Exam (elaborations)
NSG-317 Musculoskeletal EAQ
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NSG-317 Musculoskeletal EAQ
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NSG-317 MUSCULOSKELETAL EAQUESTIONS WITH COMPLETE
SOLUTION
hThe nurse is caring for a child experiencing disuse atrophy of the left arm. What is the most effective
nursing intervention that can be implemented to decrease muscle catabolism?
a) Maintaining correct body alignment
b) Performing range-of-motion exercises
c) Providing a high-protein, high-fiber diet
d) Planning play activities to use the uninvolved extremity - b) Performing range-of-motion exercises
Rationale
Performing range-of-motion exercises will help decrease muscle catabolism. Exercises incorporated into
the care of this patient can include active, passive, and stretching exercises. Maintaining correct body
alignment helps preserve joint mobility and prevent contractures. A high-protein high-fiber diet is
beneficial for a patient with a decreased metabolic rate or a decreased food intake. Planning play
activities to use the uninvolved extremity is an excellent intervention for the child who has a decreased
tolerance for exercise due to decreased muscle tone, strength, and endurance.
p. 1422
What nursing intervention is included in the plan of care for a child with a newly fiberglass-casted left
arm?
a) Elevating the extremity
b) Exposing the cast to air until dry
c) Placing the extremity on a plastic pillow
d) Engaging in quiet activities with the use of muscles - a) Elevating the extremity
Rationale
, Elevating the extremity will help promote venous return and decrease edema in the extremity in order
to help prevent compartment syndrome. During the first few hours after a cast is applied, the chief
concern is that the extremity may continue to swell to the extent that compartment syndrome occurs. A
fiberglass cast does not need to dry. A wet plaster cast should be placed on a plastic pillow and handled
by the palms of the hands to prevent indentation, which can create pressure areas. Engaging in quiet
activities and encouraging use of muscles can be included in the long-term plan of care if needed.
p. 1430
A 5-year-old child fractured the left elbow while playing with friends. The health care provider has
prescribed regular cast changes and bed rest. What should the nurse educate the parents about cast
care?
a) Apply lotion to the skin after cast removal.
b) Scrub away residual material on the skin.
c) Immerse the cast briefly in a tub bath.
d) Cover the damp cast edges with adhesive. - a) Apply lotion to the skin after cast removal.
Rationale
After the cast is removed, the skin surface will be caked with desquamated skin and sebaceous
secretions. Application of mineral oil or lotion may remove the particles and provide comfort. The
parents and child should be instructed not to pull or forcibly remove this material with vigorous
scrubbing because it may cause excoriation and bleeding. The skin under the cast may become
macerated from inadequate drying after water immersion. Adhesive will not adhere to a damp cast even
if the cast is composed of fiberglass; it takes about a half-hour for it to dry.
p. 1432
What is characteristic of fractures in children compared to adults?
a) Fractures rarely occur at the growth plate site, because it absorbs shock well.
b) Rapidity of healing is inversely related to the age of the child.
c) Pliable bones of growing children are less porous than those of the adult.
d) Periosteum of a child's bone is thinner, weaker, and has less osteogenic potential compared with that
of the adult. - b) Rapidity of healing is inversely related to the age of the child.
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