Peds Musculoskeletal NCLEX

Peds Musculoskeletal NCLEX ?'s 4.6 (5 reviews) Students also studied Terms in this set (22) University of DelawareNURS 337 Save Pediatric Neurological Practice Que...28 terms cheyenne_hutcheson Preview Pediatric Musculoskeletal Practice ...21 terms cheyenne_hutcheson Preview NCLEX Pediatrics Musculoskeletal 23 terms Kenneth_TuaPreview Pediatr 50 terms julie A child with a right femur fracture is placed in skin traction until surgery can be performed. During assessment of the child, the nurse notes that the dorsalis pedis is absent on the right foot. Which action should the nurse take?

• Administer an analgesic
• Release the skin traction
• Apply ice to the extremity
• Notify the health care provider (HCP)

D A 4-year-old has just had a plaster cast applied to a fractured left arm. The nurse provides instructions to the parents regarding care for the cast. Which statement by the parent indicates a need for further instruction"

• "The cast may feel warm as it dries."
• I can use lotion or powder around the cast edges to

relieve itching."

• "A small amount of white shoe polish can touch up a

soiled white cast."

• "If the cast becomes wet, a blow dryer set on the cool

setting may be used to dry it." B

A child who has undergone spinal fusion for scoliosis complains of abdominal discomfort and has periods of vomiting. On further assessment, the nurse notes abdominal distention. The priority action by the nurse at

this time would be to:

• administer an antiemetic
• Increase the intravenous fluids.
• Notify the health care provider (HCP).
• Place the child in Sim's position.

C Parents bring their 2-week-old infant to a clinic for treatment after a diagnosis of clubfoot was made at birth.Which statement by the parent indicated the need for further teaching regarding this disorder?

• "Treatment needs to be started as soon as possible."
• "I need to bring my child back to the clinic in 1 month

for a new cast."

• "I need to come to the clinic every week with my infant

for the casting."

• "I realize my infant will require follow-up care until he

reaches skeletal maturity." B actually, the cast is changed every 1-2 weeks The nurse is assisting the health care provider (HCP) examining an infant with developmental dysplasia of the hip perform an Ortolani maneuver. The nurse knows that this maneuver is performed for which purpose?

• To assess for hip instability
• To assess for movement of the hips
• To push the femoral head into the acetabulum
• To ensure full range of motion exists

A The nurse is working with a child who has just had a fracture reduction and casting. The nurse knows that the child is at risk for compartment syndrome. What objective assessment items will the nurse monitor for while completing the nursing assessment? Select all that apply.

• Burning
• Fever
• Weak pulse
• Tingling
• Pale grey extremity

ACDE

The nurse is planning care for a child recently admitted for Guillain-Barré Syndrome has paralysis affecting the respiratory muscles and requires mechanical ventilation.When the parents ask about the paralysis, what is the best response by the nurse?

• "It must be difficult to accept the permanency of your

child's paralysis."

• "Your child will first regain the use of their legs and

then their arms."

• "In addition to the paralysis, your child will experience

sensory loss."

• "The paralysis caused by this disease is temporary but

the recovery can take up to 2 years." D The nurse is caring for a school-aged child with Duchenne muscular dystrophy. Which would be the most appropriate nursing diagnosis?

• Anticipatory grieving
• Anxiety reduction
• Increased pain
• Activity intolerance

D Which will help the school-aged child with muscular dystrophy stay active longer?

• Normal activities, such as swimming
• Using a treadmill every day
• Several periods of rest every day
• Using a wheelchair upon getting tired

A The nurse should tell the parents of a child with Duchenne muscular dystrophy that some of the

progressive complications include:

• dry skin, hirsutism, protruding tongue, and mental

retardation.

• anorexia, gingival hyperplasia, and dry skin and hair.
• contractures, obesity, and pulmonary infections.
• trembling, frequent loss of consciousness, and slurred

speech.C When planning a rehabilitative approach for a child with osteogenesis imperfecta (OI), the nurse should work to prevent which of the following? Select all that apply.

• Positional contractures and deformities
• Bone infection
• Muscle weakness
• Osteoporosis
• Misalignment of lower extremity joints

ACDE

Which factors are associated with slipped capital femoral epiphysis (SCFE)? Select all that apply.

• Obesity
• Female gender
• African descent
• Age of 5-10 years
• Pubertal hormonal changes
• Endocrine disorders

AEF The parent of a child with osteomyelitis asks how the child acquired the illness. Which is the best response by the nurse?

• "Direct inoculation of the bone from stepping barefoot

on a sharp stick."

• "An infection from a scratched mosquito bite carried

the infection through the bloodstream to the bone."

• "The blood supply to the bone was disrupted because

of the child's diabetes."

• "An infection of the upper respiratory tract."

B A child with osteosarcoma is going to receive chemotherapy before surgery. Which statement by the parents indicates they understand the side effect of neutropenia?

• "My child will be more at risk for diarrhea."
• "My child's hair will fall out."
• "My child will be more at risk for infection."
• "My child will need to remain hydrated."

C The nurse teaching the parents of a child newly diagnosed with juvenile idiopathic arthritis (JIA). The nurse would evaluate the teaching as successful when the

parent is states that, "The disorder is caused by...:

• ...the breakdown of osteoclasts in the joint space

causing bone loss."

• ...loss of cartilage in the joints."
• ...a build-up of calcium crystals in joint spaces."
• ...an immune-stimulated inflammatory response."

D Why are chemotherapeutic agents such as methotrexate and cyclophosphamide sometimes used to treat JIA?

• Affect the immune system
• Effective against cancer-like JIA
• Are similar to NSAIDS
• Are absorbed into the synovial fluid

A