Nokea
The nurse is caring for a hospitalized adolescent whose femur was fractured 18 hours ago. The adolescent suddenly develops chest pain and dyspnea. The nurse should suspect what complication?
- A. Sepsis
- B. Osteomyelitis
- C. Pulmonary embolism
- D. Acute respiratory tract infection
Correct Answer: C
Rationale: Pulmonary embolism, often from fat emboli in long bone fractures, is likely within 12-24 hours post-injury, presenting with chest pain and dyspnea. Sepsis and osteomyelitis involve fever, and respiratory infections typically cause nasal congestion, not acute chest pain.
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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 an appropriate nursing intervention when caring for a child in traction?
- A. Removing adhesive traction straps daily to prevent skin breakdown
- B. Assessing for tightness, weakness, or contractures in uninvolved joints and muscles
- C. Providing active range of motion exercises to affected extremity three times a day
- D. Keeping child prone to maintain good alignment
Correct Answer: B
Rationale: Assessing uninvolved joints for tightness, weakness, or contractures prevents complications from traction stress. Adhesive straps are rarely removed, exercises are for unaffected limbs, and prone positioning isn?t required; alignment is maintained with movement checks.
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.
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.