NCLEX Child Health- Musculoskeletal
A school nurse is performing screening examinations for scoliosis. Which signs of scoliosis should the nurse assess for? Select all that apply.
1. Chest asymmetry 2. Unequal rib heights 3. Lateral deviation and rotation of each vertebra
The nurse is caring for a client with a cervical fracture who has been placed in Crutchfield tongs. Which activities should the nurse implement when caring for the child? Select all that apply.
1. Perform pin care every shift 2. Check neurological status frequently 3. Logrolls the child when repositioning 4. Checks the tongs for displacement and looseness frequently
The nurse instructs a mother of a child who had a plaster cast applied to the arm about measures that will help the cast dry. Which instructions should the nurse provide to the mother? Select all that apply.
1. Place the child on a firm mattress 2. Direct a fan toward the cast to facilitate drying 3. Support the cast and adjacent joints with pillows 4. Reposition the extremity with the cast every 2 to 4 hours
An adolescent is diagnosed with scoliosis. Which statements regarding scoliosis are correct? Select all that apply.
1. Scoliosis is an abnormal lateral curvature of the spine 2. Scoliosis is most typically diagnosed in the adolescent child 3. Surgical intervention may be necessary when severe curves exist 4. Selection of instrumentation systems to be used during surgery depends on client needs and surgeon's preferences
The nurse is monitoring a child after spinal fusion for the treatment of scoliosis for complications related to the procedure. The nurse prepares to monitor for superior mesenteric artery syndrome by assessing the child for which sign/symptom?
Abdominal discomfort and episodes of vomiting
The community health nurse is visiting a local school in the community and is performing musculoskeletal assessments of the school children. The nurse performs assessments, knowing that which child is at most risk of developing Osgood-Schlatter disease?
An active adolescent boy involved in sports activities
The nurse is caring for a child with a fracture who has been placed in skeletal traction. The nurse should monitor for the most serious complication associated with this type of traction by assessing for which specific finding?
An elevated temperature
An adolescent with juvenile idiopathic arthritis (JIA) is being admitted to the hospital. Which initial intervention should the nurse plan for?
Assess the adolescent's perception of the chronic illness.
A child has just returned from surgery and has a hip spica cast. What is the priority nursing action at this time?
Assess the child's circulatory status
The clinic nurse is performing an assessment of a 5-month-old infant suspected of having unilateral developmental dysplasia of the hip (DDH). Which assessment finding should the nurse expect to note in this condition?
Asymmetry of the gluteal skin folds when the infant is placed prone and the legs are extended against the examining table.
An adolescent is admitted to the orthopedic nursing unit after spinal rod insertion for the treatment of scoliosis. Which assessment is most important in the immediate postoperative period?
Capillary refill, sensation, and motion in all extremities
A nursing student is preparing to conduct a clinical conference regarding cerebral palsy. Which characteristic related to this disorder should the student plan to include in the discussion?
Cerebral palsy is a chronic disability characterized by difficulty with muscle control
The nurse is caring for an infant with spina bifida cystica (meningomyelocele type) who had the sac surgically removed. The nurse plans which intervention in the postoperative period to maintain the infant's safety?
Elevating the head with the infant in the prone position
A school-age child sustains a fracture along the epiphyseal line of the femur following a fall from the garage roof. What long-term effect might result with this type of fracture?
Growth disturbance
The clinic nurse provides instructions to the parents of an infant with hip dysplasia regarding care of the Pavlik harness. Which statement made by one of the parents indicates an understanding of the use of the harness?
I can remove the harness to bathe my infant
The nurse provides instructions about cast care to the parents of a child with a short arm cast. Which statement by a parent indicates that further teaching is necessary regarding cast care?
I can use a ruler padded with gauze to scratch under the cast
An adolescent client is preparing for discharge after spinal fusion with instrumentation for the treatment of scoliosis. Which statement by the adolescent indicates the need for further teaching?
I will not be able to go rollerblading for the first few weeks after surgery
The nurse is developing a plan of care for a newborn diagnosed with bilateral club feet. Which instruction should the nurse plan to include in the parents education?
If casting is needed, it will begin at birth and continue for 12 weeks, at which time the condition will be reevaluated
The nurse develops a plan of care for an adolescent being admitted to the hospital for treatment of a slipped capital femoral epiphysis (SCFE). What is the appropriate problem for this client?
Impaired mobility and confinement to bed
A 2-year-old child is admitted to the hospital with juvenile idiopathic arthritis (JIA). During the focused assessment, the nurse makes it a priority to note the presence of which finding?
Increased irritability and the child's insistence to be carried
A child with juvenile idiopathic arthritis (JIA) is seen in the clinic for a routine visit. The child tells the nurse that she has a difficult time getting out of bed in the morning because of early morning stiffness. Which response to the child is appropriate?
It might help to use a sleeping bag at night to stay warm
The nurse is developing a plan of care for a child with a diagnosis of juvenile idiopathic arthritis. Which is a priority for this child?
Pain
To prepare a school-age child with cerebral palsy (CP) for school, the nurse should establish goals to help the child achieve maximum potential for locomotion, self-care, and socialization. What action will assist the nurse in achieving these goals?
Placing the child on a wheeled scooter board or similar device to allow independent movement
The nurse is developing a plan of care for a child with juvenile idiopathic arthritis (JIA). Which evaluative statement should the nurse formulate that indicates a positive outcome for this child?
The child will experience relief from pain, as evidence by resting more comfortably and demonstrating increased levels of self-care.
A nursing student is assigned to care for a child who is in Dunlop traction. The nursing instructor reviews the plan of care with the student. Which statement by the student indicates a need for further teaching?
The elbow should be flexed at a 30-degree angle with the forearm in a neutral position
The emergency department nurse is providing instructions to the mother of a child who had a plaster cast applied to a lower arm. Which statement by the mother indicates a need for further teaching?
The fingers of the casted arm will probably be cooler than those of the other arm, and this is normal for the first few days.
A 13-year-old child is diagnosed with Ewing's sarcoma of the femur. After a course of radiation and chemotherapy, it has been decided that leg amputation is necessary. After the amputation, the child becomes very frightened because of aching and cramping felt in the missing limb. Which nursing statement is most appropriate to assist in alleviating the child's fear?
This aching and cramping is normal and temporary and will subside.
Russell's traction is prescribed for a child with a lower leg fracture. The mother of the child asks the nurse the purpose of the traction, and the nurse explains to the mother that this type of traction is used primarily for which purpose?
To reduce or realign a fracture site