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

Salter-Harris fractures involve the physis (growth plate) and are unique to skeletally immature patients, with classification guiding prognosis and treatment.

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

Pain with passive muscle stretch that is disproportionate to the injury is the earliest and most reliable sign of compartment syndrome.

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

Nursemaid's elbow occurs when longitudinal traction on an outstretched arm causes subluxation of the radial head beneath the annular ligament, common in toddlers.

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

Classic metaphyseal lesions (bucket-handle fractures) and posterior rib fractures are high-specificity indicators of non-accidental trauma in young children.

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

Open fractures require sterile wound coverage to reduce infection risk, proper splinting for immobilization, and prompt IV antibiotics to prevent osteomyelitis.

CPEN - Certified Pediatric Emergency Nurse Practice Test

CPEN - Certified Pediatric Emergency Nurse Practice Test

CPEN CPEN Orthopedic and Musculoskeletal Emergencies