Nclex-Rn Practice Questions-Care Of The Child - Musculoskeletal Disorders Part 2
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Question 1 |
Which problem is most commonly encountered by adolescent females with scoliosis?
A | Respiratory distress |
B | Poor self-esteem |
C | Poor appetite |
D | Renal difficulty |
Question 2 |
How would the nurse best describe Gowers’ sign to the parents of a child with muscular dystrophy?
A | A transfer technique |
B | A waddling-type gait |
C | The pelvis position during gait |
D | Muscle twitching present during a quick stretch |
Question 3 |
A nurse is instructing a wheelchair-bound client with muscular dystrophy on exercises to best prevent skin breakdown. What is the best information for the nurse to provide?
A | Wheelchair push-ups |
B | Leaning side to side |
C | Leaning forward |
D | Gluteal sets |
Question 4 |
What findings would the nurse expect when palpating the muscles of a child with muscular dystrophy?
A | Soft on palpation |
B | Firm or woody on palpation |
C | Extremely hard on palpation |
D | No muscle consistency on palpation |
Question 5 |
A child is having increased difficulty getting out of his chair at school. Which recommendation should the nurse make to assist the child?
A | A seat cushion |
B | Long leg braces |
C | Powered wheelchair |
D | Removable armrests on wheelchair |
Question 6 |
Which of the following strategies would be the first choice in attempting to maximize function in a child with muscular dystrophy?
A | Long leg braces |
B | Motorized wheelchair |
C | Manual wheelchair |
D | Walker |
Question 7 |
To promote safe transfers in a client with muscular dystrophy, a nurse should teach exercises to maintain which muscles?
A | Gastrocnemius |
B | Gluteus maximus |
C | Hamstrings |
D | Quadriceps |
Question 8 |
The parents of a child with muscular dystrophy ask the nurse what causes this condition. What is the best response by the nurse?
A | Gene mutation |
B | Chromosomal aberration |
C | Unknown nongenetic origin |
D | Environmental factors |
Question 9 |
A child has developed difficulty ambulating and tends to walk on his toes. Which surgical technique may benefit the client?
A | Adductor release |
B | Hamstring release |
C | Plantar fascia release |
D | Achilles tendon release |
Question 10 |
The nurse is planning to teach the parents of a child with newly diagnosed muscular dystrophy about the disease. Which description accurately describes this condition?
A | A demyelinating disease |
B | Lesions of the brain cortex |
C | Upper motor neuron lesions |
D | Degeneration of muscle fibers |
Question 11 |
Which activity in a client with muscular dystrophy should a nurse anticipate the client having difficulty with first?
A | Breathing |
B | Sitting |
C | Standing |
D | Swallowing |
Question 12 |
A client with muscular dystrophy has lost complete control of his lower extremities. He has some strength bilaterally in the upper extremities but poor trunk control. Which mechanism would be the most important to have on the wheelchair?
A | Antitip device |
B | Extended breaks |
C | Headrest support |
D | Wheelchair belt |
Question 13 |
The parents of a child with Duchenne’s muscular dystrophy want to know how it is acquired. What is the most accurate response by the nurse?
A | Virus |
B | Hereditary |
C | Autoimmune factors |
D | Environmental toxins |
Question 14 |
Which condition would alert the nurse that a child might be suffering from muscular dystrophy?
A | Hypertonia of extremities |
B | Increased lumbar lordosis |
C | Upper extremity spasticity |
D | Hyperactive lower extremity reflexes |
Question 15 |
The nurse is teaching the student nurse about muscular dystrophy. The student nurse asks which form of muscular dystrophy is most common. Which response is most accurate?
A | Duchenne’s |
B | Becker’s |
C | Limb girdle |
D | Myotonic |
Question 16 |
The nurse is reviewing the laboratory tests of a child diagnosed with muscular dystrophy. Which laboratory test would aid in the diagnosis of this condition?
A | Bilirubin |
B | Creatinine |
C | Serum potassium |
D | Sodium |
Question 17 |
Which information should a nurse provide to the parents of child undergoing testing for the diagnosis of muscular dystrophy?
A | The genitals will be covered by a lead apron. |
B | A local anesthetic will be used for the test. |
C | Electrode wires will be attached to the scalp. |
D | A fiber-optic endoscope will be inserted into a joint. |
Question 18 |
When a child is suspected of having muscular dystrophy, a nurse should expect which muscles to be affected first?
A | Hip muscles |
B | Foot muscles |
C | Hand muscles |
D | Respiration muscles |
Question 19 |
Which position of the femur is accurate in relation to the acetabulum in a child with developmental dysplasia of the hip (DDH)?
A | Anterior |
B | Inferior |
C | Posterior |
D | Superior |
Question 20 |
The nurse would expect her client’s suspected developmental dysplasia of the hip (DDH) to be confirmed by which diagnostic technique?
A | X-ray |
B | Positive Ortolani’s sign |
C | Positive Trendelenburg gait |
D | Audible clicking with adduction |
Question 21 |
A young child sustains a dislocated hip as well as a subcapital fracture. The nurse is aware that the client is at greatest risk for which of the following?
A | Avascular necrosis |
B | Postsurgical infection |
C | Hemorrhage during surgery |
D | Poor postsurgical ambulation |
Question 22 |
The nurse is assessing a child suspected of having muscular dystrophy for muscle weakness. At what age would evidence of muscle weakness associated with muscular dystrophy appear?
A | Age 1 |
B | Age 2 |
C | Age 3 |
D | Age 4 |
Question 23 |
A 2-year-old toddler has muscular dystrophy. His legs are held together with the knees touching. Which muscles are contracted?
A | Hip abductors |
B | Hip adductors |
C | Hip extensors |
D | Hip flexors |
Question 24 |
A client with bilateral fractured femurs is scheduled for a double–hipspica cast. She says to the nurse, “Only 3 more months and I can go home.” Further investigation reveals that the client and her family believe she’ll be hospitalized until the cast comes off. The nurse should explain to the client and her family that the client:
A | may be hospitalized 2 to 4 months. |
B | will go home 2 to 4 days after casting. |
C | will go home 1 week after casting. |
D | will go home as soon as she can move. |
Question 25 |
A nurse is caring for an infant with suspected developmental dysplasia of the hip (DDH). Which information should the nurse give the parents about diagnostic testing?
A | A diagnosis can’t be confirmed until the child begins to walk. |
B | Diagnostic testing is performed at 6 months if the dysplasia hasn’t resolved by then. |
C | A radiopaque dye will be injected into the subarachnoid space of the spine. |
D | An X-ray confirms the diagnosis. |
Question 26 |
Which hip position should be avoided in an 8-month-old infant who has been diagnosed with developmental dysplasia of the hip?
A | Extension |
B | Abduction |
C | Internal rotation |
D | External rotation |
Question 27 |
A nurse is talking with a 12-year-old boy and his parents about his osteogenesis imperfecta. The client tells the nurse he likes to swim. What is the most appropriate response by the nurse?
A | He should also add a weight-bearing exercise. |
B | Swimming isn’t safe since he can slip on the wet area around the pool. |
C | He should restrict his exercise to only swimming. |
D | Any form of exercises isn’t safe. |
Question 28 |
A 12-year-old child diagnosed with muscular dystrophy is hospitalized secondary to a fall. Surgery is necessary as well as skeletal traction. Which complication should be of greatest concern to the nursing staff?
A | Skin integrity |
B | Infection of pin sites |
C | Respiratory infection |
D | Nonunion healing of the fracture |
Question 29 |
A 13-year-old boy admitted with a fractured femur had an open reduction and internal fixation 2 days ago and currently is in traction. He asks the nurse what would happen to him if a terrorist decided to bomb the hospital. What’s the nurse’s best response?
A | “I wouldn’t worry about that. Spend your energy on getting well and going home.” |
B | “We have plans to call your parents and take care of you if there’s a problem.” |
C | “What do you think might happen if terrorists attack?” |
D | “That’s silly thinking. Why would anyone bomb a hospital?” |
Question 30 |
Which finding should a nurse expect when assessing a neonate with a positive Galeazzi sign?
A | Raised iliac crest |
B | Pelvic downward tilt on weight bearing |
C | Knees are flexed to 90 degrees, one knee higher |
D | Involved leg flexed to 90 degrees, audible click with external rotation |
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