NCLEX PEDS Musculoskeletal congenital disorders EXAM 2026
UPDATED QUESTIONS AND ANSWERS
A child with cerebral palsy is in a management program to achieve maximum potential for
locomotion, self-care, and socialization in school. The nurse works with the child to meet these
goals by performing which action?
1. Placing the child on a wheeled scooter board
2.Removing ankle-foot orthoses and braces once the child arrives at school
3. Keeping the child in a special education classroom with other children with similar disabilities
4. Placing the child in the supine position with a 30-degree elevation of the head of the bed to
facilitate feeding
Answer: 1
The correct option provides the child with maximum potential in locomotion, self-care, and
socialization. While lying on the abdomen, the child can move around independently anywhere
the child wants to go and can interact with others as desired. Orthoses need to be used all the
time to aid locomotion. Children with cerebral palsy (CP) need to be mainstreamed as much as
cognitive ability permits to provide for maximum socialization and normalization. Not all
children with CP are intellectually challenged. Just as children without CP sit up and use assistive
devices when eating, so should children with CP.
A child has a right femur fracture caused by a motor vehicle crash and is placed in skin traction
temporarily until surgery can be performed. During assessment, the nurse notes that the
dorsalis pedis pulse is absent on the right foot. Which action should the nurse take?
1.Administer an analgesic.
,2.Release the skin traction.
3.Apply ice to the extremity.
4.Notify the health care provider (HCP).
Answer: 4
An absent pulse to an extremity of the affected limb after a bone fracture could mean that the
child is developing or experiencing compartment syndrome. This is an emergency situation, and
the HCP should be notified immediately. Administering analgesics would not improve
circulation. The skin traction should not be released without an HCP's prescription. Applying ice
to an extremity with absent perfusion is incorrect. Ice may be prescribed when perfusion is
adequate to decrease swelling.
A child is placed in skeletal traction for treatment of a fractured femur. The nurse creates a plan
of care and should include which intervention?
1.Ensure that all ropes are outside the pulleys.
2.Ensure that the weights are resting lightly on the floor.
3.Restrict diversional and play activities until the child is out of traction.
4.Check the health care provider's (HCP's) prescriptions for the amount of weight to be applied.
Answer: 4
When a child is in traction, the nurse would check the HCP's prescription to verify the
prescribed amount of traction weight. The nurse would maintain the correct amount of weight
as prescribed, ensure that the weights hang freely, check the ropes for fraying and ensure that
they are on the pulleys appropriately, monitor the neurovascular status of the involved
extremity, and monitor for signs and symptoms of immobilization. The nurse would provide
therapeutic and diversional play activities for the child.
, The parents of a child with juvenile idiopathic arthritis call the clinic nurse because the child is
experiencing a painful exacerbation of the disease. The parents ask the nurse if the child can
perform range-of-motion exercises at this time. The nurse should make which response?
1."Avoid all exercise during painful periods."
2."Range-of-motion exercises must be performed every day."
3."Have the child perform simple isometric exercises during this time."
4."Administer additional pain medication before performing range-of-motion exercises."
Answer: 3
Juvenile idiopathic arthritis is an autoimmune inflammatory disease affecting the joints and
other tissues, such as articular cartilage. During painful episodes of juvenile idiopathic arthritis,
hot or cold packs and splinting and positioning the affected joint in a neutral position help
reduce the pain. Although resting the extremity is appropriate, beginning simple isometric or
tensing exercises as soon as the child is able is important. These exercises do not involve joint
movement.
A 4-year-old child sustains a fall at home. After an x-ray examination, the child is determined to
have a fractured arm and a plaster cast is applied. The nurse provides instructions to the
parents regarding care for the child's cast. Which statement by the parents indicates a need for
further instruction?
1."The cast may feel warm as the cast dries."
2."I can use lotion or powder around the cast edges to relieve itching."
3."A small amount of white shoe polish can touch up a soiled white cast."
4."If the cast becomes wet, a blow drier set on the cool setting may be used to dry the cast."
Answer: 2
Teaching about cast care is essential to prevent complications from the cast. The parents need
to be instructed not to use lotion or powders on the skin around the cast edges or inside the
UPDATED QUESTIONS AND ANSWERS
A child with cerebral palsy is in a management program to achieve maximum potential for
locomotion, self-care, and socialization in school. The nurse works with the child to meet these
goals by performing which action?
1. Placing the child on a wheeled scooter board
2.Removing ankle-foot orthoses and braces once the child arrives at school
3. Keeping the child in a special education classroom with other children with similar disabilities
4. Placing the child in the supine position with a 30-degree elevation of the head of the bed to
facilitate feeding
Answer: 1
The correct option provides the child with maximum potential in locomotion, self-care, and
socialization. While lying on the abdomen, the child can move around independently anywhere
the child wants to go and can interact with others as desired. Orthoses need to be used all the
time to aid locomotion. Children with cerebral palsy (CP) need to be mainstreamed as much as
cognitive ability permits to provide for maximum socialization and normalization. Not all
children with CP are intellectually challenged. Just as children without CP sit up and use assistive
devices when eating, so should children with CP.
A child has a right femur fracture caused by a motor vehicle crash and is placed in skin traction
temporarily until surgery can be performed. During assessment, the nurse notes that the
dorsalis pedis pulse is absent on the right foot. Which action should the nurse take?
1.Administer an analgesic.
,2.Release the skin traction.
3.Apply ice to the extremity.
4.Notify the health care provider (HCP).
Answer: 4
An absent pulse to an extremity of the affected limb after a bone fracture could mean that the
child is developing or experiencing compartment syndrome. This is an emergency situation, and
the HCP should be notified immediately. Administering analgesics would not improve
circulation. The skin traction should not be released without an HCP's prescription. Applying ice
to an extremity with absent perfusion is incorrect. Ice may be prescribed when perfusion is
adequate to decrease swelling.
A child is placed in skeletal traction for treatment of a fractured femur. The nurse creates a plan
of care and should include which intervention?
1.Ensure that all ropes are outside the pulleys.
2.Ensure that the weights are resting lightly on the floor.
3.Restrict diversional and play activities until the child is out of traction.
4.Check the health care provider's (HCP's) prescriptions for the amount of weight to be applied.
Answer: 4
When a child is in traction, the nurse would check the HCP's prescription to verify the
prescribed amount of traction weight. The nurse would maintain the correct amount of weight
as prescribed, ensure that the weights hang freely, check the ropes for fraying and ensure that
they are on the pulleys appropriately, monitor the neurovascular status of the involved
extremity, and monitor for signs and symptoms of immobilization. The nurse would provide
therapeutic and diversional play activities for the child.
, The parents of a child with juvenile idiopathic arthritis call the clinic nurse because the child is
experiencing a painful exacerbation of the disease. The parents ask the nurse if the child can
perform range-of-motion exercises at this time. The nurse should make which response?
1."Avoid all exercise during painful periods."
2."Range-of-motion exercises must be performed every day."
3."Have the child perform simple isometric exercises during this time."
4."Administer additional pain medication before performing range-of-motion exercises."
Answer: 3
Juvenile idiopathic arthritis is an autoimmune inflammatory disease affecting the joints and
other tissues, such as articular cartilage. During painful episodes of juvenile idiopathic arthritis,
hot or cold packs and splinting and positioning the affected joint in a neutral position help
reduce the pain. Although resting the extremity is appropriate, beginning simple isometric or
tensing exercises as soon as the child is able is important. These exercises do not involve joint
movement.
A 4-year-old child sustains a fall at home. After an x-ray examination, the child is determined to
have a fractured arm and a plaster cast is applied. The nurse provides instructions to the
parents regarding care for the child's cast. Which statement by the parents indicates a need for
further instruction?
1."The cast may feel warm as the cast dries."
2."I can use lotion or powder around the cast edges to relieve itching."
3."A small amount of white shoe polish can touch up a soiled white cast."
4."If the cast becomes wet, a blow drier set on the cool setting may be used to dry the cast."
Answer: 2
Teaching about cast care is essential to prevent complications from the cast. The parents need
to be instructed not to use lotion or powders on the skin around the cast edges or inside the
