Exam 3: Musculoskeletal Dysfunction NCLEX Questions with Correct Solutions Graded to Pass

a b c d f h The potential physiologic and psychologic effects of prolonged immobilization on a 9 year old child who has experienced significant trauma in a MVA include which of the following? Select all that apply a. orthostatic intolerance b. deep vein thrombosis c. pressure ulcer formation d. pneumonia e. diarrhea f. kidney stones g. sense of euphoria and elation h. constipation a b d e Disordered eating patterns, which may be observed in the female athlete triad, may include which of the following? Select all that apply a. use of diet pills and laxatives b. fasting c. binge eating d. restriction of certain foods e. inadequate caloric intake f. excessive vitamin consumption c A 2 day old infant in the newborn nursery is diagnosed with developmental dysplasia of the hip, and treatment is started by the orthopedist. The nurse assists the parents by providing home care instructions that include a. return to the orthopedist's office in 2 weeks to remove the hip spica cast b. the infant's bilateral foot cats should be elevated on pillows as much as possible c. remove the Pavlik harness once a day for no more than 2 hours and inspect skin d. remove the Pavlik harness while the infant is awake to allow "tummy time" a The nurse stops to assist a child who has been hit by a car while riding a bicycle. Someone has activated the emergency medical system. Until paramedics arrive, the nurse would consider what in caring for this child who has experienced severe trauma? a. Rapid assessment should begin with ABC status: airway, breathing, and circulation. b. Assessment should begin with the area injured; assessment of other areas can wait. c. The possibility of spinal cord injury should be ruled out before transporting the child to the hospital. d. Temperature maintenance is more difficult than in adults because young children have a larger surface area related to body mass. a Immobilization causes what effects on the cardiovascular system? a. Venous stasis b. Increased vasopressor mechanism c. Normal distribution of blood volume d. Increased efficiency of orthostatic neurovascular reflexes b A young child has recently been fitted with a knee, ankle, and foot orthosis (brace). What would be included in care of the skin? a. Apply lotion or cream to soften the skin. b. Contact a practitioner or orthotist if skin redness does not disappear. c. Place padding between the skin and brace if the child experiences a burning sensation under the brace. d. If a small blister develops, apply rubbing alcohol and place padding between the skin and the brace. b A child, age 10 years, sustained a fracture in the epiphyseal plate of her right fibula when she fell out of a tree. What does the nurse consider when discussing this injury with her parents? a. This type of fracture is inconsistent with a fall. b. Bone growth can be affected by this type of fracture. c. This is an unusual fracture site in young children. d. Healing is usually delayed in this type of fracture. d What would cause a nurse to suspect that an infection has developed under a cast? a. Cold toes b. Increased respirations c. Complaint of paresthesia d. "Hot spots" felt on the cast surface d What statement is correct regarding sports injuries during adolescence? a. Rapidly growing bones, muscles, joints, and tendons offer some protection from unusual strain. b. The increase in strength and vigor during adolescence helps prevent injuries related to fatigue. c. More injuries occur during organized athletic competition than during recreational sports participation. d. Adolescents may not possess the insight and judgment to recognize when an activity is beyond their capabilities. c What results when ice is applied immediately after a soft tissue injury, such as a sprained ankle? a. Increases the pain threshold. b. Increases metabolism in the tissues. c. Produces deep tissue vasoconstriction. d. Leads to release of more histamine-like substances. d A 4-year-old child is newly diagnosed with Legg-Calvé-Perthes disease. Nursing considerations include what? a. Encourage normal activity for as long as possible. b. Explain the cause of the disease to the child and family. c. Prepare the child and family for long-term, permanent disabilities. d. Teach the family the care and management of the corrective appliance. a The nurse is preparing an adolescent girl for surgery to treat scoliosis. What would the nurse include? a. Blood administration may be an option. b. Ambulation will not be allowed for up to 3 months. c. Surgery eliminates the need for casting and bracing. d. Discomfort can be controlled with nonpharmacologic methods. c What is an important nursing consideration when caring for a child with juvenile idiopathic arthritis? a. Apply ice packs to relieve stiffness and pain. b. Administer acetaminophen to reduce inflammation. c. Teach the child and family the correct administration of medications. d. Encourage range of motion exercises during periods of inflammation. b A nurse discovers a 5 year old lying in the street next to his bicycle. The nurse sends another witness to activate the EMS while the nurse begins a primary assessment of the child. Which of the following best describes the primary assessment and its correct sequence? a. body inspection, head to toe survey, and airway patency b. airway patency, respiratory effectiveness, circulatory status c. open airway, head to toe assessment for injuries, and chest compressions d. weight estimation, symptom analysis, blood pressure measurement a Major consequences of immobility in the pediatric patient include which of the following? a. bone demineralization leading to osteoporosis b. orthostatic hypoertension c. dependent edema in the lower extremities d. decrease in metabolic rate a Nursing interventions aimed at preventing problems associated with immobility include which of the following? a. encouraging self-care b. restricting fluids with strict intake and output c. limiting active range of motion exercises to once per day d. decreasing sensory stimulation to allow adequate rest a Which of the following is a complication of immobility that is easily prevented with appropriate nursing intervention? a. disuse atrophy and loss of muscle mass b. constipation c. hypocalcemia d. pain