MULTIPLE CHOICE

1. The nurse is caring for a 4-year-old child immobilized by a fractured hip. Which complication should the nurse monitor related to the child’s immobilization status?

a. Metabolic rate increases

b. Increased joint mobility leading to contractures

c. Bone calcium increases, releasing excess calcium into the body (hypercalcemia)

d. Venous stasis leading to thrombi or emboli formation

2. The nurse is caring for a preschool child immobilized by a spica cast. Which effect on metabolism should the nurse monitor on this child related to the immobilized status?

a. Hypocalcemia

b. Decreased metabolic rate

c. Positive nitrogen balance

d. Increased production of stress hormones

3. The nurse should monitor for which effect on the cardiovascular system when a child is immobilized?

a. Venous stasis

b. Increased vasopressor mechanism

c. Normal distribution of blood volume

d. Increased efficiency of orthostatic neurovascular reflexes

4. Which can result from the bone demineralization associated with immobility?

a. Osteoporosis

b. Urinary retention

c. Pooling of blood

d. Susceptibility to infection

5. A young girl has just injured her ankle at school. In addition to calling the child’s parents, the most appropriate, immediate action by the school nurse is to:

a. apply ice.

b. observe for edema and discoloration.

c. encourage child to assume a position of comfort.

d. obtain parental permission for administration of acetaminophen or aspirin.

6. Which term is used to describe a type of fracture that does not produce a break in the skin?

a. Simple

b. Compound

c. Complicated

d. Comminuted

7. Kristin, age 10 years, sustained a fracture in the epiphyseal plate of her right fibula when she fell off of a tree. When discussing this injury with her parents, the nurse should consider which statement?

a. Healing is usually delayed in this type of fracture.

b. Growth can be affected by this type of fracture.

c. This is an unusual fracture site in young children.

d. This type of fracture is inconsistent with a fall.

8. The nurse is conducting a staff in-service on casts. Which is an advantage to using a fiberglass cast instead of a plaster of Paris cast?

a. Cheaper

b. Dries rapidly

c. Molds closely to body parts

d. Smooth exterior

9. The nurse is conducting teaching to parents of a 7-year-old child who fractured an arm and is being discharged with a cast. Which instruction should be included in the teaching?

a. Swelling of the fingers is to be expected for the next 48 hours.

b. Immobilize the shoulder to decrease pain in the arm.

c. Allow the affected limb to hang down for 1 hour each day.

d. Elevate casted arm when resting and when sitting up.

10. The nurse uses the palms of the hands when handling a wet cast for which reason?

a. To assess dryness of the cast

b. To facilitate easy turning

c. To keep the patient’s limb balanced

d. To avoid indenting the cast