Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. The nurse is providing care to a preschool-aged child who has been placed in a hip Spica
cast for treatment of a femur fracture. The child is given narcotic pain medication for the
first 48 hours before being sent home. When providing discharge instructions to the
child’s parents, which is the most important?
a. Assist the child to find ways to play while in the cast.
b. Ensure the cast is not too tight around the abdomen.
c. Keep the cast clean by using absorbent pads when toileting.
d. Avoid giving the child sugary snacks while being treated.
ANS: B
Chapter: Chapter 21 Musculoskeletal Disorders
Chapter Learning Objective: 5. Explain the applicable nursing interventions for
musculoskeletal disorders.
Page: 521
Heading: Fractures > Classification of Fractures > Femur Fractures > Care of Child in
a Spica Cast
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Analysis [Analyzing]
Concept: Mobility
Difficulty: Moderate
Feedback
A. This is incorrect. Play is important to psychological well-being; however, it is not
the priority in this situation.
B. This is correct. Preventing injury from the cast due to reducing circulation or
placing pressure on the abdominal area is the priority.
C. This is incorrect. Keeping the cast clean is important; however, it is not the
priority in this situation.
D. This is incorrect. Avoiding sugary treats are important; however; it is not the
priority in this situation.
PTS: 1 CON: Mobility
2. A 2-year-old child is being evaluated for a musculoskeletal disorder. The child’s
laboratory results indicate hypophosphatemia, a normal erythrocyte sedimentation rate,
and negative rheumatoid factor. Which disorder is the child likely experiencing?
, a. Juvenile arthritis
b. Genu varum (bowlegs)
c. Septic arthritis
d. Avascular necrosis
ANS: B
Chapter: Chapter 21 Musculoskeletal Disorders
Chapter Learning Objective: 4. Describe the diagnostic tests and lab values typically
monitored in musculoskeletal disorders.
Page: 526
Heading: Congenital Musculoskeletal Abnormalities > Genu Varum (Bowlegs)
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Analysis [Analyzing]
Concept: Mobility
Difficulty: Moderate
Feedback
A. This is incorrect. Juvenile arthritis demonstrates a positive rheumatoid factor.
B. This is correct. Genu varum (bowlegs) can be associated with hypophosphatemia.
C. This is incorrect. Septic arthritis is associated with inflammation evidenced by an
elevated erythrocyte sedimentation rate (ESR).
D. This is incorrect. Avascular necrosis is associated with abnormal radiologic
examinations.
PTS: 1 CON: Mobility
3. The parent of a 3-month-old returns for a visit with the health-care provider who is caring
for the infant’s hip dysplasia. However, the nurse notes that on arrival, the infant is not
wearing the prescribed Pavlick harness. The parent indicates they removed the harness,
believing the infant was uncomfortable. Which is the best response by the nurse?
a. Inform the parent how to check for capillary refill in the toes.
b. Assess the infant for trauma or swelling to the lower extremities.
c. Report the findings to the health-care provider before entering the examination
room.
d. Ask the parent to demonstrate how to place the Pavlick harness.
ANS: A
Chapter: Chapter 21 Musculoskeletal Disorders
Chapter Learning Objective: 9. Describe strategies to support patient/caregiver
education about musculoskeletal disorders.
Page: 528
Heading: Congenital Musculoskeletal Abnormalities > Hip Dysplasia > Treatment
Integrated Processes: Teaching and Learning
, Client Need: Physiological Integrity: Reduction of Risk Potential Cognitive Level:
Analysis [Analyzing]
Concept: Mobility
Difficulty: Moderate
Feedback
A. This is correct. This is done when the child is wearing the harness.
B. This is incorrect. Assessing for trauma or injury does not address the need to
wear the harness as prescribed.
C. This is incorrect. The nurse is responsible to teach about care of the patient and
has the responsibility to teach the parent rather than report to the health-care
provider.
D. This is incorrect. This allows the nurse to determine whether the patient’s parent
can effectively apply the harness and assess what teaching needs completed to
promote proper treatment.
PTS: 1 CON: Mobility
4. The nurse is providing care to a 7-year-old child who has been diagnosed with avascular
necrosis. The patient’s guardians ask the nurse what to expect due to this diagnosis.
Which would be appropriate information to provide to the parents?
a. The child will be hospitalized and placed in traction.
b. The child will be treated by surgically placing a femoral screw.
c. The child will be placed in a Pavlik harness for several weeks.
d. The child will be given medication while on bedrest.
ANS: A
Chapter: Chapter 21 Musculoskeletal Disorders
Chapter Learning Objective: 6. Integrate acute hospital care concepts for
musculoskeletal disorders.
Page: 529
Heading: Congenital Musculoskeletal Abnormalities > Avascular Necrosis >
Treatment
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Analysis [Analyzing]
Concept: Mobility
Difficulty: Difficult
Feedback
A. This is correct. The child may be treated by being placed in traction (Buck’s or
Bryant’s) while hospitalized
B. This is incorrect. This is treatment for a slipped capital femoral epiphysis.
C. This is incorrect. This is treatment for hip dysplasia.
Identify the choice that best completes the statement or answers the question.
1. The nurse is providing care to a preschool-aged child who has been placed in a hip Spica
cast for treatment of a femur fracture. The child is given narcotic pain medication for the
first 48 hours before being sent home. When providing discharge instructions to the
child’s parents, which is the most important?
a. Assist the child to find ways to play while in the cast.
b. Ensure the cast is not too tight around the abdomen.
c. Keep the cast clean by using absorbent pads when toileting.
d. Avoid giving the child sugary snacks while being treated.
ANS: B
Chapter: Chapter 21 Musculoskeletal Disorders
Chapter Learning Objective: 5. Explain the applicable nursing interventions for
musculoskeletal disorders.
Page: 521
Heading: Fractures > Classification of Fractures > Femur Fractures > Care of Child in
a Spica Cast
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Analysis [Analyzing]
Concept: Mobility
Difficulty: Moderate
Feedback
A. This is incorrect. Play is important to psychological well-being; however, it is not
the priority in this situation.
B. This is correct. Preventing injury from the cast due to reducing circulation or
placing pressure on the abdominal area is the priority.
C. This is incorrect. Keeping the cast clean is important; however, it is not the
priority in this situation.
D. This is incorrect. Avoiding sugary treats are important; however; it is not the
priority in this situation.
PTS: 1 CON: Mobility
2. A 2-year-old child is being evaluated for a musculoskeletal disorder. The child’s
laboratory results indicate hypophosphatemia, a normal erythrocyte sedimentation rate,
and negative rheumatoid factor. Which disorder is the child likely experiencing?
, a. Juvenile arthritis
b. Genu varum (bowlegs)
c. Septic arthritis
d. Avascular necrosis
ANS: B
Chapter: Chapter 21 Musculoskeletal Disorders
Chapter Learning Objective: 4. Describe the diagnostic tests and lab values typically
monitored in musculoskeletal disorders.
Page: 526
Heading: Congenital Musculoskeletal Abnormalities > Genu Varum (Bowlegs)
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Analysis [Analyzing]
Concept: Mobility
Difficulty: Moderate
Feedback
A. This is incorrect. Juvenile arthritis demonstrates a positive rheumatoid factor.
B. This is correct. Genu varum (bowlegs) can be associated with hypophosphatemia.
C. This is incorrect. Septic arthritis is associated with inflammation evidenced by an
elevated erythrocyte sedimentation rate (ESR).
D. This is incorrect. Avascular necrosis is associated with abnormal radiologic
examinations.
PTS: 1 CON: Mobility
3. The parent of a 3-month-old returns for a visit with the health-care provider who is caring
for the infant’s hip dysplasia. However, the nurse notes that on arrival, the infant is not
wearing the prescribed Pavlick harness. The parent indicates they removed the harness,
believing the infant was uncomfortable. Which is the best response by the nurse?
a. Inform the parent how to check for capillary refill in the toes.
b. Assess the infant for trauma or swelling to the lower extremities.
c. Report the findings to the health-care provider before entering the examination
room.
d. Ask the parent to demonstrate how to place the Pavlick harness.
ANS: A
Chapter: Chapter 21 Musculoskeletal Disorders
Chapter Learning Objective: 9. Describe strategies to support patient/caregiver
education about musculoskeletal disorders.
Page: 528
Heading: Congenital Musculoskeletal Abnormalities > Hip Dysplasia > Treatment
Integrated Processes: Teaching and Learning
, Client Need: Physiological Integrity: Reduction of Risk Potential Cognitive Level:
Analysis [Analyzing]
Concept: Mobility
Difficulty: Moderate
Feedback
A. This is correct. This is done when the child is wearing the harness.
B. This is incorrect. Assessing for trauma or injury does not address the need to
wear the harness as prescribed.
C. This is incorrect. The nurse is responsible to teach about care of the patient and
has the responsibility to teach the parent rather than report to the health-care
provider.
D. This is incorrect. This allows the nurse to determine whether the patient’s parent
can effectively apply the harness and assess what teaching needs completed to
promote proper treatment.
PTS: 1 CON: Mobility
4. The nurse is providing care to a 7-year-old child who has been diagnosed with avascular
necrosis. The patient’s guardians ask the nurse what to expect due to this diagnosis.
Which would be appropriate information to provide to the parents?
a. The child will be hospitalized and placed in traction.
b. The child will be treated by surgically placing a femoral screw.
c. The child will be placed in a Pavlik harness for several weeks.
d. The child will be given medication while on bedrest.
ANS: A
Chapter: Chapter 21 Musculoskeletal Disorders
Chapter Learning Objective: 6. Integrate acute hospital care concepts for
musculoskeletal disorders.
Page: 529
Heading: Congenital Musculoskeletal Abnormalities > Avascular Necrosis >
Treatment
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Analysis [Analyzing]
Concept: Mobility
Difficulty: Difficult
Feedback
A. This is correct. The child may be treated by being placed in traction (Buck’s or
Bryant’s) while hospitalized
B. This is incorrect. This is treatment for a slipped capital femoral epiphysis.
C. This is incorrect. This is treatment for hip dysplasia.
