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The middle school nurse is speaking to parents about prevention of injuries as a goal of the physical education program. How should the goal be achieved?
- A. Use of protective equipment at the familys discretion
- B. Education of adults to recognize signs that indicate a risk for injury
- C. Sports medicine program to help student athletes work through overuse injuries
- D. Arrangements for multiple sports to use same athletic fields to accommodate more children
Correct Answer: B
Rationale: Educating adults to recognize fatigue, dehydration, and injury risk signs prevents sports injuries. Protective equipment is mandatory, working through overuse injuries is harmful, and shared fields increase distraction and injury risk.
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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.
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.
A 7-year-old child has just had a cast applied for a fractured arm with the wrist and elbow immobilized. What information should be included in the home care instructions?
- A. No restrictions of activity are indicated.
- B. Elevate casted arm when both upright and resting.
- C. The shoulder should be kept as immobile as possible to avoid pain.
- D. Swelling of the fingers is to be expected. Notify a health professional if it persists more than 48 hours.
Correct Answer: B
Rationale: Elevating the casted arm during rest and in a sling when upright promotes venous return and reduces swelling. Strenuous activity is limited initially, shoulder movement is encouraged, and finger swelling requires immediate reporting to prevent neurovascular damage.
The nurse at a summer camp recognizes the signs of heatstroke in an adolescent girl. Her temperature is 40 C (104 F). She is slightly confused but able to drink water. Nursing care while waiting for transport to the hospital should include what intervention?
- A. Administer antipyretics.
- B. Administer salt tablets.
- C. Apply towels wet with cool water.
- D. Sponge with solution of rubbing alcohol and water.
Correct Answer: C
Rationale: Applying cool, wet towels and removing clothing cools the body in heatstroke, addressing thermoregulatory failure. Antipyretics are ineffective, salt tablets worsen dehydration, and rubbing alcohol is harmful and not used.
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.