What intervention is appropriate for a nurse assessing a preadolescent child for scoliosis?

Ask the child to bend forward at the waist and observe the child’s back for asymmetry.

Observe the gait while the child is walking forward heel to toe.

Have the child flex the knees and look for uneven knee height.

Look at the child’s shoulders and hips while fully clothed.

Answer and Explanation

The Correct Answer is A

Choice A reason: The forward bend test is the standard for scoliosis screening, revealing spinal asymmetry (rib hump) due to lateral curvature. It detects abnormal spinal alignment in preadolescents, when growth spurts exacerbate scoliosis, allowing early intervention to prevent progression.
Choice B reason: Observing gait (heel-to-toe walking) assesses neurological or musculoskeletal function but not spinal curvature. Scoliosis primarily affects spinal alignment, not gait, unless severe, making this less effective for detecting the lateral curvature characteristic of scoliosis.
Choice C reason: Flexing the knees to check knee height assesses leg length discrepancy, not spinal curvature. Scoliosis involves lateral spinal deviation, and knee height is unrelated to detecting the spinal asymmetry critical for diagnosis.
Choice D reason: Observing shoulders and hips while clothed is less effective, as clothing obscures subtle asymmetries. The forward bend test, performed without clothing, better reveals spinal curvature or rib hump, the hallmark signs of scoliosis in preadolescents.

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Correct Answer is B

Explanation

Choice A reason: Guiding a child to the floor during a seizure is unsafe, as it risks injury to both the child and nurse due to uncontrolled movements. Leaving to get help abandons the child, increasing injury risk during the seizure’s tonic-clonic phase.
Choice B reason: Moving objects away from a child during a tonic-clonic seizure prevents injury from striking hard surfaces. Generalized seizures cause uncontrolled muscle contractions, increasing the risk of trauma. Ensuring a safe environment is a priority to minimize harm during the seizure event.
Choice C reason: Inserting a tongue blade, even padded, risks dental injury or airway obstruction, as jaw clenching is common in tonic-clonic seizures. Current guidelines advise against placing objects in the mouth, as it does not prevent tongue biting and may cause harm.
Choice D reason: Restraining a child during a seizure can cause fractures or soft tissue injury due to forceful muscle contractions. It also increases stress and hypoxia risk. Allowing the seizure to occur while ensuring safety is the recommended approach to minimize complications.

A. Have adequate help to transfer the patient. B. Provide socks so the patient can slide easier. C. Tell the patient full weight bearing is allowed. D. Use a footstool to elevate the patient’s leg.

Correct Answer is A

Explanation

Choice A reason: Uncemented hip arthroplasty requires careful transfer to prevent dislocation of the new joint, which relies on bone ingrowth for stability. Adequate help (e.g., two staff members) ensures safe transfer, minimizing stress on the surgical site and reducing the risk of falls or prosthesis misalignment.
Choice B reason: Providing socks to “slide easier” increases the risk of slipping during transfer, which could lead to falls or hip dislocation. Non-slip footwear is preferred to ensure stability and safety during mobilization post-hip arthroplasty.
Choice C reason: Full weight bearing is typically restricted after uncemented hip arthroplasty to allow bone ingrowth into the prosthesis. Informing the patient that full weight bearing is allowed is incorrect and could lead to implant failure or dislocation.
Choice D reason: Using a footstool to elevate the leg during transfer is inappropriate, as it may cause hip flexion beyond 90 degrees, increasing the risk of dislocation. Elevation is used in specific positions but not during initial transfers.

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What intervention is appropriate for a nurse assessing a preadolescent child for scoliosis?

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Naxlex Comprehensive Predictor Exams

What is an appropriate nursing action when a child is experiencing a generalized tonic-clonic seizure?

Correct Answer is B

Explanation

A client is getting out of bed into a chair for the first time after an uncemented total hip arthroplasty. What action by the nurse is appropriate?

Correct Answer is A

Explanation

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