Nclex-Rn Practice Questions-Care Of The Child - Musculoskeletal Disorders Part 1
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Question 1 |
A client has developed a right torticollis with side bending to the right and rotation to the left. The nurse is aware that which exercises may assist in reduction of the torticollis?
A | Rotation exercises to the right |
B | Rotation exercises to the left |
C | Cervical extension exercises |
D | Cervical flexion exercises |
Question 2 |
The nurse is caring for a client with severe scoliosis. The nurse determines that the client is at risk for which of the following?
A | Increased vital capacity |
B | Increased oxygen uptake |
C | Diminished vital capacity |
D | Decreased residual volume |
Question 3 |
Which statement by the parents of a child with crutches indicates understanding of how to safely walk down stairs?
A | “First, place the crutches on the lower step.” |
B | “Advance the fractured leg first.” |
C | “Advance the strong leg first.” |
D | “First, place the crutch on the fractured side on the lower step.” |
Question 4 |
During a scoliosis screening, a school nurse notices a raised iliac crest height. She should suspect which condition?
A | Forward head posture |
B | Leg length discrepancy |
C | Increased lumbar lordosis |
D | Increased thoracic kyphosis |
Question 5 |
The school nurse is providing instructions on scoliosis screening for the student nurses. The nurse explains that which structure is best to observe when screening a child?
A | Iliac crests |
B | Spinous processes |
C | Acromion processes |
D | Posterior superior iliac spines |
Question 6 |
Which intervention may be a possible treatment choice for talipes equinovarus?
A | Traction |
B | Serial casting |
C | Short leg braces |
D | Inversion range-of-motion exercises |
Question 7 |
Which observation by a nurse indicates that the parent of a neonate with developmental dysplasia of the hip understands the discharge teaching?
A | A folded towel is placed between the infant’s legs. |
B | The infant is wearing three diapers. |
C | The infant is tightly swaddled in a blanket. |
D | The infant is placed in a prone position to sleep. |
Question 8 |
A physical therapist has instructed the nursing staff in range-of-motion (ROM) exercises for an infant with torticollis. The nurse is uncomfortable performing the exercises that result in crying and grimacing of the client. What is the most important action for the nurse to take?
A | Check the primary health care provider’s orders. |
B | Call the primary health care provider. |
C | Call the physical therapist. |
D | Discontinue the exercises. |
Question 9 |
The nurse determines that an adolescent client with scoliosis understands the treatment plan when the client makes which statement?
A | “I will have to wear a brace for several years.” |
B | “I can put on the brace after I get home from school.” |
C | “I should avoid any exercise that will stretch my spine.” |
D | “I can remove the brace at night.” |
Question 10 |
A mother of a neonate with clubfoot feels guilty because she believes she did something to cause the condition and asks the nurse how this happened to her baby. The nurse should explain that the cause of clubfoot is:
A | unknown. |
B | hereditary. |
C | due to restricted movement in utero. |
D | an anomalous embryonic development. |
Question 11 |
The nurse is aware that the strengthening of which muscle group is important for a client diagnosed with talipes equinovarus?
A | Evertors |
B | Invertors |
C | Plantar flexors |
D | Plantar fascia musculature |
Question 12 |
The Milwaukee brace is commonly used in the treatment of scoliosis. Which position best describes the placement of the pressure rods?
A | Laterally on convex portion of the curve |
B | Laterally on concave portion of the curve |
C | Posteriorly on convex portion of the curve |
D | Posteriorly along the spinal column at the exact level of the curve |
Question 13 |
The parents of an infant born with clubfoot express feelings of guilt and anxiety about their child’s condition to the nurse. What is the most appropriate intervention by the nurse?
A | Teach them about their child’s condition. |
B | Introduce them to other parents whose children have the same condition. |
C | Ask if they would like to speak with the chaplain. |
D | Encourage discussion of their feelings. |
Question 14 |
The nurse is caring for a child with a newly applied wet hip-spica cast. What is the most important nursing intervention?
A | Use the abductor bar to help move the child. |
B | Cover the cast in plastic to keep it clean. |
C | Reposition the child every 1 to 2 hours. |
D | Use the fingertips when handling the cast. |
Question 15 |
When performing stretches with a child who has scoliosis, which technique should be used by the nurse?
A | Slow and sustained |
B | Until a change in muscle length is seen |
C | Quick movements to the end range of pain |
D | Slow movements for brief, 3- to 4-second periods |
Question 16 |
Which technique may assist a 3-month-old client diagnosed with torticollis?
A | Lying supine |
B | Gentle massage |
C | Range-of-motion (ROM) exercises |
D | Lying on the side |
Question 17 |
A nurse is teaching the parents of a 3-month-old infant with severe torticollis who has presented with the head rotated to the left and the side bent to the right. The nurse determines that teaching has been effective when the parents identify which muscle as being shortened?
A | Left upper trapezius |
B | Right middle trapezius |
C | Left sternocleidomastoid |
D | Right sternocleidomastoid |
Question 18 |
The parents of a 4-year-old child diagnosed with cerebral palsy and resultant thoracic scoliosis ask the nurse what caused the scoliosis. What is the best response by the nurse?
A | Hypotonia |
B | Mental retardation |
C | Autonomic dysreflexia |
D | Increased thoracic kyphosis |
Question 19 |
A child has just returned to his room with a cast on his leg after open reduction of a fractured femur. The nurse assesses the child and notes a 6 cm by 10 cm area of blood on the cast. What is the most important action for the nurse to take?
A | Tape gauze pads over the bloody area. |
B | Mark the bloody drainage and monitor hourly. |
C | Assess vital signs. |
D | Call the physician. |
Question 20 |
Which nursing diagnosis has the highest priority in a 6-year-old child who had a plaster cast applied 6 hours ago to the left leg for a fracture of the tibia?
A | Deficient knowledge |
B | Impaired physical mobility |
C | Risk for peripheral neurovascular dysfunction |
D | Dressing self-care deficit |
Question 21 |
A school nurse is performing a scoliosis screening on a group of students. Which student would most commonly develop this condition?
A | A 7-year-old girl |
B | A 7-year-old boy |
C | A 13-year-old girl |
D | A 13-year old boy |
Question 22 |
Which statement by the father of an 8-year-old boy with Duchenne’s muscular dystrophy indicates that he has realistic expectations about the course of the disease?
A | “My son will gradually lose his ability to walk.” |
B | “Corticosteroids will help prevent muscle degeneration.” |
C | “Surgery will help my son walk.” |
D | “My son will have a normal lifespan.” |
Question 23 |
Which observation by a nurse indicates proper fit of crutches in a 9-yearold boy?
A | The crutches fit snugly under the axilla. |
B | The crutches end 2 in. (5 cm) below the axilla. |
C | The elbow is flexed 60 degrees. |
D | The elbow is flexed 90 degrees. |
Question 24 |
A 9-month-old infant has torticollis with rotation of the head to the left and side bending to the right. The nurse is aware that placing the infant in which position would be most effective for developing muscle lengthening?
A | Prone |
B | Supine |
C | Left side-lying |
D | Right side-lying |
Question 25 |
A nurse is caring for a 10-year old in Buck’s traction for a fractured femur following a bicycle accident. The child complains of increasing pain 1 hour after receiving an I.V. opioid analgesic. What is the most appropriate action by the nurse?
A | Tell the child that he needs to give the analgesic time to work. |
B | Perform a neurovascular assessment. |
C | Make sure the weights are hanging freely. |
D | Administer more analgesics. |
Question 26 |
A nurse is teaching a 13-year-old girl diagnosed with scoliosis and her parents how to apply a Milwaukee brace. Which action should the nurse do first?
A | Refer them to a scoliosis support group. |
B | Ask them to read the brochure that comes with the brace and then answer their questions. |
C | Ask them what they already know about the brace and answer their questions. |
D | Develop learning objectives and then explain them to the parents and teen. |
Question 27 |
A nurse is caring for a 15-year old who sustained a fracture of the femur 24 hours ago. Which finding would alert the nurse to an early complication?
A | Pain |
B | Local swelling |
C | Loss of function |
D | Dyspnea |
Question 28 |
Which observation by a nurse indicates that an 18-month-old in Bryant’s traction is properly positioned?
A | The hips are resting on the bed. |
B | The hips are slightly elevated off the bed. |
C | The hips are elevated above the level of the heart. |
D | The hips are resting on a pillow. |
Question 29 |
A nurse is caring for a child who received a hip-spica cast 24 hours ago for hip dysplasia. Which nursing diagnosis should the nurse give the highest priority?
A | Impaired gas exchange |
B | Risk for peripheral neurovascular dysfunction |
C | Risk for impaired skin integrity |
D | Urinary retention |
Question 30 |
The nurse is caring for a child with a Harrington instrumentation rod placement. While assessing the child on the second postoperative day, the nurse is most concerned when the data include which finding?
A | Fever of 99.5° F (37.5° C) |
B | Pain along the incision |
C | Decreased urinary output |
D | Hypoactive bowel sounds |
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