Nokea
Which observation requires a nursing intervention?
- A. Child's heels are placed firmly against the foot of the bed.
- B. Head of bed is elevated 20 degrees.
- C. Weights are hanging freely.
- D. Ropes are on pulleys.
Correct Answer: A
Rationale: Heels against the bed disrupt Buck traction's counterweight mechanism, requiring intervention to elevate them.
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How does the pediatric skeletal system differ from that of the adult?
- A. Lower mineral content
- B. More ossification
- C. Open epiphyses
- D. Less porosity
- E. Greater strength
Correct Answer: A,C,E
Rationale: The pediatric skeletal system has lower mineral content, open epiphyses, and greater strength, with greater porosity, not less.
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.
What type of fracture would be the most likely to alert the nurse to the possibility of physical abuse?
- A. Stress fracture
- B. Compound fracture
- C. Spiral fracture
- D. Greenstick fracture
Correct Answer: C
Rationale: Spiral fractures, caused by twisting motions, may suggest abuse if the injury history does not match the findings.
What would the nurse consider an abnormal finding on a musculoskeletal assessment of a 4-year-old child?
- A. Has inward-turned knees while standing.
- B. Walks on the toes.
- C. Appears to have flat feet.
- D. Swings his arms when walking.
Correct Answer: B
Rationale: Toe walking after age 3 may indicate a muscle problem, unlike other findings which are typical in young children.
How long does it take for the toe to regain color if adequate perfusion is assessed?
- A. 3 seconds
- B. 4 seconds
- C. 5 seconds
- D. 6 seconds
Correct Answer: A
Rationale: Capillary refill in 3 seconds or less indicates adequate perfusion in a child in Bryant's traction.