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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.
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Parents bring a 7-year-old child to the clinic for evaluation of an injured wrist after a bicycle accident. The parents and child are upset, and the child will not allow an examination of the injured arm. What priority nursing intervention should occur at this time?
- A. Send the child to radiology so radiography can be performed.
- B. Initiate an intravenous line and administer morphine for the pain.
- C. Calmly ask the child to point to where the pain is worst and to wiggle fingers.
- D. Have the parents hold the child so that the nurse can examine the arm thoroughly.
Correct Answer: C
Rationale: Gaining the child?s trust by calmly assessing pain location and finger movement is the priority to evaluate neurovascular status without increasing distress. Radiography requires initial assessment, morphine is premature, and restraining the child escalates anxiety.
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.
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 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.
The nurse is teaching the girls varsity sports teams about the female athlete triad. What is essential information to include?
- A. They should take low to moderate calcium to avoid hypercalcemia.
- B. They have strong bones because of the athletic training.
- C. Pregnancy can occur in the absence of menstruation.
- D. A diet high in carbohydrates accommodates increased training.
Correct Answer: C
Rationale: Pregnancy is possible despite amenorrhea in the female athlete triad, necessitating contraceptive education. High calcium (1500 mg) prevents osteoporosis, low estrogen weakens bones, and high-protein, high-calorie diets, not just carbohydrates, support intense training.