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Pediatric Success Orthopedic Exam Questions And Complete Answers., Exams of Nursing

Stanford UniversityNursing

Pediatric Success Orthopedic Exam Questions And Complete Answers.

Typology: Exams

2024/2025

Available from 07/04/2025

joyce-williams
joyce-williams 🇺🇸

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Pediatric Success Orthopedic Exam Questions
And Complete Answers
Which would the nurse expect to assess on a 3-week-old infant with developmental
dysplasia of the hip (DDH)?
1. Excessive hip abduction.
2. Femoral lengthening of an affected leg.
3. Asymmetry of gluteal and thigh folds.
4. Pain when lying prone. - answer 3. In DDH, asymmetrical thigh and gluteal
folds are frequently present.
Which should the nurse stress to the parents of an infant in a Pavlik harness for treatment
of developmental dysplasia of the hip (DDH)?
1. Put socks on over the foot pieces of the harness to help stabilize the harness.
2. Use lotions or powder on the skin to prevent rubbing of straps.
3. Remove harness during diaper changes for ease of cleaning diaper area.
4. Check under the straps at least two to three times daily for red areas. - answer 4.
Checking under straps frequently is
suggested to prevent skin breakdown.
Which can occur in untreated developmental dysplasia of the hip (DDH)? Select all
that apply.
1. Duck gait.
2. Pain.
3. Osteoarthritis in adulthood.
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Pediatric Success Orthopedic Exam Questions

And Complete Answers

Which would the nurse expect to assess on a 3-week-old infant with developmental dysplasia of the hip (DDH)?

  1. Excessive hip abduction.
  2. Femoral lengthening of an affected leg.
  3. Asymmetry of gluteal and thigh folds.
  4. Pain when lying prone. - answer 3. In DDH, asymmetrical thigh and gluteal folds are frequently present. Which should the nurse stress to the parents of an infant in a Pavlik harness for treatment of developmental dysplasia of the hip (DDH)?
  5. Put socks on over the foot pieces of the harness to help stabilize the harness.
  6. Use lotions or powder on the skin to prevent rubbing of straps.
  7. Remove harness during diaper changes for ease of cleaning diaper area.
  8. Check under the straps at least two to three times daily for red areas. - answer 4. Checking under straps frequently is suggested to prevent skin breakdown. Which can occur in untreated developmental dysplasia of the hip (DDH)? Select all that apply.
  9. Duck gait.
  10. Pain.
  11. Osteoarthritis in adulthood.
  1. Osteoporosis in adulthood.
  2. Increased flexibility of the hip joint in adulthood. - answer 1, 2, 3.
  3. Due to abnormal hip joint function, the patient's gait is stiff and waddling.
  4. Due to abnormal femoral head placement, the patient may experience pain and decreased flexibility in adulthood.
  5. Due to abnormal femoral head placement, the patient may experience osteoarthritis in the hip joint in adulthood. The nurse is teaching about congenital clubfoot in infants. The nurse evaluates the teaching as successful when the parent states that clubfoot is best treated when?
  6. Immediately after diagnosis.
  7. At age 4 to 6 months.
  8. Prior to walking (age 9 to 12 months).
  9. After walking is established (age 15 to 18 months). - answer 1. The best outcomes for clubfoot are seen if casting begins as soon as the diagnosis is made. Which is the definition of talipes varus?
  10. An inversion or bending inward of the foot.
  11. An eversion or bending outward of the foot.
  12. A high arch of the foot.
  13. A low arch (flatfoot) of the foot. - answer 1. Talipes varus is an inversion of the foot.
  1. A long-term goal in caring for a child with OI is to prevent contractures and deformities.
  2. There is no increased risk for bone infection in OI.
  3. A long-term goal in caring for a child with OI is to prevent muscle weakness. 230 PEDIATRIC SUCCESS
  4. A long-term goal in caring for a child with OI is to prevent osteoporosis.
  5. A long-term goal in caring for a child with OI is to prevent misalignment of lower extremity joints. Which classification of osteogenesis imperfecta (OI) is lethal in utero and in infancy?
  6. Type I.
  7. Type II.
  8. Type III.
  9. Type IV. - answer 2. Type II is lethal in utero and in infancy because of multiple fractures and deformities and underdeveloped lungs. When counseling the parents of a child with osteogenesis imperfecta (OI), the nurse should include which of the following? Select all that apply.
  10. Discourage future children because the condition is inherited.
  11. Provide education about the child's physical limitations.
  1. Give the parents a letter signed by the primary care provider explaining OI.
  2. Provide information on contacting the Osteogenesis Imperfecta Foundation.
  3. Encourage the parents to treat the child like their other children.
  4. Encourage use of calcium to decrease risk of fractures. - answer 2, 3, 4.
  5. Genetic counseling should be provided as part of long-term care so that the parents can make an informed decision about future children.
  6. The nurse should provide education about the child's physical limitations so that physical therapy and appropriate activity can be encouraged.
  7. OI is frequently confused with child abuse. Carrying a letter stating that the child has OI and what that condition looks like can ease the stressors of an emergency department visit.
  8. The Osteogenesis Imperfecta Foundation is an organization that can provide information and support for a family with a child with the condition.
  9. Children with OI must be treated with careful handling and cannot be allowed to participate in all activities that unaffected
  1. A physical examination of hip, thigh, and knees.
  2. A complete blood count.
  3. A radiographic examination of the hip. - answer 4. Radiographic examination is the only definitive diagnostic tool for SCFE. TEST-TAKING HINT: The most definitive tool in assessing a hip is radiographic examination. Which should be included in teaching a family about post-surgical care for slipped capital femoral epiphysis (SCFE)? Select all that apply.
  4. The patient will receive help with weight-bearing ambulation 24 to 48 hours after surgery.
  5. Monitoring of pain medication to prevent drug dependence.
  6. Instruction on pin site care.
  7. Offering low-calorie meals to encourage weight loss.
  8. Correct use of crutches by the patient.
  9. Outpatient physical therapy for 6 to 8 weeks. - answer 3, 5.
  10. Ambulation is to be non-weight bearing with crutches until range of motion is painless. This is usually 4 to 8 weeks.
  11. Pain medication is to be administered regularly during hospitalization to provide comfort to the patient and encourage cooperation with daily activities and ambulation. Drug dependence for the

post-operative patient is not a significant concern.

  1. The parents will be assessing pin sites for infection and stability upon discharge. Instructions on care should be demonstrated for and then by the parents.
  2. Although obesity is often a factor in SCFE, the patient requires adequate caloric intake for healing and recovery post-operatively. Obesity issues can be addressed after surgical recovery.
  3. Instruction on crutch usage will be given prior to discharge. Crutch walking will not be done during the early post-operative stage. Which would the nurse assess in a child diagnosed with osteomyelitis? Select all that apply.
  4. Unwillingness to move affected extremity.
  5. Severe pain.
  6. Fever.
  7. Previous closed fracture of an extremity.
  8. Redness and swelling at the site. - answer 1, 2, 3, 5.

The child is allergic to amoxicillin. Vital signs are T 101.8°F (38.8°C), BP 100/60, P 96, R 24. Which is the primary reason for surgical treatment?

  1. Young age.
  2. Drug allergies.
  3. Nonresponse to intravenous antibiotics.
  4. Physician preference. - answer 3. If a patient does not respond to an appropriate antibiotic within 48 hours, surgery may be indicated. The nurse expects the blood culture report of an 8-year-old with septic arthritis to grow which causative organism?
  5. Streptococcus pneumoniae.
  6. Escherichia coli.
  7. Staphylococcus aureus.
  8. Neisseria gonorrhoeae. - answer 3. S. aureus is a common organism found on the skin and is frequently the cause of septic arthritis. Which instruction(s) should the nurse give the parents of an adolescent with slipped capital femoral epiphysis (SCFE)? Select all that apply.
  9. Continue upper body exercises to limit loss of muscle strength.
  10. Do not turn the teen in bed when complaining of pain.
  11. Provide homework, computer games, and other activities to decrease boredom.
  12. Do most activities of daily living for the teen.
  1. Expect expressions of anger and hostility.
  2. Continue setting limits on behavior. - answer 1, 3, 5, 6.
  3. Immobilization can lead to a decrease in muscle strength. Upper body exercises should be continued soon after surgery.
  4. Although turning the patient in bed after surgery may be painful, it is essential that parents and the patient know that it is necessary to prevent skin ulcerations and promote healing.
  5. It is important for this patient to continue as many normal activities as possible. This should include schoolwork and leisure activities.
  6. To promote independence that is essential for a teenager, this patient should be encouraged to continue activities of daily living.
  7. Some expressions of anger and hostility are normal, as this adolescent is losing some independence with this immobility.
  8. Continuation of setting limits on

likelihood of a recurrence.

  1. Because clubfoot can recur, it is important to have regular follow-up with the orthopedic surgeon until age 18 years.
  2. After treatment, most children are able to participate in any sport.
  3. Even with proper bracing, there may be a recurrence.
  4. Most children treated for clubfeet develop normally appearing and functioning feet.
  5. Most children do not require surgery at puberty. Which parts of the body should the nurse assess on a child in a spica cast? List the relevant label(s) from the following figure. - answer C, D. The nurse needs to assess areas under the cast for drainage through the cast and assess neurocirculatory status of the feet. When a child is suspected of having osteomyelitis, the nurse can prepare the family to expect which of the following? Select all that apply.
  6. Pain medication is contraindicated so that symptoms are not masked.
  7. Blood cultures will be obtained.
  1. Pus will be aspirated from the subperiosteum.
  2. An intravenous line with antibiotics will be started.
  3. Surgery will be necessary. - answer 2, 3, 4.
  4. Medication will be given regularly to help with the pain.
  5. Blood cultures will be obtained.
  6. Pus will be aspirated from the subperiosteum.
  7. Antibiotics will be given via an intravenous line.
  8. Surgery is indicated only when medication fails. Where should the top of the crutch bar be in relation to the axilla? - answer The crutch bar should not put pressure on nerves in the axilla. Select the number of inches lateral to the heel where a crutch should be placed.
  9. 1 to 3.
  10. 4 to 5.
  11. 6 to 8.
  12. 9 to 10. - answer 3. This position provides the best protection for balance and stability.

poor appetite.

  1. Although decreased appetite is expected, it is something that needs nursing intervention in order to promote healing.
  2. An intravenous line is necessary for antibiotics, so it cannot be removed to encourage oral intake.
  3. Although some pain medications cause nausea, their use is important. If patients are in pain, they are not likely to want to eat.
  4. Small, frequent meals might increase daily caloric intake. The nurse on the pediatric floor is receiving a child with the possible diagnosis of septic arthritis of the elbow. Which would the nurse expect on assessment? Select all that apply.
  5. Resistance to bending the elbow.
  6. Nausea and vomiting.
  7. Fever.
  8. Bruising of the elbow.
  9. Swelling of the elbow.
  10. A history of nursemaid's elbow as a toddler. - answer 1, 2, 3, 5.
  11. Infection of the elbow joint can cause

pain that leads to protecting the joint and resisting movement.

  1. Infection of the elbow may cause generalized nausea and vomiting.
  2. Infection of the elbow frequently causes fever.
  3. There is no bruising with septic arthritis.
  4. Septic arthritis can cause swelling of the joint.
  5. There is no increased risk with a history of nursemaid elbow. A 12-year-old diagnosed with scoliosis is to wear a brace for 23 hours a day. What is the most likely reason the child will not wear it for that long?
  6. Pain from the brace.
  7. Difficulty in putting the brace on.
  8. Self-consciousness about appearance.
  9. Not understanding what the brace is for. - answer 3. Children this age are very conscious of their appearance and fitting in with their peers, so they might be very resistant to wearing a brace. A spinal curve of less than _________ degrees that is non progressive does not require treatment for scoliosis. - answer 20. A 20-degree spinal curve that is nonprogressive

opioid analgesia. What should the nurse do first?

  1. Give more pain medication.
  2. Perform a neuromuscular assessment.
  3. Call the surgeon for orders.
  4. Tell the child to wait another hour for the medication to work. - answer 2. The nurse looks for the source of the pain by performing a neuromuscular assessment. A 14-year-old with osteogenesis imperfecta (OI) is confined to a wheelchair. Which nursing interventions will promote normal development? Select all that apply.
  5. Encourage participation in groups with teens who have disabilities or chronic illness.
  6. Encourage decorating the wheelchair with stickers.
  7. Encourage transfer of primary care to an adult provider at age 18 years.
  8. Allow the teen to view the radiographs.
  9. Help the teen set realistic goals for the future.
  10. Discourage discussion of sexuality, as the child is not likely to date. - answer 1, 2, 4, 5. After the birth of an infant with clubfoot, the nursery nurse should do which when instructing the parents? Select all that apply.
  11. Speak in simple language about the defect.
  12. Avoid the parents unless providing direct care so they can grieve privately.
  13. Keep the infant's feet covered at all times.
  14. Present the infant as precious; emphasize the well-formed parts of the body.
  1. Tell the parent that defects could be much worse.
  2. Be prepared to answer questions multiple times. - answer 1, 4, 6.
  3. The parents will likely be shocked immediately after the birth of the child. To facilitate their understanding, the nurse should speak in simple terms.
  4. Avoiding the parents is not therapeutic.
  5. The baby should be shown to the parents as are all newborns, without hiding the clubfoot.
  6. The baby should be shown to the parents as are all newborns, emphasizing the well-formed parts of the body.
  7. Negating the parents' grieving is not therapeutic.
  8. Information may need to be repeated as the family begins to absorb the information. When instructing a family about care of an orthosis, the nurse should emphasize which of the following?
  9. Clean the brace with diluted bleach.
  10. Dry the brace over a heater or in the sun.
  11. Clean the brace weekly with mild soap and water.