Ch 48 PEDS Musculoskeletal Practice Questions

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)?

-Positive Ortolani sign -Unequal gluteal folds

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

-abdominal mass -sore throat and ear pain -ecchymosis of conjunctiva

A school-age child is diagnosed with systemic lupus erythematosus (SLE). The nurse should plan to implement which interventions for this child (Select all that apply)?

-instructions to avoid exposure to sunlight -teaching about body changes associated w/ SLE

The nurse is caring for a preschool child with a cast applied recently for a fractured tibia. Which assessment findings indicate possible compartment syndrome (Select all that apply)?

-severe pain not relieved by analgesics -tinging of extremity -inability to move extremity

When infants are seen for fractures, which nursing intervention is a priority?

Assess for child abuse. Fractures in infants are often nonaccidental

An appropriate nursing intervention when caring for a child in traction is to:

Assess for tightness, weakness, or contractures in uninvolved joints and muscles.

The nurse uses the palms of the hands when handling a wet cast to:

Avoid identing the cast

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

Growth can be affected by this type of fracture

The primary method of treating osteomyelitis is:

Intravenous antibiotic therapy

Which medication is usually tried first when a child is diagnosed with juvenile idiopathic arthritis (JIA)?

NSAIDs

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

Nasogastric intubation and urinary catheter may be required

Four-year-old David is placed in Bucks extension traction for Legg-Calv-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?

Notify the practitioner of the changes noted

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

Return to the clinic every 1-2 wks

Discharge planning for the child with juvenile arthritis includes the need for:

Routine ophthalmologic examinations to assess for visual problems.

Which type of traction uses skin traction on the lower leg and a padded sling under the knee?

Russell

An important nursing consideration when caring for a child with juvenile idiopathic arthritis (JIA) is to

Teach child and family the correct administration of meds

A 4-year-old child is newly diagnosed with Legg-Calv-Perthes disease. Nursing considerations should include which action?

Teaching the family the care and management of the corrective appliance

When assessing the child with osteogenesis imperfecta, the nurse should expect to observe:

discolored teeth

A neonate is born with mild clubfeet. When the parents ask the nurse how this will be corrected, the nurse should explain that:

frequent, serial casting is tried first

What would cause a nurse to suspect that an infection has developed under a cast?

hot spots felt on cast surface

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

kyphosis

Which condition can result from the bone demineralization associated with immobility?

osteoporosis

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

simple

A child is upset because, when the cast is removed from her leg, the skin surface is caked with desquamated skin and sebaceous secretions. What should the nurse suggest to remove this material?

soak in a bathtub

What is most descriptive of the therapeutic management of osteosarcoma?

treatment usually consists of surgery and chemo

What effect does immobilization have on the cardiovascular system?

venous stasis

Which statement is accurate concerning a childs musculoskeletal system and how it may be different from an adults?

Because soft tissues are resilient in children, dislocations and sprains are less common than in adults

The nurse is teaching the parents of a 7-year-old child who has just had a cast applied for a fractured arm with the wrist and elbow immobilized. Which instructions should be included in the teaching?

Elevate casted arm when resting and when sitting up.

Which nursing intervention is appropriate to assess for neurovascular competency in a child who fell off the monkey bars at school and hurt his arm?

The skin color, temp, movement, sensation, and cap refill of the extremity

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?

We're glad there is a cure for this disorder

An adolescent is scheduled for a leg amputation in 2 days for treatment of osteosarcoma. The nurses approach should include:

answering questions w/ straightforward honesty

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

apply ice

Which interaction is part of the discharge plan for a school-age child with osteomyelitis who is receiving home antibiotic therapy?

arrangements for tutoring and schoolwork

The nurse is caring for a 4-year-old child immobilized by a fractured hip. Which complications should the nurse monitor?

decreased metabolic rate

An advantage to using a fiberglass cast instead of a plaster cast is that a fiberglass cast:

dries rapidly

When does idiopathic scoliosis become most noticeable?

during preadolescent growth spurt

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

femur