CPEN CPEN Orthopedic and Musculoskeletal Emergencies 4

Question 1

A 10-year-old presents after falling on an outstretched hand. X-ray shows a fracture through the distal radial physis with the epiphysis displaced. Which Salter-Harris classification is this?

Accepted Answer

Type II

Answer

Salter-Harris Type II involves a fracture through the physis that extends into the metaphysis, making it the most common type.

Question 2

A 7-year-old with sickle cell disease presents with severe bilateral leg pain, fever, and swelling. The nurse suspects which orthopedic emergency?

Accepted Answer

Vaso-occlusive bone infarction

Answer

Vaso-occlusive crisis in sickle cell disease causes bone infarction due to sickling within the bone marrow vasculature, presenting with severe pain and swelling.

Question 3

An 8-year-old boy presents with hip pain and a limp for 3 weeks. X-ray shows flattening of the left femoral head. Which condition is most likely?

Accepted Answer

Legg-Calvé-Perthes disease

Answer

Legg-Calvé-Perthes disease is avascular necrosis of the femoral head in children aged 4–10, presenting with insidious hip pain and characteristic X-ray changes.

Question 4

A 14-year-old obese male presents with left hip and knee pain after playing basketball. His left leg is externally rotated. Which diagnosis should the nurse prioritize?

Accepted Answer

Slipped capital femoral epiphysis

Answer

Slipped capital femoral epiphysis (SCFE) is most common in obese adolescents and presents with hip or referred knee pain and external rotation of the affected leg.

Question 5

A 5-year-old is brought in with refusal to use the right arm after being swung by the arms. Examination shows the arm held in pronation with elbow slightly flexed. Which intervention is appropriate?

Accepted Answer

Perform hyperpronation or supination-flexion maneuver

Answer

Nursemaid's elbow (radial head subluxation) is treated with a hyperpronation or supination-flexion reduction maneuver, which is typically immediately effective.

CPEN - Certified Pediatric Emergency Nurse Practice Test

CPEN - Certified Pediatric Emergency Nurse Practice Test

CPEN CPEN Orthopedic and Musculoskeletal Emergencies 4