Situational Multiple Choice Quiz: Alterations in Musculoskeletal Coordination

1. A child presents with a limp and hip pain. On examination, a Galeazzi test is positive. What condition should the nurse suspect?
a. Clubfoot
b. Congenital hip dysplasia
c. Osteogenesis imperfecta
d. Scoliosis

2. During a newborn assessment, a nurse notices a clicking sound when performing the Ortolani maneuver. What does this suggest?
a. Spina bifida
b. Hip dysplasia
c. Rheumatoid arthritis
d. Talipes equinovarus

3. A school-aged child is diagnosed with scoliosis, showing a 25-degree curve in the thoracic region. What is the most appropriate treatment?
a. Immediate surgery
b. Regular observation
c. Bracing
d. Physical therapy only

4. After being casted for clubfoot, what is the priority nursing action for the child?
a. Elevating the leg to reduce swelling
b. Removing the cast after 24 hours
c. Applying heat packs to the foot
d. Encouraging early ambulation

5. Which clinical manifestation is most commonly associated with juvenile idiopathic arthritis?
a. Decreased muscle tone
b. Morning stiffness in joints
c. Hypermobile joints
d. Pain in the hips at night

6. A nurse is assessing a child with osteogenesis imperfecta. What should the nurse expect to find?
a. Blue sclera
b. Café-au-lait spots
c. Gait disturbances
d. Kyphoscoliosis

7. In managing a child with a greenstick fracture, what is the primary treatment goal?
a. Immediate surgical intervention
b. Realigning the bone with closed reduction
c. Administering antibiotics
d. Bone grafting

8. A child presents with a severe clubfoot. Which non-surgical intervention is likely to be tried first?
a. Physical therapy
b. Orthotic shoe inserts
c. Serial casting
d. Splinting

9. A nurse observes a child with juvenile rheumatoid arthritis who has developed uveitis. What is the most important nursing intervention?
a. Administering pain medications
b. Applying cold compresses
c. Coordinating with an ophthalmologist
d. Encouraging fluid intake

10. What diagnostic test is essential for confirming developmental dysplasia of the hip in a newborn?
a. X-ray
b. MRI
c. Ultrasound
d. CT scan

11. After a spinal fusion surgery for scoliosis, what is the priority nursing intervention?
a. Encourage early ambulation
b. Log-rolling the patient
c. Elevating the lower extremities
d. Applying a warm compress to the surgical site

12. A nurse is caring for a child with a supracondylar fracture of the humerus. What complication should the nurse be most concerned about?
a. Compartment syndrome
b. Bone malunion
c. Osteoporosis
d. Delayed bone healing

13. A patient diagnosed with carpal tunnel syndrome complains of tingling and numbness. Which test is most likely to confirm the diagnosis?
a. Phalen's test
b. Tinel’s sign
c. McMurray test
d. Thomas test

14. Which characteristic finding is associated with scoliosis during a physical examination?
a. One shoulder is higher than the other
b. Lordosis
c. Pain in both legs
d. Difficulty standing straight

15. A child diagnosed with a burst fracture is at risk for which complication?
a. Nerve damage
b. Joint dislocation
c. Bone necrosis
d. Osteoarthritis

16. A nurse is teaching a family about the Ponsetti method for treating clubfoot. What information should the nurse include?
a. The cast is changed weekly to gradually reposition the foot
b. Surgery is the primary treatment for all patients
c. The child will wear a full-leg cast for 12 months
d. The child will need to avoid weight-bearing for a year

17. After undergoing a closed reduction for a dislocated shoulder, what is the priority for nursing care?
a. Ensuring proper immobilization
b. Encouraging range of motion exercises
c. Applying heat packs
d. Administering anti-inflammatory medications

18. In caring for a child with rheumatoid arthritis, what intervention helps maintain joint mobility?
a. Applying cold compresses
b. Encouraging high-impact exercises
c. Performing range-of-motion exercises
d. Encouraging complete bed rest

19. A 7-year-old with scoliosis has a Cobb angle of 50 degrees. What is the expected management?
a. Observation
b. Bracing
c. Surgical intervention
d. Chiropractic therapy

20. A child has been diagnosed with osteogenesis imperfecta. What safety education should the nurse provide to the parents?
a. Encourage the child to engage in contact sports
b. Implement fall prevention strategies in the home
c. Limit the child's physical activity
d. Avoid using calcium supplements

21. A child presents with leg pain and a visible lump on the femur. Which condition should the nurse suspect?
a. Juvenile idiopathic arthritis
b. Ewing sarcoma
c. Rheumatoid arthritis
d. Carpal tunnel syndrome

22. Which finding is a classic sign of carpal tunnel syndrome?
a. Pain in the hip and knees
b. Weak grip strength
c. Shoulder stiffness
d. Painless wrist swelling

23. A child with juvenile idiopathic arthritis is prescribed methotrexate. What side effect should the nurse monitor for?
a. Nausea and vomiting
b. Skin rashes
c. Decreased urine output
d. High fever

24. A child presents with clubfoot deformity at birth. Which diagnostic test is most useful to assess the severity of the condition?
a. X-ray
b. MRI
c. Ultrasound
d. CT scan

25. What is the most appropriate initial treatment for congenital hip dysplasia in a newborn?
a. Spica casting
b. Pavlik harness
c. Hip surgery
d. Physical therapy

26. A child with rheumatoid arthritis reports worsening morning stiffness. Which nursing intervention is most appropriate?
a. Administering a corticosteroid
b. Encouraging high-impact exercise
c. Providing passive range-of-motion therapy
d. Applying a cold pack to the affected joints

27. A child with scoliosis is concerned about their appearance. What nursing action best supports the child’s psychosocial needs?
a. Avoid discussing the physical changes
b. Refer the child to a support group
c. Encourage the child to hide the brace under clothing
d. Focus on teaching about treatment benefits

28. A 9-year-old presents with a limp and hip pain, diagnosed with Legg-Calvé-Perthes disease. What is the goal of treatment?
a. Reduce pain with NSAIDs
b. Prevent hip deformity by maintaining joint function
c. Perform surgery immediately
d. Restrict all weight-bearing activities

29. A child diagnosed with juvenile rheumatoid arthritis is experiencing joint deformities. What is a potential long-term complication?
a. Joint replacement surgery
b. Sepsis
c. Loss of mobility
d. Peripheral neuropathy

30. In a child with congenital scoliosis, what is the primary factor influencing treatment decisions?
a. Family history of scoliosis
b. Location and severity of the curve
c. Physical activity level
d. Age of the child

Answer Key:

1. b

2. b

3. c

4. a

5. b

6. a

7. b

8. c

9. c

10. c

11. b

12. a

13. a

14. a

15. a

16. a

17. a

18. c

19. c

20. b

21. b

22. b

23. a

24. a

25. b

26. a

27. b

28. b

29. c

30. b