Question 1

The nurse who is checking for capillary refill on a child in Bryant's traction will record adequate perfusion if the toe regains color in _____ seconds.

Accepted Answer

Capillary refill in 3 seconds or less is determined to be indicative of adequate perfusion.

Question 2

A 6-year-old sustained a fractured femur and was put in Russell traction 2 days ago.She screams in pain when she raises herself onto the bedpan.The nursing diagnosis that takes highest priority for this child is:

Accepted Answer

Although all of these nursing diagnoses are relevant to the child in traction,pain resulting from muscle spasm and tissue trauma is the highest priority.

Question 3

The nurse caring for a child in Buck's skin traction will keep the:

Accepted Answer

Buck's traction is a type of skin traction that relies on the child's weight as counterbalance The child must be kept with head elevated no more than 20 degrees,pulled up in bed,and the feet should not touch the bed surface or the foot of the bed.

Question 4

The observation that may cause the nurse to consider the possibility of child abuse when a mother says that her young child fell down the basement stairs is:

Accepted Answer

As bruises heal,they change color in stages.Different colors of bruises indicate that injuries have not all occurred at the same time.The nurse must consider whether the bruises match the caretaker's explanation of what happened.

Question 5

A nurse assessing a preadolescent child for scoliosis would:

Accepted Answer

The nurse looks at the back as the child bends forward for general body alignment and asymmetry.

Question 6

The nurse,assessing the neurovascular status of a child in Russell traction should report immediately the finding of:

Accepted Answer

Cyanosis or pallor noted in an extremity is an indication of circulatory impairment.

Question 7

The nurse caring for a child in Bryant's traction knows that the risk of serious complications will be reduced by ensuring that:

Accepted Answer

The nurse caring for a child in traction must be alert for Volkmann's ischemia,which occurs when circulation is obstructed.

Question 8

When a 13-year-old girl is diagnosed with functional scoliosis,the nurse would explain the spinal curvature defect is usually caused by:

Accepted Answer

Functional scoliosis usually is caused by poor posture,and it is not a spinal disease.

Question 9

The nurse assessing a child with juvenile rheumatoid arthritis notes the child's right knee and ankle are swollen,warm,and tender and with a temperature of 38.8 ° C (102° F)and abdominal pain.These findings suggest that this child has the ___________ type of juvenile rheumatoid arthritis.

Accepted Answer

The systemic form of juvenile rheumatoid arthritis is associated with an elevated temperature,erythrocyte sedimentation rate (ESR),and C-reactive protein;abdominal pain;and a macular rash.

Question 10

A child hospitalized for treatment of osteomyelitis complains that he is tired of being sick and wants to know when the antibiotic protocol will end.The nurse responds that antibiotic therapy will probably last for:

Accepted Answer

Because osteomyelitis is an infection in the bone,antibiotics are given intravenously for 4 to 6 weeks.

Question 11

The nurse reviewing the characteristics of Ewing's sarcoma would point out that:

Accepted Answer

Ewing's sarcoma is sensitive to radiation therapy and chemotherapy.Amputation of the affected extremity is not recommended.This cancer occurs in school-age children and does metastasize.

Question 12

The nurse explains that Russell traction is a type of skin traction that:

Accepted Answer

Russell traction is skin traction,similar to Buck's,with a sling positioned under the knee,which prevents subluxation of the tibia.Although the traction interferes with full ROM,the patient can change position without disrupting the continuous pull in two directions.

Question 13

The interventions that would be helpful in relieving morning discomfort associated with juvenile rheumatoid arthritis would be:

Accepted Answer

Application of moist heat,with a compress or by tub bath upon awakening,will help to lessen stiffness.

Question 14

The nurse caring for a child with Duchenne's muscular dystrophy notes a characteristic manifestation,which is that the child:

Accepted Answer

Frequent falling and clumsiness are clinical manifestations of Duchenne's muscular dystrophy.

Question 15

The nurse notes as an abnormal finding on a musculoskeletal assessment of a 4-year-old that the child:

Accepted Answer

Toe walking after 3 years of age may indicate a muscle problem.

Question 16

The nurse providing instructions to an adolescent who has been fitted with a Milwaukee brace would teach the patient to:

Accepted Answer

A Milwaukee brace is worn approximately 23 hours a day over a T-shirt,which protects the skin.

Question 17

The nurse is providing instructions about how to treat a sprained ankle.The nurse will recognize the need for additional teaching when the mother states:

Accepted Answer

Heat is not a treatment for soft tissue injuries.The principles of managing soft tissue injuries are rest,ice,compression,and elevation.

Question 18

The parent of a child with osteomyelitis asks why his child is in so much pain.The nurse's response will be based on the understanding that the pain of osteomyelitis is caused by:

Accepted Answer

Osteomyelitis is an infection of the bone.Inflammation produces an exudate that collects under the marrow and cortex of the bone.The vessels are compressed and thrombosis occurs,producing ischemia and pain.

Question 19

In planning teaching to parents of a child with Legg-Calvé-Perthes disease about the long-term effects of this disease,the nurse would include that:

Accepted Answer

Marked distortion of the head of the femur may lead to an imperfect joint or to degenerative arthritis of the hip later in life.

Question 20

When caring for a child in Buck's extension,the nurse would include:

Accepted Answer

The skin exposed to frequent friction may break down.

Quiz 24: The Child with a Musculoskeletal Condition