Chapter 26: The Child with a Musculoskeletal Alteration

Chapter 26: The Child with a Musculoskeletal Alteration

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1. Which of the following is an accurate statement concerning a child’s 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 not fused.
c.	Because soft tissues are resilient in children, dislocations and sprains are less common than in adults.
d.	Their bones have less blood flow.

 

 

ANS:   C

 

	Feedback
A	A child’s growth occurs because of an increase in size rather than an increase in the number of the muscle fibers.
B	This is not a true statement. Fractures in children younger than 1 year are unusual because a large amount of force is necessary to fracture their bones.
C	Because soft tissues are resilient in children, dislocations and sprains are less common than in adults. This is an accurate statement.
D	A child’s bones have greater blood flow than an adult’s bones.

 

 

DIF:    Cognitive Level: Comprehension      REF:    Text Reference: pg 832

OBJ:    Nursing Process Step: Planning         MSC:   NCLEX: Physiological Integrity

 

2. When infants are seen for fractures, which of the following nursing interventions is a priority?

a.	No intervention is necessary. It is not uncommon for infants to fracture bones.
b.	Assess the family’s safety practices. Fractures in infants usually result from falls.
c.	Assess for child abuse. Fractures in infants are often nonaccidental.
d.	Assess for genetic factors.

 

 

ANS:   C

 

	Feedback
A	Fractures in infancy are not common.
B	Infants should be cared for in a safe environment and should not be falling.
C	Fractures in infants warrant further investigation to rule out child abuse. Fractures in children younger than 1 year are unusual because of the cartilaginous quality of the skeleton, a large amount of force is necessary to fracture their bones.
D	Fractures in infancy are usually nonaccidental rather than related to a genetic factor.

 

 

DIF:    Cognitive Level: Application             REF:    Text Reference: pg 832

OBJ:    Nursing Process Step: Planning         MSC:   NCLEX: Physiological Integrity

 

3. Which of the following nursing interventions is appropriate to assess for neurovascular competency?

a.	The degree of motion and ability to position the extremity
b.	The length, diameter, and shape of the extremity
c.	The amount of swelling noted in the extremity and pain intensity
d.	The skin color, temperature, movement, sensation, and capillary refill of the extremity

 

 

ANS:   D

 

	Feedback
A	The degree of motion in the affected extremity and ability to position the extremity are incomplete assessments of neurovascular competency.
B	The length, diameter, and shape of the extremity are not assessment criteria in a neurovascular evaluation.
C	Although the amount of swelling is an important factor in assessing an extremity, it is not a criterion for a neurovascular assessment.
D	A neurovascular evaluation includes assessing skin color and temperature, ability to move the affected extremity, degree of sensation experienced, and speed of capillary refill in the extremity.

 

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: pg 838

OBJ:    Nursing Process Step: Assessment    MSC:   NCLEX: Physiological Integrity

 

4. A mother whose 7-year-old child has been placed in a cast for a fractured right arm reports he will not stop crying even after taking Tylenol with codeine. He also will not straighten the fingers on his right arm. The nurse tells the mother to do which of the following?

a.	Take him to the emergency department.
b.	Put ice on the injury.
c.	Avoid letting him get so tired.
d.	Wait another hour. If the he is still crying, call back.

 

 

ANS:   A

 

	Feedback
A	Unrelieved pain and the child’s inability to extend his fingers are signs of compartmental syndrome, which requires immediate attention.
B	Placing ice on the extremity is an inappropriate action for the presenting symptoms.
C	This is an inappropriate response to give to a mother who is concerned about her child.
D	A child who has signs and symptoms of compartmental syndrome should be seen immediately. Waiting an hour could compromise the recovery of the child.

 

 

DIF:    Cognitive Level: Analysis                  REF:    Text Reference: pg 840

OBJ:    Nursing Process Step: Intervention

MSC:   NCLEX: Health Promotion and Maintenance