Problems of locomotion – Osteomyelitis, Poliomyelitis, Kyphosis, Lordosis, Scoliosis, Fractures
Time: 15:00
A patient with a new tibial fracture and a full leg cast complains of severe pain unrelieved by analgesics, along with numbness and tingling in their toes. The nurse recognizes these as hallmark signs of which serious complication?
[a] Osteomyelitis.
[b] Fat Embolism Syndrome.
[c] Compartment Syndrome.
[d] A deep vein thrombosis (DVT).
The school nurse is screening for scoliosis. Which assessment technique is most commonly used for this purpose?
[a] Measuring leg length.
[b] Assessing the range of motion of the spine.
[c] Palpating the spinal processes for tenderness.
[d] The Adam's forward bend test.
A child is admitted with acute hematogenous osteomyelitis. What is the priority nursing intervention in the initial management?
[a] Encouraging weight-bearing on the affected limb.
[b] Applying warm compresses to the affected area.
[c] Administering intravenous antibiotics as prescribed.
[d] Preparing the child for immediate surgical debridement.
The most effective method of preventing poliomyelitis is through:
[a] Strict hand hygiene.
[b] Prophylactic antiviral medication.
[c] Widespread immunization.
[d] Isolation of infected individuals.
An elderly patient presents with an exaggerated posterior curvature of the thoracic spine, often referred to as "humpback." The nurse correctly identifies this condition as:
[a] Scoliosis.
[b] Lordosis.
[c] Kyphosis.
[d] Spondylolisthesis.
A patient is placed in skeletal traction for a femur fracture. A critical nursing responsibility is to:
[a] Remove the weights for one hour every shift to relieve pressure.
[b] Ensure the weights hang freely and are not resting on the floor.
[c] Encourage the patient to lift the weights to strengthen the muscle.
[d] Keep the head of the bed elevated at 90 degrees.
An excessive inward curvature of the lumbar spine, or "swayback," which is common in pregnancy and obesity, is known as:
[a] Kyphosis.
[b] Scoliosis.
[c] Lordosis.
[d] Ankylosis.
During the acute phase of paralytic poliomyelitis, the nurse's priority assessment should focus on the patient's:
[a] Nutritional status.
[b] Respiratory function.
[c] Bowel and bladder control.
[d] Skin integrity.
A greenstick fracture, common in children, is best described as:
[a] A fracture where the bone is crushed into several pieces.
[b] A fracture that breaks through the skin.
[c] An incomplete fracture where one side of the bone breaks and the other side bends.
[d] A fracture that runs parallel to the long axis of the bone.
A key component of patient education for an adolescent wearing a brace for scoliosis is to:
[a] Apply lotions or powders under the brace to prevent chafing.
[b] Remove the brace whenever it feels uncomfortable.
[c] Wear a clean, snug-fitting cotton shirt under the brace.
[d] Adjust the brace straps daily for a tighter fit.
A patient is suspected of having osteomyelitis. The nurse anticipates that which laboratory values will be elevated, indicating inflammation or infection?
[a] Serum calcium and phosphate.
[b] Hemoglobin and hematocrit.
[c] Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP).
[d] Alanine aminotransferase (ALT) and aspartate aminotransferase (AST).
The "5 P's" of a neurovascular assessment for a patient with a fracture include Pain, Pallor, Pulselessness, Paresthesia, and:
[a] Pressure.
[b] Position.
[c] Paralysis.
[d] Perspiration.
A patient with a history of poliomyelitis from decades ago now reports new-onset muscle weakness, pain, and fatigue. The nurse recognizes these symptoms as being characteristic of:
[a] Guillain-Barré syndrome.
[b] Multiple sclerosis.
[c] Post-polio syndrome.
[d] An acute recurrence of the poliovirus.
A patient has just undergone spinal fusion surgery for severe scoliosis. Which nursing action is essential in the immediate post-operative period?
[a] Encouraging the patient to sit up in a chair as soon as possible.
[b] Bending the patient at the waist to help with repositioning.
[c] Using the log-rolling technique to turn the patient.
[d] Placing pillows under the patient's knees to relieve back pain.
A patient with a fractured femur develops sudden shortness of breath, confusion, and a petechial rash on the chest and neck. The nurse should have a high index of suspicion for:
[a] Pulmonary embolism.
[b] Fat Embolism Syndrome.
[c] Compartment Syndrome.
[d] Anaphylactic shock.
Which instruction is most important for a nurse to give a patient who has just had a plaster cast applied to their arm?
[a] "Cover the cast with a plastic bag for the first 48 hours."
[b] "Do not stick any objects, such as a coat hanger, inside the cast to scratch an itch."
[c] "The cast will be fully dry and hardened in about 2-3 hours."
[d] "It's normal for your fingers to be cold and blue for the first day."
The primary mode of transmission for the poliovirus is the:
[a] Respiratory route.
[b] Blood-borne route.
[c] Fecal-oral route.
[d] Vector-borne route (e.g., mosquitoes).
A patient with chronic osteomyelitis is being discharged. The nurse anticipates that the patient will require:
[a] A short course of oral antibiotics for one week.
[b] Daily physical therapy sessions.
[c] Complete immobilization of the affected limb.
[d] Long-term intravenous antibiotic therapy via a central line.
A spiral fracture in a non-ambulatory infant is a significant finding that should prompt the nurse to assess for:
[a] Osteogenesis imperfecta.
[b] Nutritional deficiencies like rickets.
[c] Possible child abuse.
[d] Congenital hip dysplasia.
Scoliosis is defined as a deformity of the spine characterized by:
[a] A posterior curvature.
[b] An anterior curvature.
[c] A lateral curvature.
[d] A compression of the vertebrae.
In addition to pain, a common local sign of acute osteomyelitis is:
[a] Crepitus over the affected bone.
[b] Swelling, redness, and warmth over the affected area.
[c] A palpable hardening of the muscle tissue.
[d] Numbness and tingling in the distal extremity.
What is the primary purpose of applying a cast to a fractured limb?
[a] To reduce swelling and inflammation.
[b] To immobilize the bone and maintain alignment for proper healing.
[c] To prevent infection in an open fracture.
[d] To completely eliminate pain.
Management of mild adolescent kyphosis often focuses on:
[a] Surgical intervention.
[b] The use of a rigid back brace 23 hours a day.
[c] Physical therapy to strengthen core and back muscles.
[d] A long course of anti-inflammatory medication.
A fracture in which the bone is broken into two or more fragments is called a:
[a] Greenstick fracture.
[b] Transverse fracture.
[c] Comminuted fracture.
[d] Oblique fracture.
Which of the following is considered the definitive host of the poliovirus?
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