Nokea
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.
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What finding is characteristic of fractures in children?
- A. Fractures rarely occur at the growth plate site because it absorbs shock well.
- B. Rapidity of healing is inversely related to the childs age.
- C. Pliable bones of growing children are less porous than those of adults.
- D. The periosteum of a childs bone is thinner, is weaker, and has less osteogenic potential compared to that of an adult.
Correct Answer: B
Rationale: Fractures in children heal faster in younger individuals due to robust periosteum and bone pliability. Growth plates are prone to fractures, children?s bones are more porous and pliable, and their periosteum is thicker with greater osteogenic potential than adults?.
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?
- A. Soak in a bathtub.
- B. Vigorously scrub the leg.
- C. Carefully pick material off the leg.
- D. Apply powder to absorb the 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.
Immobilization causes what effect on metabolism?
- A. Hypocalcemia
- B. Decreased metabolic rate
- C. Positive nitrogen balance
- D. Increased levels of stress hormones
Correct Answer: B
Rationale: Immobilization reduces metabolic rate, slowing systems and food intake. It causes hypercalcemia, negative nitrogen balance from muscle atrophy, and decreased stress hormone production due to reduced coping capacity.
The nurse is teaching parents the proper use of a hip-knee-ankle-foot orthosis (HKAFO) for their 4-year-old child. The parents demonstrate basic essential knowledge by making what statement?
- A. Alcohol will be used twice a day to clean the skin around the brace.
- B. Weekly visits to the orthotist are scheduled to check screws for tightness.
- C. Initially, a burning sensation is expected and the brace should remain in place.
- D. Condition of the skin in contact with the brace should be checked every 4 hours.
Correct Answer: D
Rationale: Checking skin every 4 hours prevents breakdown from HKAFO contact points. Alcohol dries skin, parents can check screws, and burning requires brace removal and orthotist consultation, not tolerance.
What condition can result from the bone demineralization associated with immobility?
- A. Osteoporosis
- B. Pooling of blood
- C. Urinary retention
- D. Susceptibility to infection
Correct Answer: A
Rationale: Bone demineralization from immobility leads to osteoporosis, increasing fracture and renal calculi risk. Blood pooling, urinary retention, and infection susceptibility are other immobilization effects but not directly caused by bone demineralization.