Nokea
The nurse is preparing to teach the family of an infant with developmental dysplasia of the hip how to apply the Pavlik harness illustrated that has white velcro straps. Place the steps for applying the Pavlik harness in the correct sequence.
- A. Connect the chest halter and leg straps in front.
- B. Position the legs and feet in the stirrups.
- C. Connect the chest halter and leg straps in back.
- D. Position the chest halter at nipple line and fasten with Velcro.
- E. Be sure the hips are flexed and abducted before fastening with Velcro.
Correct Answer: D,B,E,A,C
Rationale: The correct sequence ensures proper positioning and secure application of the Pavlik harness.
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Which intervention should the nurse implement when caring for the child with an Ilizarov external fixator applied to a lower extremity for bone lengthening?
- A. Loosening the bolts and lengthening the rods on the fixator every other day
- B. Cleansing the external fixator pin sites with sterile saline twice daily
- C. Discouraging the child from bearing any weight on the involved extremity
- D. Removing sections of the fixator apparatus when the child is positioned in bed
Correct Answer: B
Rationale: Regular cleansing of pin sites with sterile saline prevents infection in an Ilizarov fixator.
The client has been flat in bed in traction for two weeks, and she is to be allowed out of bed for the first time today. What must the nurse be particularly alert for when getting the client out of bed?
- A. Renal complications
- B. Depression
- C. Orthostatic hypotension
- D. Skin breakdown
Correct Answer: C
Rationale: Prolonged bed rest increases the risk of orthostatic hypotension when first mobilizing, requiring careful monitoring.
Which statement should the nurse include when teaching parents about bacterial meningitis?
- A. Symptoms of meningitis often develop over time, making it easier to diagnose than other infections.
- B. Having a seizure associated with a high temperature usually indicates a problem other than meningitis.
- C. High-risk children 2 to 10 years and other children 11 years and older should receive the meningococcal conjugate vaccine (MCV4).
- D. Intravenous antibiotics are administered to family members who may have been in close contact with the child.
Correct Answer: C
Rationale: The meningococcal conjugate vaccine (MCV4) is recommended for high-risk children and those 11 years and older to prevent bacterial meningitis.
Which technique is the best strategy for assessing circulation in the leg in Buck's traction?
- A. Observe whether the client can wiggle or move the toes.
- B. Palpate for pulsation of the dorsalis pedis artery.
- C. Take the client's blood pressure with a thigh cuff positioned on the affected leg.
- D. Determine whether the client can feel sharp and dull sensations.
Correct Answer: B
Rationale: Palpating the dorsalis pedis pulse directly assesses arterial circulation in the leg, providing the most accurate indication of blood flow. Toe movement and sensation are less specific, and blood pressure measurement is not relevant.
How should the nurse explain the purpose of methotrexate in treating a child with juvenile arthritis?
- A. Improves functional ability
- B. Controls the febrile response
- C. Minimizes the effects of uveitis
- D. Decreases the inflammatory response
Correct Answer: D
Rationale: Methotrexate is a disease-modifying antirheumatic drug that reduces inflammation in juvenile arthritis.