CPEN CPEN Orthopedic and Musculoskeletal Emergencies

Question 1

A child presents with pain and inability to bear weight after a fall. Which radiographic finding is unique to pediatric fractures?

Accepted Answer

Salter-Harris growth plate fracture

Answer

Comminuted fracture pattern

Answer

Spiral shaft fracture only

Answer

Open fracture with bone exposure

Question 2

Which clinical finding is the hallmark of compartment syndrome in a pediatric extremity injury?

Accepted Answer

Pain with passive stretch of the affected muscles out of proportion to the injury

Answer

Ecchymosis alone

Answer

Normal distal pulses

Answer

Mild warmth and erythema

Question 3

A 2-year-old presents with refusal to use his right arm after being lifted by the arm. Which injury is most likely?

Accepted Answer

Nursemaid's elbow (radial head subluxation)

Answer

Clavicle fracture

Answer

Supracondylar fracture

Answer

Shoulder dislocation

Question 4

Which type of fracture in a young child should raise suspicion for non-accidental trauma (NAT)?

Accepted Answer

Classic metaphyseal lesion or posterior rib fractures

Answer

Greenstick fracture of the radius

Answer

Toddler's spiral tibial fracture from walking fall

Answer

Clavicle fracture from delivery

Question 5

What is the priority nursing intervention for a child with an open fracture?

Accepted Answer

Cover the wound with a sterile moist dressing, immobilize, and administer antibiotics

Answer

Apply traction to realign the bone immediately

Answer

Irrigate the wound with hydrogen peroxide

Answer

Apply a tight circumferential bandage over the wound

Question 6

A child with a suspected supracondylar fracture should be monitored closely for which neurovascular complication?

Accepted Answer

Anterior interosseous nerve injury and brachial artery compromise

Answer

Peroneal nerve palsy

Answer

Radial nerve palsy only

Answer

Axillary nerve palsy