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What finding would the nurse assessing the neurovascular status of a child in Russell traction report immediately?
- A. Skin that's warm to the touch
- B. Capillary refill less than 3 seconds
- C. Ability to wiggle toes
- D. Bluish coloration of skin
Correct Answer: D
Rationale: Bluish skin (cyanosis) indicates circulatory impairment, requiring immediate reporting to prevent complications.
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What statement by the mother does the nurse recognize as indicative of a need for additional teaching?
- A. Apply warm compresses to the ankle for the first 24 hours.'
- B. Put an ice pack on the ankle, alternating 30 minutes on with 30 minutes off.'
- C. Wrap the ankle in an Ace bandage for support.'
- D. Keep the leg elevated when sitting.'
Correct Answer: A
Rationale: Warm compresses are incorrect for sprained ankle treatment; rest, ice, compression, and elevation are the appropriate interventions.
What nursing action will significantly decrease the risk of serious complications for a child in Bryant's traction?
- A. Neurovascular checks are done frequently.
- B. Bandages are wrapped tightly.
- C. The child is restrained from rolling over.
- D. The child's buttocks are resting on the bed.
Correct Answer: A
Rationale: Frequent neurovascular checks help detect Volkmann's ischemia, reducing the risk of circulatory complications.
What would the nurse include in planning teaching to parents of a child with Legg-Calv?©-Perthes disease about the long-term effects of this disease?
- A. There are no long-term effects.
- B. The disease is self-limited and requires no long-term treatment.
- C. Degenerative arthritis may develop later in life.
- D. There is risk of osteogenic sarcoma in adulthood.
Correct Answer: C
Rationale: Marked distortion of the femoral head in Legg-Calv?©-Perthes disease may lead to degenerative arthritis in adulthood.
Which intervention would be helpful in relieving morning discomfort associated with juvenile rheumatoid arthritis?
- A. Wearing splints at night to prevent extension contractures
- B. Applying moist heat packs upon awakening
- C. Taking a warm tub bath the evening before
- D. Sleeping with two pillows under the head
Correct Answer: B
Rationale: Moist heat packs upon awakening reduce morning stiffness associated with juvenile rheumatoid arthritis.
What type of juvenile rheumatoid arthritis do these findings suggest?
- A. Psoriatic
- B. Enthesitis
- C. Systemic
- D. Acute febrile
Correct Answer: C
Rationale: Systemic juvenile rheumatoid arthritis presents with fever, joint swelling, warmth, tenderness, abdominal pain, and elevated inflammatory markers.