority for the nurse? a. The nurse should monitor for decreased circulation every 4 hours b. The nurse should clean the pine sites at least once every 8 hours c. The nurse should provide age-appropriate activities for the child d. The nurse should record accurate intake and output

a. The nurse should monitor for decreased circulation every 4 hours

Which diagnostic measure is most accurate in detecting neural tube defects? a. flat plate of the lower abdomen after the 23rd week of gestation b. significant level of alpha-fetoprotein present in amniotic fluid c. amniocentesis for lecithin-sphingomyelin (L/S) ratio d. presence of high maternal levels of albumin after 12th week of gestation

b. significant level of alpha-fetoprotein present in amniotic fluid

Which of these strategies would be the first choice in attempting to maximize function in a child with muscular dystrophy? a. long leg braces b. motorized wheelchair c. manual wheelchair d. walker

a. long leg braces