11. Which should cause a nurse to suspect that an infection has developed under a cast?

a. Complaint of paresthesia

b. Cold toes

c. Increased respirations

d. “Hot spots” felt on cast surface

12. A child is upset because, when the cast is removed from her leg, the skin surface is caked with desquamated skin and sebaceous secretions. Which should the nurse suggest to remove this material?

a. Soak in a bathtub.

b. Vigorously scrub leg.

c. Apply powder to absorb material.

d. Carefully pick material off leg.

13. An adolescent with a fractured femur is in Russell’s traction. Surgical intervention to correct the fracture is scheduled for the morning. Nursing actions should include which action?

a. Maintaining continuous traction until 1 hour before the scheduled surgery

b. Maintaining continuous traction and checking position of traction frequently

c. Releasing traction every hour to perform skin care

d. Releasing traction once every 8 hours to check circulation

14. Which is a type of skin traction with legs in an extended position?

a. Dunlop

b. Bryant

c. Russell

d. Buck extension

15. Which type of traction uses skin traction on the lower leg and a padded sling under the knee?

a. Dunlop

b. Bryant

c. Russell

d. Buck extension

16. Four-year-old David is placed in Buck extension traction for Legg-Calvé-Perthes disease. He is crying with pain as the nurse assesses that the skin of his right foot is pale with an absence of pulse. Which action should the nurse take first?

a. Notify the practitioner of the changes noted.

b. Give the child medication to relieve the pain.

c. Reposition the child and notify physician.

d. Chart the observations and check the extremity again in 15 minutes.

17. Which is an appropriate nursing intervention when caring for a child in traction?

a. Remove adhesive traction straps daily to prevent skin breakdown.

b. Assess for tightness, weakness, or contractures in uninvolved joints and muscles.

c. Provide active range-of-motion exercises to affected extremity three times a day.

d. Keep the child in one position to maintain good alignment.

18. The nurse is teaching a family how to care for their infant in a Pavlik harness to treat developmental dysplasia of the hip. Which should be included?

a. Apply lotion or powder to minimize skin irritation.

b. Remove harness several times a day to prevent contractures.

c. Return to clinic every 1 to 2 weeks.

d. Place diaper over harness, preferably using a superabsorbent disposable diaper that is relatively thin.

19. A neonate is born with bilateral mild talipes equinovarus (clubfoot). When the parents ask the nurse how this will be corrected, the nurse should give which explanation?

a. Traction is tried first.

b. Surgical intervention is needed.

c. Frequent, serial casting is tried first.

d. Children outgrow this condition when they learn to walk.

20. A 4-year-old child is newly diagnosed with Legg-Calvé-Perthes disease. Nursing considerations should include which action?

a. Encouraging normal activity for as long as is possible

b. Explaining the cause of the disease to the child and family

c. Preparing the child and family for long-term, permanent disabilities

d. Teaching the family the care and management of the corrective appliance