Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A 10-year-old child with a distal femoral fracture involving the growth plate is admitted for treatment. Which nursing action should be prioritized to prevent long-term complications related to growth disturbances?
A. instruct the child to avoid weight-bearing activities indefinitely to prevent fracture displacement.
Instruct the child to avoid weight-bearing activities indefinitely is incorrect because prolonged immobilization is unnecessary and can lead to muscle atrophy and delayed functional recovery. Weight-bearing should be restricted only as medically indicated during the initial healing phase.
B. Assure the parents that damage to the growth plate will not affect the length or shape of the child's limb.
Assure the parents that damage to the growth plate will not affect the length or shape of the child's limb is incorrect because growth plate (physeal) fractures can lead to limb length discrepancies or angular deformities if not properly monitored. Providing false reassurance could delay necessary interventions.
C. Explain that the fracture will heal at the same rate as an adult fracture regardless of age or growth plate involvement.
Explain that the fracture will heal at the same rate as an adult fracture regardless of age or growth plate involvement is incorrect because pediatric fractures involving the growth plate may have unique healing patterns and potential complications, including growth disturbances.
D. Educate the family on the importance of follow-up visits for growth assessment and early detection of limb length discrepancies.
Educate the family on the importance of follow-up visits for growth assessment and early detection of limb length discrepancies is correct because distal femoral physeal fractures carry a high risk for growth disturbances, including limb shortening or angular deformities. Regular follow-up with imaging and growth monitoring allows early identification and intervention, minimizing long-term functional and cosmetic complications.
This question is an excerpt from Nurse Dive's nursing test bank - Ati dmmsn 650 OB/Pediatrics Proctored Exams. Take the full exam now
Full Explanation
A. Instruct the child to avoid weight-bearing activities indefinitely is incorrect because prolonged immobilization is unnecessary and can lead to muscle atrophy and delayed functional recovery. Weight-bearing should be restricted only as medically indicated during the initial healing phase.
B. Assure the parents that damage to the growth plate will not affect the length or shape of the child's limb is incorrect because growth plate (physeal) fractures can lead to limb length discrepancies or angular deformities if not properly monitored. Providing false reassurance could delay necessary interventions.
C. Explain that the fracture will heal at the same rate as an adult fracture regardless of age or growth plate involvement is incorrect because pediatric fractures involving the growth plate may have unique healing patterns and potential complications, including growth disturbances.
D. Educate the family on the importance of follow-up visits for growth assessment and early detection of limb length discrepancies is correct because distal femoral physeal fractures carry a high risk for growth disturbances, including limb shortening or angular deformities. Regular follow-up with imaging and growth monitoring allows early identification and intervention, minimizing long-term functional and cosmetic complications.
Similar Questions
A nurse is assessing the sexual maturity of a 14-year-old male during a routine check-up. Based on Tanner's stages of sexual development, which of the following characteristics would the nurse expect to observe in a male at Tanner stage 3?
A. Enlargement of the testes and scrotum with the appearance of pubic hair
Enlargement of the testes and scrotum with the appearance of pubic hair is characteristic of Tanner stage 2, which marks the early stages of puberty. This is when initial changes in the genitalia and pubic hair begin.
B. Penile enlargement and deepening of the voice
Penile enlargement and deepening of the voice is correct because these changes occur during Tanner stage 3, representing continued pubertal development. Stage 3 includes further growth of the penis, continued enlargement of the testes, increased pubic hair that is darker and coarser, and the beginning of voice changes.
C. Increased muscle mass and facial hair growth
Increased muscle mass and facial hair growth is incorrect because these changes are more characteristic of Tanner stage 4–5, the later stages of puberty, when secondary sexual characteristics become more pronounced.
D. Full development of genitalia and the growth of axillary hair
Full development of genitalia and the growth of axillary hair is incorrect because this represents Tanner stage 5, which indicates full sexual maturity and adult genital development.
Full Explanation
A. Enlargement of the testes and scrotum with the appearance of pubic hair is characteristic of Tanner stage 2, which marks the early stages of puberty. This is when initial changes in the genitalia and pubic hair begin.
B. Penile enlargement and deepening of the voice is correct because these changes occur during Tanner stage 3, representing continued pubertal development. Stage 3 includes further growth of the penis, continued enlargement of the testes, increased pubic hair that is darker and coarser, and the beginning of voice changes.
C. Increased muscle mass and facial hair growth is incorrect because these changes are more characteristic of Tanner stage 4–5, the later stages of puberty, when secondary sexual characteristics become more pronounced.
D. Full development of genitalia and the growth of axillary hair is incorrect because this represents Tanner stage 5, which indicates full sexual maturity and adult genital development.
A nurse is assessing a newborn who is 12 hours old. The infant's total serum bilirubin is 13 mg/dL and jaundice is visible on the face and chest. The nurse knows this level is most likely
Full Explanation
Pathologic jaundice (Select 1): The most critical factor here is that the jaundice appeared within the first 24 hours of life. Physiologic jaundice typically appears after 24 hours, peaks between days 3–5, and usually does not reach levels as high as 13 mg/dL so rapidly. A level of 13 mg/dL at only 12 hours old is significantly elevated and indicates a rapid rise, which is characteristic of pathologic conditions like Rh/ABO incompatibility or sepsis.
Phototherapy (Select 2): This is the first-line medical intervention for significant hyperbilirubinemia. It uses light energy to change unconjugated bilirubin into a water-soluble form (lumirubin) that can be excreted in the bile and urine without needing to be processed by the liver.
A 10-year-old child with a known history of asthma presents to the clinic with increased coughing, wheezing, and chest tightness, especially at night. The nurse explains that these symptoms are related to the underlying pathophysiology of asthma. Which of the following best describes the primary pathophysiologic processes occurring during an asthma exacerbation?
A. Bronchial smooth muscle relaxation and increased surfactant production
Bronchial smooth muscle relaxation and increased surfactant production is incorrect because asthma exacerbations are characterized by bronchoconstriction, not relaxation. Surfactant production is not the primary issue in asthma.
B. Acute upper airway infection leading to mucus obstruction in the sinuses
Acute upper airway infection leading to mucus obstruction in the sinuses is incorrect because while infections can trigger exacerbations, asthma itself is a lower airway disease involving the bronchi and bronchioles, not the sinuses.
C. Collapse of alveoli due to surfactant deficiency and impaired gas exchange
Collapse of alveoli due to surfactant deficiency and impaired gas exchange is incorrect because this describes respiratory distress in premature infants (e.g., neonatal respiratory distress syndrome), not asthma.
D. Chronic airway inflammation, bronchoconstriction, and increased mucus production
Chronic airway inflammation, bronchoconstriction, and increased mucus production is correct because asthma is a chronic inflammatory disorder of the airways. During an exacerbation, inflammation causes airway edema, bronchial smooth muscle constriction narrows the airway, and excess mucus further obstructs airflow, leading to symptoms like wheezing, cough, and chest tightness.
Full Explanation
A. Bronchial smooth muscle relaxation and increased surfactant production is incorrect because asthma exacerbations are characterized by bronchoconstriction, not relaxation. Surfactant production is not the primary issue in asthma.
B. Acute upper airway infection leading to mucus obstruction in the sinuses is incorrect because while infections can trigger exacerbations, asthma itself is a lower airway disease involving the bronchi and bronchioles, not the sinuses.
C. Collapse of alveoli due to surfactant deficiency and impaired gas exchange is incorrect because this describes respiratory distress in premature infants (e.g., neonatal respiratory distress syndrome), not asthma.
D. Chronic airway inflammation, bronchoconstriction, and increased mucus production is correct because asthma is a chronic inflammatory disorder of the airways. During an exacerbation, inflammation causes airway edema, bronchial smooth muscle constriction narrows the airway, and excess mucus further obstructs airflow, leading to symptoms like wheezing, cough, and chest tightness.