A 6-year-old patient who has been placed in skeletal traction has pain, edema, and fever.
The nurse should assess which of the following?

Neurologic status

Range of motion of all extremities

Warmth at site of pain

Blood pressure

Answer and Explanation

The Correct Answer is C

In the given scenario, the 6-year-old patient in skeletal traction is experiencing
pain, edema, and fever. These symptoms raise concerns about the possibility of an infection
at the site of traction. In such cases, the nurse should assess for warmth at the site of pain.
Increased warmth can indicate inflammation, which may be associated with infection. This
assessment finding would require further investigation and intervention, such as notifying the
healthcare provider and obtaining appropriate cultures or imaging studies.
Neurologic status in (Option A) is incorrect because assessing neurologic status, is important
but not the priority in this scenario. Neurologic status assessment is typically performed to
evaluate any neurovascular compromise resulting from the traction, but the presence of pain,
edema, and fever suggests a potential infection that requires immediate attention.
Range of motion of all extremities in (Option B) is incorrect because assessing the range of
motion of all extremities, is not directly relevant to the given symptoms and should not take
priority over assessing for warmth at the site of pain.
Blood pressure in (Option D) is incorrect because assessing blood pressure, is not directly
related to the symptoms of pain, edema, and fever in the context of skeletal traction. While
blood pressure is an essential vital sign, it does not provide specific information about the
potential infection at the site of pain in this situation.

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Correct Answer is D

Explanation

The first sign of pubertal change seen with boys is testicular enlargement. This is known as testicular or scrotal growth and is one of the earliest physical signs of puberty in boys. Testicular enlargement is followed by other changes such as the growth of pubic hair, penile growth, voice deepening, and facial hair growth.

voice deepening in (option A) is incorrect because it, typically occurs after testicular enlargement and is associated with the growth and development of the larynx during puberty.

scrotal enlargement in (option B) is incorrect because it, may occur simultaneously or shortly after testicular enlargement as part of overall genital growth during puberty.

, facial hair growth in (option C) is incorrect because it, is a later sign of pubertal development in boys and typically occurs after the initial testicular enlargement and growth of pubic hair.

A. Organisms destroy intestinal mucosal cells, resulting in an increased intestinal surface area. B. Malabsorption results in metabolic alkalosis. C. Increased motility results in impaired absorption of fluid and nutrients. D. Diarrhea results from a fluid deficit in the small intestine.

Correct Answer is C

Explanation

Diarrhea is characterized by increased motility of the intestines, which leads to a decreased absorption of fluid and nutrients. This statement correctly indicates an understanding of the teaching regarding diarrhea.

Organisms destroy intestinal mucosal cells, resulting in an increased intestinal surface area in (Option A) is incorrect because organisms causing diarrhea can lead to damage or inflammation of the intestinal mucosal cells, but they do not destroy them to increase the intestinal surface area.

Malabsorption results in metabolic alkalosis in (Option B) is incorrect because malabsorption does not result in metabolic alkalosis. Malabsorption refers to the impaired absorption of nutrients, but it does not directly affect the acid-base balance in the body.

Diarrhea results from a fluid deficit in the small intestine in (Option D) is incorrect because diarrhea does not result from a fluid deficit in the small intestine. Diarrhea is characterized by an increased volume of fluid in the intestines and increased frequency of bowel movements.

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A 6-year-old patient who has been placed in skeletal traction has pain, edema, and fever. The nurse should assess which of the following?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is C

Explanation

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A 6-year-old patient who has been placed in skeletal traction has pain, edema, and fever.
The nurse should assess which of the following?