Nokea
A 14-year-old is admitted to the emergency department with a fracture of the right humerus epiphyseal plate through the joint surface. What information does the nurse know regarding this type of fracture?
- A. It will create difficulty because the child is left handed.
- B. It will heal slowly because this is the weakest part of the bone.
- C. This type of fracture requires different management to prevent bone growth complications.
- D. This type of fracture necessitates complete immobilization of the shoulder for 4 to 6 weeks.
Correct Answer: C
Rationale: A Salter type III fracture through the epiphyseal plate requires specific management, often surgical, to prevent growth complications like angular deformities. Hand dominance is irrelevant, healing is rapid at the growth plate, and complete immobilization isn?t always needed.
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An adolescent comes to the school nurse after experiencing shin splints during a track meet. What reassurance should the nurse offer?
- A. Shin splints are expected in runners.
- B. Ice, rest, and nonsteroidal anti-inflammatory drugs (NSAIDs) usually relieve pain.
- C. It is generally best to run around and work the pain out.
- D. Moist heat and acetaminophen are indicated for this type of injury.
Correct Answer: B
Rationale: Shin splints, caused by ligament stress on the tibial shaft, are relieved by ice, rest, and NSAIDs. They aren?t expected, running worsens the injury, and moist heat with acetaminophen is less effective than ice and NSAIDs for inflammation.
A young girl has just injured her ankle at school. In addition to notifying the childs parents, what is the most appropriate, immediate action by the school nurse?
- A. Apply ice.
- B. Observe for edema and discoloration.
- C. Encourage child to assume a position of comfort.
- D. Obtain parental permission for administration of acetaminophen or aspirin.
Correct Answer: A
Rationale: Applying ice immediately reduces swelling and pain in soft tissue injuries, followed by rest, elevation, and compression. Observing edema, finding a comfortable position, and administering medication are secondary to ice application.
What is a physiologic effect of immobilization on children?
- A. Metabolic rate increases.
- B. Venous return improves because the child is in the supine position.
- C. Circulatory stasis can lead to thrombus and embolus formation.
- D. Bone calcium increases, releasing excess calcium into the body (hypercalcemia).
Correct Answer: C
Rationale: Immobilization reduces muscle contraction, causing venous stasis, which increases the risk of thrombus and embolus formation. Metabolic rate decreases, venous return diminishes, and bone demineralization leads to hypercalcemia, not increased bone calcium.
What is the recommended drink for athletes during practice and competition?
- A. Sports drinks to replace carbohydrates
- B. Cold water for gastrointestinal tract rapid absorption
- C. Carbonated beverages to help with acid-base balance
- D. Enhanced performance carbohydrate-electrolyte drinks
Correct Answer: B
Rationale: Cold water, consumed 4-8 oz every 15-20 minutes, promotes rapid gastric and intestinal absorption for hydration. Sports drinks may cause gastrointestinal upset, carbonated beverages are discouraged, and enhanced drinks lack evidence of performance benefits.
What statement is correct regarding sports injuries during adolescence?
- A. Conditioning does not help prevent many sports injuries.
- 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 insight and judgment to recognize when a sports activity is beyond their capabilities.
Correct Answer: D
Rationale: Adolescents? lack of insight and judgment can lead to injuries when activities exceed their physical capabilities. Conditioning reduces injuries, fatigue-related injuries occur from overuse, and recreational sports cause more injuries than organized competition.