A nurse is evaluating a child during a well exam. The nurse discovers that one leg is shorter than the other. Which is most likely the cause of the difference in leg length?
Fracture of the epiphyseal plate.
Scoliosis.
Comminuted clavicle fracture.
Juvenile idiopathic arthritis.
The Correct Answer is A
A. A fracture involving the epiphyseal plate (growth plate) can lead to differential growth in the affected limb. If a fracture occurs before the growth plate has closed, it can potentially result in the shorter leg as the growth in that limb may be inhibited compared to the unaffected leg.
B. While scoliosis can lead to asymmetrical body positioning and potentially cause a perception of leg length discrepancy, it does not typically cause a true difference in bone length. Instead, scoliosis affects the spine's curvature and may alter posture, but it’s not a direct cause of one leg being shorter than the
other.
C. A comminuted clavicle fracture primarily affects the shoulder and does not impact leg length. It involves the upper limb and does not contribute to any differences in the lengths of the legs, making this option irrelevant to the observed leg length discrepancy.
D. JIA can lead to joint inflammation and may affect limb growth if it causes significant damage to the joints. However, while it can potentially cause some discrepancies in limb length due to joint issues, it is less directly associated with one leg being shorter than the other compared to an epiphyseal plate fracture.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. In roseola (also known as exanthem subitum or sixth disease), a child typically develops a rash that is characterized by small, rose-colored spots (maculopapular rash) after the fever resolves. However, it is not primarily described as a "red papular rash" at the onset, which can lead to some confusion.
B. Koplik spots are small, white lesions that appear inside the mouth and are characteristic of measles, not roseola. They do not occur in roseola.
C. A severe cough is not a symptom of roseola. While respiratory symptoms can be present in many viral infections, roseola is primarily characterized by a high fever followed by a rash, with minimal respiratory involvement.
D. Inflammation of the parotid gland is associated with mumps, not roseola. Roseola does not typically involve swelling of the salivary glands.
Correct Answer is C
Explanation
A. While calamine lotion can be soothing and help alleviate itching, applying a thick coat over open lesions is not advisable. It may not allow the skin to breathe and can potentially lead to further irritation or infection. Therefore, while this option has some merit, it is not the priority intervention.
B. Diphenhydramine (Benadryl) is an antihistamine that can help relieve itching. This option can be beneficial for managing pruritus and may help the child sleep better. However, while it can be useful, there are other interventions that can provide immediate comfort more effectively.
C. Applying a cool cloth to the rash is an immediate and effective way to provide comfort and relieve itching. The coolness can soothe inflamed skin and reduce the urge to scratch, which helps prevent secondary infections.
D. While giving ibuprofen or acetaminophen can help reduce fever and discomfort associated with varicella, it does not specifically address pruritus. These medications are helpful for pain management but are not the best choice for alleviating itching directly.
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