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Which statement should the nurse include in the instructions for parents of an infant with osteogenesis imperfecta (OI)?
- A. "Check the color of your infant's nailbeds and mucous membranes for signs of circulatory impairment."
- B. "If you note signs of infection, bring your infant to the clinic because the infant has a significant immune dysfunction."
- C. "Protect your infant from injury and handle your baby carefully because your infant's bones can break very easily."
- D. "Notify your physician if your infant does not respond to sound because the infant's CNS fails to develop completely."
Correct Answer: C
Rationale: OI causes brittle bones, so careful handling is essential to prevent fractures.
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A cast has just been applied to a client's left forearm, and he has 10 lbs of Russell's traction on his left leg. Which of the following nursing concerns takes priority in the care of this client?
- A. The casted extremity may swell, and the cast will become a tourniquet.
- B. Heat conduction from the wet cast can cause burning to the skin below.
- C. Muscle atrophy of the areas involved can lead to decreased muscle tone.
- D. Skin irritation from the cast edges can cause abrasions.
Correct Answer: A
Rationale: Swelling in a newly casted extremity can cause the cast to act as a tourniquet, compromising circulation, which is the priority concern. Heat from a wet cast does not burn skin, muscle atrophy is a long-term issue, and skin irritation is less urgent.
Which statement indicates that the client understands the restrictions to be followed?
- A. I should avoid pointing my toes.
- B. I shouldn't cross my legs.
- C. I shouldn't lie flat in bed.
- D. I shouldn't stand upright.
Correct Answer: B
Rationale: Crossing legs can dislocate the hip prosthesis.
The nurse is caring for clients on an orthopedic floor. Which client should be assessed first?
- A. The client diagnosed with back pain who is complaining of a '4' on a 1-to-10 scale.
- B. The client who has undergone a myelogram who is complaining of a slight headache.
- C. The client two (2) days post-disk fusion who has T 100.4, P 96, R 24, and BP 138/78.
- D. The client diagnosed with back pain who is being discharged and whose ride is here.
Correct Answer: C
Rationale: Fever, tachycardia, and tachypnea post-disk fusion suggest infection or complications, requiring urgent assessment. Mild pain, headache, and discharge are lower priority.
Which interventions are appropriate for an adolescent experiencing a seizure?
- A. A tongue blade inserted into the adolescent's mouth during a seizure can cause injury.
- B. Padding protects the adolescent's limbs from injury against the hard side rails during a seizure.
- C. Airway obstruction can occur during or after the seizure. An oropharyngeal airway should be available but should not be inserted during the seizure. If the seizure has commenced, nothing should be forced into the adolescent's mouth.
- D. The etiology is unknown. Only if an airborne or droplet infectious disease were suspected as the cause would droplet precautions be considered.
- E. Suctioning equipment may be needed to clear secretions after the seizure.
Correct Answer: B,C,E
Rationale: Padding protects limbs from injury, an oropharyngeal airway should be available but not inserted during a seizure, and suctioning equipment may be needed post-seizure to clear secretions.
What should the nurse emphasize when preparing to teach the child and family about the treatment for Legg-Calvé-Perthes disease?
- A. Once treatment starts, it will likely continue for about 6 months.
- B. The treatment goal is a pain-free joint with full range of motion.
- C. Activities requiring hip adduction are encouraged for joint placement.
- D. Most of the treatments will be completed while the child is hospitalized.
Correct Answer: B
Rationale: The primary goal of treatment for Legg-Calvé-Perthes disease is to achieve a pain-free joint with full range of motion.