ATI LPN
Wong's Essentials of Pediatric Nursing 11th Edition Test Bank
Chapter 29 : The Child with Musculoskeletal or Articular Dysfunction Questions
Question 1 of 5
Parents bring a 7-year-old child to the clinic for evaluation of an injured wrist after a bicycle accident. The parents and child are upset, and the child will not allow an examination of the injured arm. What priority nursing intervention should occur at this time?
Correct Answer: C
Rationale: Gaining the child?s trust by calmly assessing pain location and finger movement is the priority to evaluate neurovascular status without increasing distress. Radiography requires initial assessment, morphine is premature, and restraining the child escalates anxiety.
Question 2 of 5
A 7-year-old child has just had a cast applied for a fractured arm with the wrist and elbow immobilized. What information should be included in the home care instructions?
Correct Answer: B
Rationale: Elevating the casted arm during rest and in a sling when upright promotes venous return and reduces swelling. Strenuous activity is limited initially, shoulder movement is encouraged, and finger swelling requires immediate reporting to prevent neurovascular damage.
Question 3 of 5
The nurse uses the five Ps to assess ischemia in a child with a fracture. What finding is considered a late and ominous sign?
Correct Answer: C
Rationale: Paresthesia, indicating nerve compression or ischemia distal to the fracture, is a late and ominous sign requiring immediate action to prevent permanent damage within 6-8 hours. Petaling is cast maintenance, posturing isn?t ischemia-related, and positioning affects comfort, not ischemia.
Question 4 of 5
A child is upset because, when the cast is removed from her leg, the skin surface is caked with desquamated skin and sebaceous secretions. What technique should the nurse suggest to remove this material?
Correct Answer: A
Rationale: Soaking in a bathtub gently removes desquamated skin and secretions over days, avoiding skin damage. Scrubbing or picking risks excoriation, and powder is ineffective; oil or lotion may help comfort, not removal.
Question 5 of 5
A child with a hip spica cast is being prepared for discharge. Recognizing that caring for a child at home is complex, the nurse should include what instructions for the parents discharge teaching?
Correct Answer: B
Rationale: Specially designed car restraints ensure safe transport for a child in a hip spica cast. Turning should occur more frequently, diapers are needed to maintain cleanliness, and the abduction bar is not used for turning to avoid cast damage.