Nokea
A student athlete was injured during a basketball game. The nurse observes significant swelling. The player states he thought he heard a pop, that the pain is pretty bad, and that the ankle feels as if it is coming apart. Based on this description, the nurse suspects what injury?
- A. Sprain
- B. Fracture
- C. Dislocation
- D. Stress fracture
Correct Answer: A
Rationale: A sprain, common in ankle injuries, involves ligament stretching or tearing, often with a pop sound, severe pain, and joint instability. Fractures involve bone, dislocations disrupt joint alignment, and stress fractures result from repetitive stress, not acute trauma with a pop.
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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.
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.
An 8-year-old child is hit by a motor vehicle in the school parking lot. The school nurse notes that the child is responding to verbal stimulation but is not moving his extremities when requested. What is the first action the nurse should take?
- A. Wait for the childs parents to arrive.
- B. Move the child out of the parking lot.
- C. Have someone notify the emergency medical services (EMS) system.
- D. Help the child stand to return to play.
Correct Answer: C
Rationale: Activating EMS is critical for a child unable to move extremities post-collision, indicating potential spinal cord injury requiring immediate hospital evaluation. Moving the child risks further injury, waiting for parents delays care, and standing is contraindicated.
The nurse is caring for an immobilized preschool child. What intervention is helpful during this period of immobilization?
- A. Encourage wearing pajamas.
- B. Let the child have few behavioral limitations.
- C. Keep the child away from other immobilized children if possible.
- D. Take the child for a walk by wagon outside the room.
Correct Answer: D
Rationale: Transporting the child by wagon outside the room provides social and environmental stimulation, aiding psychosocial health. Street clothes, not pajamas, reduce illness perception; appropriate behavioral limits are needed; and isolation from other children isn?t necessary.
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.