C HAPTER 3: U LNAR F RACTURE
1. Which statement is most correct with regard to childhood musculoskeletal
injuries?
a. After the injury is iced, the swelling decreases, indicating the injury is not
severe.
b. The presence of localized tenderness indicates a more serious injury.
c. The more swelling there is, the less severe the injury is.
d. The less willing the child is to bear weight, the more serious the injury is.
ANS: D
An inability to bear weight on the affected extremity is indicative of a more
serious injury. With a fracture, general manifestations include pain or
tenderness at the site, immobility or decreased range of motion, deformity of
the extremity, edema, and inability to bear weight. A decrease in swelling
after icing does not identify the degree of the injury. Localized tenderness
along with limited joint mobility may indicate serious injury, but an inability
to bear weight on the extremity is a more reliable sign. The degree of swelling
does not indicate how serious the injury is.
2. In caring for a child with a compound fracture, what should the nurse carefully
assess for?
a. Infection
b. Osteoarthritis
c. Epiphyseal disruption
d. Periosteum thickening
ANS: A
, Because the skin has been broken, the child is at risk for organisms to enter
the wound. The incidence of osteoarthritis and the chance of epiphyseal
disruption are not increased with compound fracture. Periosteum thickening is
part of the healing process and is not a complication.
3. A child who has fractured his forearm is unable to extend his fingers. The nurse
knows that this:
a. is normal following this type of injury.
b. may indicate compartmental syndrome.
c. may indicate fat embolism.
d. may indicate damage to the epiphyseal plate.
ANS: B
Swelling causes pressure to rise within the immobilizing device leading to
compartmental syndrome. Signs include severe pain, often unrelieved by
analgesics, and neurovascular impairment. It is not uncommon in the forearm,
so the inability to extend the fingers may indicate compartmental syndrome. It
is not normal that the child is unable to extend his fingers; this indicates
neurovascular compromise of some type. Paresthesia or numbness or loss of
feeling can indicate a neurovascular compromise and can result in paralysis.
Fat embolism causes respiratory distress with hypoxia and respiratory
acidosis. Paresthesia is not related to damage to the epiphyseal plate.
4. Which is an accurate statement concerning a childs musculoskeletal system and
how it may be different from adults?
a. Growth occurs in children as a result of an increase in the number of
muscle fibers.
b. Infants are at greater risk for fractures because their epiphyseal plates are
1. Which statement is most correct with regard to childhood musculoskeletal
injuries?
a. After the injury is iced, the swelling decreases, indicating the injury is not
severe.
b. The presence of localized tenderness indicates a more serious injury.
c. The more swelling there is, the less severe the injury is.
d. The less willing the child is to bear weight, the more serious the injury is.
ANS: D
An inability to bear weight on the affected extremity is indicative of a more
serious injury. With a fracture, general manifestations include pain or
tenderness at the site, immobility or decreased range of motion, deformity of
the extremity, edema, and inability to bear weight. A decrease in swelling
after icing does not identify the degree of the injury. Localized tenderness
along with limited joint mobility may indicate serious injury, but an inability
to bear weight on the extremity is a more reliable sign. The degree of swelling
does not indicate how serious the injury is.
2. In caring for a child with a compound fracture, what should the nurse carefully
assess for?
a. Infection
b. Osteoarthritis
c. Epiphyseal disruption
d. Periosteum thickening
ANS: A
, Because the skin has been broken, the child is at risk for organisms to enter
the wound. The incidence of osteoarthritis and the chance of epiphyseal
disruption are not increased with compound fracture. Periosteum thickening is
part of the healing process and is not a complication.
3. A child who has fractured his forearm is unable to extend his fingers. The nurse
knows that this:
a. is normal following this type of injury.
b. may indicate compartmental syndrome.
c. may indicate fat embolism.
d. may indicate damage to the epiphyseal plate.
ANS: B
Swelling causes pressure to rise within the immobilizing device leading to
compartmental syndrome. Signs include severe pain, often unrelieved by
analgesics, and neurovascular impairment. It is not uncommon in the forearm,
so the inability to extend the fingers may indicate compartmental syndrome. It
is not normal that the child is unable to extend his fingers; this indicates
neurovascular compromise of some type. Paresthesia or numbness or loss of
feeling can indicate a neurovascular compromise and can result in paralysis.
Fat embolism causes respiratory distress with hypoxia and respiratory
acidosis. Paresthesia is not related to damage to the epiphyseal plate.
4. Which is an accurate statement concerning a childs musculoskeletal system and
how it may be different from adults?
a. Growth occurs in children as a result of an increase in the number of
muscle fibers.
b. Infants are at greater risk for fractures because their epiphyseal plates are
