Nclex-Rn Practice Questions-Care Of The Child - Musculoskeletal Disorders Part 3
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Question 1 |
After assisting the primary health care provider in applying a cast, a nurse should include which intervention in the immediate cast care?
A | Rest the cast on the bedside table. |
B | Dispose of the plaster water in the sink. |
C | Support the cast with her palms. |
D | Wait until the cast dries before cleaning surrounding skin. |
Question 2 |
Which activity may be most helpful for a child who’s allowed full activity after repair of a clubfoot?
A | Playing catch |
B | Standing |
C | Swimming |
D | Walking |
Question 3 |
Which strategy should a nurse teach an adolescent to prevent sportsrelated injuries?
A | Warming up |
B | Pacing activity |
C | Building strength |
D | Moderating intensity |
Question 4 |
The nurse instructs a client with a hip-spica cast to avoid gas-forming foods. The client asks the nurse what can happen if the food is consumed. What is the best response by the nurse?
A | Flatus |
B | Diarrhea |
C | Constipation |
D | Abdominal distention |
Question 5 |
Which nursing intervention should be taken if, while a cast is drying, the client complains of heat from the cast?
A | Remove the cast immediately. |
B | Notify the primary health care provider. |
C | Assess the client for other signs of infection. |
D | Explain to the client that this is a normal sensation. |
Question 6 |
A school-age child tells a nurse that he’s experiencing intense itching from under his cast. What is the most appropriate response by the nurse?
A | “Toughen up; there’s nothing that can be done.” |
B | “Place the eraser end of a new pencil under the cast to scratch.” |
C | “Elevate the cast above the level of your heart.” |
D | “Aim cool air from a hair dryer under the cast.” |
Question 7 |
Nursing care for a client in traction may include which intervention?
A | Assessing pin sites every shift and as needed |
B | Ensuring that the rope knots catch on the pulley |
C | Adding and removing weights per client’s request |
D | Placing all joints through range of motion (ROM) every shift |
Question 8 |
A child in skeletal traction for a fracture of the right femur exhibits a positive Homans’ sign, complains of left-sided leg pain, and has edema in the left leg. A nurse should further assess the child for which condition?
A | A fat emboli |
B | An infection |
C | A pulmonary embolism |
D | Deep vein thrombosis (DVT) |
Question 9 |
At the scene of a trauma, which nursing intervention is appropriate for a child with a suspected fracture?
A | Never move the child. |
B | Sit the child up to facilitate breathing. |
C | Move the child to a safe place immediately. |
D | Immobilize the extremity and then move the child to a safe place. |
Question 10 |
The nurse receives a report on a child admitted with the most severe form of muscular dystrophy. The nurse knows this means the child has which type of muscular dystrophy?
A | Duchenne’s |
B | Facioscapulohumeral |
C | Limb girdle |
D | Myotonic |
Question 11 |
Which intervention should a nurse expect to use to prevent venous stasis after skeletal traction application?
A | Bed rest only |
B | Convoluted foam mattress |
C | Vigorous pulmonary care |
D | Antiembolism stockings or an intermittent compression device |
Question 12 |
Immediately after a spinal fusion, which restriction is usually put on the child’s activity?
A | Supine bed rest |
B | Non–weight bearing |
C | No restriction |
D | Limited weight bearing |
Question 13 |
A nurse recognizes that the parent of a child with developmental hip dysplasia needs more teaching when the parent places the child in a position that encourages:
A | hip abduction. |
B | knee extension. |
C | external rotation. |
D | internal rotation. |
Question 14 |
The nurse assesses a client with a cast following a fracture of the radius and is most concerned about which finding?
A | Discomfort occurs at the site of the break. |
B | Fingers are pink and warm. |
C | Swelling is reduced with cast elevation. |
D | Pain occurs over a bony prominence. |
Question 15 |
Which complication involving leg length should a nurse anticipate in a client with developmental dysplasia of the hip?
A | Increased hip abduction |
B | Increased leg length on the affected side |
C | Decreased leg length on the affected side |
D | No change in muscle length or leg length |
Question 16 |
The parents of a child with newly diagnosed developmental dysplasia of the hip (DDH) ask the nurse how their child developed this condition. The nurse explains that the greatest number of cases is caused by which condition?
A | Dislocation |
B | Subluxation |
C | Acetabular dysplasia |
D | Dislocation with fracture |
Question 17 |
The nurse observes a client who has a positive Trendelenburg gait. Which characteristic would indicate this gait?
A | Pelvis tilts downward upon weight bearing |
B | Pelvis tilts upward upon weight bearing |
C | Abnormal height of the iliac crests |
D | Leg length discrepancy |
Question 18 |
Which finding would the nurse expect in a client with developmental dysplasia of the hip (DDH)?
A | Ligamentum teres is shortened. |
B | Femoral head loses contact with acetabulum and is displaced inferiorly. |
C | Femoral head loses contact with the acetabulum and is displaced posteriorly. |
D | Femoral head maintains contact with acetabulum, but there’s noted capsular rupture |
Question 19 |
A toddler is immobilized with traction to the legs. Which play activity would be appropriate for the nurse to include in the plan of care for this child?
A | Pounding board |
B | Tinker toys |
C | Pull toy |
D | Board games |
Question 20 |
A child in a hip-spica cast needs to be toileted. How should the nurse position the child?
A | Supine |
B | Sitting in a toilet chair |
C | Shoulder lower than buttocks |
D | Buttocks lower than shoulder |
Question 21 |
An unlicensed assistive personnel (UAP) asks the nurse how to care for a client’s hip-spica cast that has been soiled. What is the best response by the nurse?
A | Clean with damp cloth and dry cleanser. |
B | Clean with soap and water. |
C | Don’t do anything. |
D | Change the cast. |
Question 22 |
Which intervention should a nurse perform in a 4-year-old child in Buck’s traction?
A | Provide daily pin site care. |
B | Release weights for 1 hour each day. |
C | Change the child’s position every 4 hours. |
D | Unwrap the elastic bandage every shift to assess the skin. |
Question 23 |
Which history finding is the most significant related to developmental dysplasia of the hip (DDH)?
A | Mother’s activity during the third trimester |
B | Breech presentation at birth |
C | Infant’s serum calcium level at birth |
D | Apgar score of 4 at 1 minute and 6 at 5 minutes |
Question 24 |
The parent of an infant diagnosed with clubfoot is discussing the casting treatment regimen with the nurse. The nurse determines further instruction is not needed when the parent states that the cast will be changed:
A | in 8 weeks. |
B | in 2 weeks. |
C | when his child starts to walk. |
D | when his child starts to crawl. |
Question 25 |
Which instruction should the nurse include in the teaching plan for a 10- year-old child with a fracture of the radial bone?
A | Report capillary refill less than 3 seconds. |
B | Report warmth under the cast during the first 24 hours after application. |
C | Report foul odors coming from the cast. |
D | Report cool fingers that warm within 20 minutes of being covered. |
Question 26 |
A 13-year-old girl is suspected of having structural scoliosis by her school nurse. What should the nurse ask the girl to do to help confirm her suspicion?
A | Bend over and touch her toes while the nurse observes from the back. |
B | Stand sideways while the nurse observes her profile. |
C | Assume a knee-chest position on the examination table. |
D | Arch her back while the nurse observes her from the back. |
Question 27 |
A nurse is assessing an 18-month-old infant who’s in Bryant’s traction for a fractured left femur. The infant is properly positioned when:
A | the left leg is extended 90 degrees off the bed. |
B | the right leg is extended 90 degrees off the bed. |
C | both legs are extended 90 degrees off the bed. |
D | both legs are extended at 180 degrees with the upper body. |
Question 28 |
A nurse determines that a client with a fractured left femur understands the instructions for touch-down weight bearing when the client makes which statement?
A | “I will place full weight on my left leg.” |
B | “I will place about 30% to 50% of my weight on my left leg.” |
C | “I will keep my left leg off the floor.” |
D | “I will allow my left leg to touch the floor without placing weight on it.” |
Question 29 |
Which nursing intervention can be implemented to prevent foot drop in a casted leg?
A | Encourage bed rest. |
B | Support the foot with 45 degrees of flexion. |
C | Support the foot with 90 degrees of flexion. |
D | Place a stocking on the foot to provide warmth. |
Question 30 |
Which observation by a nurse indicates that an infant in a hip-spica cast is properly positioned?
A | The infant’s upper body and cast are at a 180-degree angle. |
B | The infant’s hips are higher than the head. |
C | The infant’s upper body and the cast are at a 45-degree angle. |
D | The infant is flat in bed. |
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