Quiz
Pediatric Musculoskeletal Dysfunction
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Questions in this quiz (42)
1Which of the following would NOT be a sign that an infant has developmental dysplasia of the hip?
- ALimited ABDUCTION of the affected hip
- BLimited ADDUCTION of the affected hip
- CAsymmetry of the gluteal and thigh fat folds
- DTelescoping or pistoning of the thigh
- EUnequal leg length
2How long should the nurse screen for asymmetry of the gluteal and thigh fat folds?
- A6 months of age
- B1 year of age
- C1 1/2 years of age
- D2 years of age
3A positive Ortolani's Sign means that a click or a clunk is felt upon abduction of the legs.
- ATrue
- BFalse
4When is Ortolani's sign MOST reliable?
- AIn first 12 months of life
- BIn first 6 months of life
- CIn first 4 months of life
- DIn first 2 months of life
5How long can Ortolani's sign be performed for?
- AUntil 1 year of age
- BUntil 8 months of age
- CUntil 6 months of age
- DUntil 2 years of age
6When can ultrasound accurately be done to detect for developmental dysplasia of the hip?
- A4-6 weeks old
- B2 months old
- C4-6 months old
- D1 year old
7When can X-ray be done to detect developmental dysplasia of the hip in an infant?
- AWithin first 2 months of age
- BAt 4-6 weeks old
- CAT 4-6 months of age
- DAFTER 4-6 months of age
8Children who have developmental dysplasia of the hip have issues reaching developmental milestones and walking like normal, even if it is treated.
- ATrue
- BFalse
9You are delivering teaching about the Pavlik harness to the parents of a child with developmental dysplasia of the hip.
Which of the following statements shows that teaching has been received?- A"The Pavlik harness is a splint that allows for movement. It will need to be worn for 23 hours per day; for the 1 hour it is removed, the hips and buttocks will need to be supported."
- B"The Pavlik harness is a splint that allows for movement. It needs to be left on all day with a shirt placed under it. It can only be removed to bathe our baby and check the skin."
- C"The Pavlik harness is a splint that allows for movement. It will need to be worn for 23 hours per day, and our infant will require it for the first year of his life."
- D"The Pavlik harness is a brace that allows our infant to walk and crawl."
10You have delivered teaching to the parents of a child with a Pavlik harness to treat developmental dysplasia of the hip.
Which of the following statements shows that MORE teaching is needed?- A"Our baby will need to wear it for 23 hours per day."
- B"The harness is padded to prevent skin irritation."
- C"The hips and buttocks will need to be supported when the baby is out of the harness for skin check and bathing."
- D"The baby will be kept in the harness for about 3 months."
11Between 6 to 18 months of age, a plastic cruiser brace is used to treat developmental dysplasia of the hip.
- ATrue
- BFalse
12What is scoliosis?
- AA lateral curve of the spine
- BA convex curve of the spine
- CA lumbar curve in the spine
13What is kyphosis?
- AA lateral curve of the spine
- BA convex curve of the spine
- CA lumbar curve of the spine
14What is lordosis?
- AA lateral curve of the spine
- BA convex curve of the spine
- CA lumbar curve of the spine
15Which of the following is UNTRUE about spinal deformities?
- AA curve of more than 10 degrees is abnormal.
- BEarly detection is essential to limiting or stopping the progression of the deformity.
- CSpecial exercises that will be performed if the curve is 10-20 degrees.
- DThe Boston, TLSO, or Milwaukee brace are used for curves of 20+ degrees.
16Which of the following are you NOT assessing for when assessing spinal deformities from the front?
- AHead location
- BShoulders height bilaterally
- CSpace between arms and body bilaterally
- DHips height bilaterally
17Which of the following is NOT a part of the screening for spinal deformity when assessing from the back?
- AHead location
- BShoulder height bilaterally
- CScapulae prominence and height bilaterally
- DStraightness of spine
- EHip height bilaterally
- FSpace between arms and body bilaterally
18The shoulders, arms, body space, scapulae, and hips should be equal bilaterally upon assessment.
- ATrue
- BFalse
19Which of the following assessment findings would be abnormal when screening for a spinal deformity?
- AScapular humps equal bilaterally when assessing child from back with hands together and body slightly bent.
- BFlank humps even when assessing child from back with hands together and body fully bent toward floor.
- CSpine is straight when assessing child from back with hands together and body fully bent toward floor.
- DUpper back humped when assessing child from the side, when viewed from the back with hands together and body fully bent toward floor.
20Screening for spinal deformity should begin at about 10 years old.
- ATrue
- BFalse
21What are the nursing actions for a patient in Buck's traction?
- AThe skin at and around the device should be assessed for breakdown as ordered.
- BThe apparatus should be assessed to be sure that the weights are hanging freely and the line of pull is patent.
- CNever elevate the foot of the bed.
- DKnots should be secured with tape.
- EThe area above and under the Velcro boot should be wrapped in compression bandages.
- FVascular and neuro checks should be performed per unit policy.
22Manual traction should be used when redoing traction.
- ATrue
- BFalse
23You have delivered teaching to the family of a child newly diagnosed with osteogenesis imperfecta.
Which of the following statements shows that MORE teaching is needed?- A"OI is caused by a defect in type I collagen."
- B"OI is primarily a recessive disorder, meaning that both of us carried the gene for it and passed it on without knowing it."
- C"WIth OI, our child is likely to have issues with fractures and early deafness."
- D"There are different degrees of severity in OI. Some types are so severe that they cause death prenatally or in infancy, and others cause progressive issues and a shortened life span."
24You have delivered teaching to the parents of a toddler newly diagnosed with type I osteogenesis imperfecta.
Which of the following statements shows that MORE teaching is needed?- A"Unfortunately, our child will continue to have bone fractures very often for the rest of her life."
- B"This disorder is the reason the white part of our child's eyes are blue-tinted."
- C"We will probably need to take our child to the dentist more often than usual, and be careful what we give her to eat and drink."
- D"There is a possibility that our child will have hearing loss by adolescence."
- E"With proper management, our child can have a full lifespan."
25Growth hormone can improve bone histology in all individuals with osteogenesis imperfecta.
- ATrue
- BFalse
26Which of the following medications is given to people with ostogeneisis imperfecta to increase bone density and decrease bone turnover and new fractures?
- APamidronate
- BGrowth hormone
- CDenosumab
- DRaloxifene
27Which of the following is untrue about Duchenne muscular dystrophy?
- AMost diagnosed at about 5 years old, when physical ability begins to deviate from peers.
- BMuscle strength begins to deteriorate in the upper extremities first, then moves down as the disorder progresses.
- CChildren with Duchenne MS usually require a wheelchair before teen years.
- DThe mean age at death is 19 years old.
- EThe disorder is X-linked
28How can a nurse manage nutrition in a child with Duchenne muscular dystrophy?
- AAssess swallow status periodically.
- BProvide a full liquid diet.
- CEncourage enteral feedings as early as possible.
- DAssure adequate fluid intake.
- EProvide a high-fiber diet.
- FProcure a dietary consultation to adjust calorie count when needed.
29You have administered teaching about treatment options to the parents of a child with Duchenne muscular dystrophy.
Which of the following statements shows that teaching has been received?- A"Drugs called glucocorticoids can help cure our child by slowing muscle decline, increasing strength, reducing risk of scoliosis, and stabilizing pulmonary function."
- B"Physical therapy can help cure our child by increasing muscle strength."
- C"A combination of glucocorticoids and physical therapy can help cure our child's MS."
- D"Glucocorticoids and physical therapy cannot cure our child's MS, but they can slow the disease progression and increase quality of life."
30What symptoms would make you concerned that a teenage patient with a cast on his left leg has compartment syndrome?
- AThe patient reports pain at a 6 out of 10 in the left leg that increases to an 8 out of 10 with palpation.
- BThe teenager reports tingling and numbness under the cast.
- CThe toes on the left foot appears swollen upon inspection.
- DThe foot under the cast is warm and the pedal pulses are +2.
- EThe toes on the left foot are consistent with skin tone.
31Compartment syndrome can be suspected if the patient's pain and swelling and disproportionate to negative x-ray findings
- ATrue
- BFalse
32Which of the following is NOT a cause of compartment syndrome?
- AFracture
- BMuscle bruise
- CCrush injury
- DExcessively tight bandage or cast
- ESprains
33Compartment syndrome can be prevented by elevation, icing, and delaying casting.
- ATrue
- BFalse
34Volkmann contracture is a common complication of compartment syndrome after elbow injuries.
- ATrue
- BFalse
35Which of the following set of symptoms would make you concerned that a patient has a deep vein thrombosis?
- AThe patient reports a "cramping pain" at a 6 out of 10 in her left leg, which appears red and swollen upon inspection and warm upon palpation.
- BThe patient reports pain at a 1 out of 10 in her left leg, which is consistent with body temperature (warm) upon palpation. The leg is not red and swollen upon inspection.
- CThe patient's left leg appears red and swollen and the patient reports no pain or cramping
- DThe patient's left leg is warm, the patient does not report pain, and the leg is not red or swollen.
36What can the nurse do to prevent a deep vein thrombosis from forming?
- AKeep the fracture immobilized as early as possible
- BAvoid ambulating the patient.
- CAmbulate the patient in the halls at least 3 times per day
- DProcure an order for anticoagulant medication, such as Warfarin or heparin.
- EHave the patient wear compression stockings when resting in bed.
37Why should a deep vein thrombosis promptly be treated?
- AIt can cause stroke
- BIt can cause pulmonary embolism
- CIt can cause myocardial infarction
- DIt can cause limb amputation
- EIt can cause permanent limb paralysis
38How could you explain fat embolism syndrome to the parents of a child suffering from the complication following a car accident?
- A"This complication occurs when pieces of fat, called fat emboli,
enter the bloodstream and become trapped. It may occur with long bone and pelvic fractures. Most major trauma victims have fat embolisms, but it's rare for it to progress to FES." - B"This complication occurs when pieces of fat, called fat emboli,
enter the bloodstream and become trapped. It may occur with long bone and pelvic fractures. Most major trauma victims have fat embolisms, and the progression to FES is quite common." - C"This complication occurs when pieces of fat, called fat emboli,
enter the bloodstream and become trapped. It may occur with long bone and pelvic fractures. It is rare for anybody with a broken bone to have a fat embolism, let alone for it to progress to FES." - D"This complication occurs when pieces of fat, called fat emboli,
enter the bloodstream and become trapped. It may occur with long bone and pelvic fractures. Most major trauma victims have fat embolisms, but it's rare for it to progress to FES in any age group but the elderly."
- A"This complication occurs when pieces of fat, called fat emboli,
39Which of the following children may have fat embolism syndrome?
- AA 15-year-old with a femur fracture that suddenly developed dyspnea, petechial rash, mild fever, confusion, and restlessness and required mechanical ventilation.
- BAn 8-year-old with an ulnar fracture that went into respiratory failure after it was documented that he had redness, swelling, and pain in the leg.
- CA 12-year-old with gradual painless vision loss after having a broken skull and brain trauma in a motor vehicle accident.
- DA 16-year-old with a broken humerus that had confusion and restlessness that progressed to seizure and coma after reporting cramping and swelling at an 8 our of 10 on the right arm.
40Approximately half of patients who develop fat embolism syndrome require mechanical ventilation, but most symptoms resolve with adequate oxygenation.
- ATrue
- BFalse
41Early immobilization of the injury can prevent both fat embolism syndrome and deep vein thrombosis
- ATrue
- BFalse
42Which of the following children is at HIGHEST risk for developing an infection?
- AA healthy 14-year-old who required surgical correction of a patellar fracture following a sports injury and had extensive damage to the patellar and quadriceps tendon, as shown by a CT scan.
- BA healthy 15-year-old who had a closed ulnar and radial fracture and no extensive soft tissue damage who sustained injury after failing to land a skateboard trick
- CA healthy 9-year-old with an open fibial fracture and no extensive soft tissue damage that sustained injury after jumping off a swing and landing incorrectly
- DA 6-year-old with a closed ankle fracture and no soft tissue damage that sustained injury after jumping off the bed and landing incorrectly.
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- NCLEX Nursing (Pediatrics) Quiz on Pediatric Musculoskeletal Dysfunction, created by Olivia McRitchie on 04/12/2019.
- Author
- Olivia McRitchie
- Language
- English
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