Musculoskeletal
4. The nurse is teaching about congenital clubfoot in infants. The nurse evaluates the teaching as successful when the parent states that clubfoot is best treated when? 1. Immediately after diagnosis. 2. At age 4 to 6 months. 3. Prior to walking (age 9 to 12 months). 4. After walking is established (age 15 to 18 months).
1
65. A nurse is caring for a 5-year-old who has a fracture of the tibia involving the growth plate. When providing information to the parents, the nurse should indicate that: 1. This is a serious injury that could cause long-term growth issues. 2. The fracture usually heals within 6 weeks without further complications. 3. The child will never be able to play contact sports. 4. Fractures involving the growth plate require pain medication.
1
63. Nursing care of a child with a fractured extremity in whom there is suspected compartment syndrome includes which of the following? Select all that apply. 1. Assess pain. 2. Assess pulses. 3. Elevate extremity above the level of the heart. 4. Monitor capillary refi ll. 5. Provide pain medication as needed.
1, 2, 4, 5
A 17 year old comes to visit the school nurse after recess. He states "I rolled my ankle during gym." The school nurse's assessment does not reveal cause for potential fracture, and the school nurse is describing home care to the teen. Which of the following are components of the POLICE mnemonic? 1. Protect the affected joint 2. Optimal loading of the affected extremity 3. Complete rest of the affected extremity 4. Compression of the affected joint 5. Ice application 6. Heat application 7. Exercise of the affected extremity
1, 2, 4, 5
During a soccer game, a 10 year old is noted to trip, landing awkwardly with his right arm outstretched. He now complains of wrist pain. The nurse goes to assess the patient, and knows that which of the following are signs and symptoms that are consistent with a fracture? Select all that apply 1. Pinpoint tenderness 2. Guarding of the extremity 3. Increased range of motion 4. Deformity of the extremity 5. Crepitus
1, 2, 4, 5
Which musculoskeletal deformity would be considered to be a normal variation in development (if not extreme) at 2-7yrs? 1. clubfoot 2. genu valgum 3. metatarus adductus 4. internal tibial torsion 5. genu varum 6. internal femoral torsion
2
18. The parent of a 3-week-old states that the infant was recasted this morning for clubfoot and has been crying for the past hour. Which intervention should the nurse suggest the parent do fi rst? 1. Give pain medication. 2. Reposition the infant in the crib. 3. Check the neurocirculatory status of the foot. 4. Use a cool blow-dryer to blow into the cast to control itching.
3
27. A 12-year-old diagnosed with scoliosis is to wear a brace for 23 hours a day. What is the most likely reason the child will not wear it for that long? 1. Pain from the brace. 2. Diffi culty in putting the brace on. 3. Self-consciousness about appearance. 4. Not understanding what the brace is for.
3
12. Which should be included in teaching a family about postsurgical care for slipped capital femoral epiphysis (SCFE)? Select all that apply. 1. The client will receive help with weight-bearing ambulation 24 to 48 hours after surgery. 2. Monitoring of pain medication to prevent drug dependence. 3. Instruction on pin site care. 4. Offering low-calorie meals to encourage weight loss. 5. Correct use of crutches by the client. 6. Exercises to strengthen hip and leg muscles.
3, 5, 6
11. Which should be obtained to make a diagnosis of slipped capital femoral epiphysis (SCFE)? 1. A history of hip trauma. 2. A physical examination of hip, thigh, and knees. 3. A complete blood count. 4. A radiographic examination of the hip.
4
2. Which should the nurse stress to the parents of an infant in a Pavlik harness for treatment of developmental dysplasia of the hip (DDH)? 1. Put socks on over the foot pieces of the harness to help stabilize the harness. 2. Use lotions or powder on the skin to prevent rubbing of straps. 3. Remove harness during diaper changes for ease of cleaning diaper area. 4. Check under the straps at least two to three times daily for red areas.
4
Which musculoskeletal deformity would be considered to be a normal variation in development (if not extreme) before 2yrs? 1. clubfoot 2. genu valgum 3. metatarus adductus 4. internal tibial torsion 5. genu varum 6. internal femoral torsion
5
35. Which condition is the Pavlik harness used to treat?
DDH in neonates
