Chapter 50, Adaptive Quizzing Chapter 50
The nursing instructor is teaching a group of nursing students about ganglions. Which statement made by a student indicates the need for further instruction?
"Activity should be avoided for 24 hours after surgery of a large ganglion cyst."
Which nursing action is appropriate when a patient requests spiritual guidance during a preoperative assessment?
offer assistance to arrange for a hospital chaplain to talk with the patient before surgery
Which medical term refers to bone infection caused by bacteria, viruses, or fungi?
osteomyelitis
What is the medical term for the bone disease caused by reduced blood flow to the bones in the joints?
osteonecrosis
Which chronic metabolic disease causes decreased bone density and possible fracture?
osteoporosis
Which is a priority problem for the older adult patient diagnosed with bone cancer?
potential for injury related to weakness and drug therapy
The nurse is assessing a patient with Ewing's sarcoma. Which finding does the nurse expect to observe?
leukocytosis
The nurse is teaching a patient with bunions on both feet about bone resection and fusion. Which statement made by the patient indicates that more teaching is needed?
"Healing time will take two weeks for each foot
The nurse completes a teaching session on safe drug administration for a patient with Paget's disease taking oral bisphosphonates. Which patient statement indicates a need for further teaching?
"I should go to sleep immediately after taking the drug."
The nurse assesses a middle-aged female patient. Which statement made by the patient causes the nurse to teach the patient about preventing hallux valgus?
"I wear high heels to work every day."
Which statement by a nursing student about the health economics associated with osteoporosis indicates a need for further teaching by the nursing instructor?
"Peripheral quantitative ultrasound (pQUS) is rarely used as a screening tool for osteoporosis detection because of its high cost."
The nurse is caring for a preoperative patient who is about to undergo a partial fasciectomy to treat Dupuytren contracture. The nurse ensures that the patient understands the procedure. Which statement made by the patient causes the nurse to do additional teaching?
"This surgery will tighten the fascia in my hand."
When performing a physical assessment, the nurse notices the patient has an ingrown toenail. What does the nurse advise the patient? Select all that apply.
"When you do not trim your nails the right way, you can get a secondary infection." "Sometimes with ingrown toenails, the necrotic nail will have to be removed surgically." "It is important for you to trim your nails properly so that you do not get chronic hypertrophy of the nail lip."
The nurse is providing postoperative care to a patient immediately following an osteotomy for the correction of hammertoe. What information does the nurse tell the patient?
"You can put all of your weight on your foot in a few weeks."
The nurse provides a patient with information about how to prevent osteomalacia. Which statement made by the patient indicates the need for further teaching?
"i should exclude chicken and swordfish from my diet"
The nurse is teaching a young patient about ways to prevent osteoporosis in later adulthood. Which information does the nurse provide?
"limit the consumption of carbonated beverages"
The nurse is teaching a patient ways to increase vitamin D in the diet using natural foods (unfortified). Which food choices indicate the patient understands the teaching? Select all that apply.
milk, tofu, eggs, and liver
The nurse is teaching the importance of nutrition to a 74-year-old patient who is lactose-intolerant and at risk for osteoporosis. What nutritional considerations does the nurse teach? Select all that apply.
Limit consumption of carbonated beverages. Avoid excessive intake of alcohol and caffeine. Drink fruit juices fortified with calcium
A 67-year-old patient is diagnosed with plantar fasciitis. What conservative management does the nurse suggest? Select all that apply.
Apply an ice pack to the site. Strap the affected foot. Wear shoes with good support.
The nurse is caring for a patient immediately following a bunionectomy. What is the nurse's priority action?
Assessing the patient's neurovascular status
The nurse plans to refer a patient diagnosed with osteoporosis to which community resource?
national osteoporosis foundation
After dental work, a female patient taking medications for osteoporosis reports pain, bleeding gums, and halitosis. Upon examination, the bone is found to be exposed. Which medication is the cause for this condition?
Bisphosphosphonates
which group has the least risk of developing osteomalacia
Caucasian population
What complication of osteoporosis can cause a patient to lose up to 3 inches of height in 20 years?
Dowager's hump
Which is a deformity of the hand?
Dupuytren's contracture
The nurse is caring for a patient with an open wound from chronic osteomyelitis. How does the nurse ensure that this patient receives increased tissue perfusion?
Exposing the affected area to a high concentration of oxygen.
Which statement is true regarding a ganglion cyst? Select all that apply.
Ganglion cysts can rapidly disappear and recur. Treatment includes the aspiration of cystic fluid with a fine needle. Ganglion cysts form due to the degeneration of synovium surrounding the tendon
what is the most common assessment finding associated with osteoporosis
bone fractures
A patient with bone cancer is scheduled for a right upper extremity amputation. Which statement by the patient's husband indicates an effective coping strategy?
I'll have to find ways to help my wife focus on positive aspects of her body
Which drug is a bisphosphonate that is approved by the Food and Drug Administration (FDA) and is commonly used for the prevention and treatment of osteoporosis?
Ibandronate
What is the pathophysiology of osteoporosis?
Increased osteoclastic activity over osteoblastic activity
The nurse is teaching a patient ways to increase vitamin D in the diet using natural foods (unfortified). Which food choices indicate the patient understands the teaching? Select all that apply.
Milk eggs tofu liver
What interventions may be utilized to manage a patient with chronic osteomyelitis? Select all that apply.
Packing the wound with bone cement bead impregnated with antibiotic Irrigating wounds through the window of a cast Exposing the affected area to hyperbaric oxygen therapy
The nurse is caring for a patient with prostate cancer who has bone metastasis. The nurse anticipates that the health care provider will prescribe which medication?
Pamidronate
A patient has had a sequestrectomy of the right fibula for osteomyelitis 1 day ago. Which assessment finding requires the nurse to contact the surgeon immediately?
Paresis of right lower extremity
Which foot disorder is one of the most common causes of heel pain?
Plantar fascitis
Which is a priority problem for the older adult patient diagnosed with bone cancer?
Potential for injury related to weakness and drug therapy
A patient has recently undergone surgery to treat osteomyelitis. What are the signs of neurovascular compromise after the surgery? Select all that apply.
Pulselessness Paresis or paralysis Paresthesia Uncontrollable pain
An enlarged first metatarsal head is known as what?
bunion
The nurse suspects that a patient may have plantar fasciitis if the patient has which assessment finding?
Severe pain in the arch of the foot, especially when getting out of bed
The nurse observes that a patient has an ingrown toenail that is hindering the patient's ambulation. What treatments does the nurse suggest for this patient? Select all that apply.
Soaking the foot in warm water Applying antibiotic ointment
The hallux valgus deformity can cause what other condition?
bunions
The nurse is assessing a patient with a hallux valgus deformity. What term is used to refer to an enlargement of the first metatarsal head commonly seen with this kind of deformity?
bunions
Which instructions would the nurse give to a patient with osteoporosis who has been prescribed alendronate? Select all that apply.
Take the medication early in the morning with 8 ounces of water. Remain upright for 30 minutes after taking the medication. Discontinue the medication if chest discomfort develops
The nurse is assessing a patient who is reporting pain under the arch of the foot when getting out of bed in the morning. The nurse suspects the patient may have plantar fasciitis. What information does the nurse give to the patient to help manage the onset of the condition?
Telling the patient to manage his or her weight
The nurse is assessing a patient diagnosed with acute osteomyelitis. What features of this disorder does the nurse expect to find? Select all that apply.
Temperature above 101° F Swelling around the affected area Erythema around the affected area Pulsating pain that worsens with movement
The nurse is caring for a patient with bone cancer of the right hip who has undergone radical resection of the tumor and has received a prosthetic implant. Which patient statement indicates effective coping after the procedure?
The nurse is caring for a patient with bone cancer of the right hip who has undergone radical resection of the tumor and has received a prosthetic implant. Which patient statement indicates effective coping after the procedure?
The patient's blood test shows a count of 12,000 white blood cells (WBCs) per microliter. Which finding does the nurse suspect is causing this laboratory value?
The patient has an inflamed ingrown toe nail.
Which nursing intervention helps prevent the incidence of osteomyelitis in a patient receiving hemodialysis?
instructing the client to brush teeth after every meal
What are the risk factors for primary osteoporosis? Select all that apply.
Thin build with low body weight Parental history of osteoporosis Chronic low calcium and vitamin D intake
A patient whose fracture of the right ulnar bone was immobilized in a cast for nearly 8 weeks reports swelling and pain in the right forearm. Why would the patient be advised to undergo bone mineral density (BMD) test?
To evaluate for secondary osteoporosis
What teaching does the nurse provide to a patient who had outpatient surgery for hallux valgus?
Wear an orthopedic boot or shoe
A patient has a callus of the foot. What treatment does the nurse anticipate for this patient?
application of padding and lanolin cream
The nurse observes that a patient has an ingrown toenail that is hindering the patient's ambulation. What treatments does the nurse suggest for this patient? Select all that apply.
applying antibiotic ointment, and soaking the foot in warm water
Which part of the body is affected by plantar fasciitis?
arch of the foot
A patient has undergone surgery on a lower extremity for a primary bone tumor. What intervention does the nurse perform for this patient?
assess neurovascular status of the extremity every 1 to 2 hours after the surgery
After dental work, a female patient taking medications for osteoporosis reports pain, bleeding gums, and halitosis. Upon examination, the bone is found to be exposed. Which medication is the cause for this condition?
bisphosphosphonates
An 80-year-old patient experiencing severe pain in the lower jaw is diagnosed with acute osteomyelitis. Which symptom may be least likely found?
body temperature of 102 F
An 80-year-old patient experiencing severe pain in the lower jaw is diagnosed with acute osteomyelitis. Which symptom may be least likely found?
body temperature of 102 degrees F
The patient has a flat, poorly defined mass on the sole of the foot. What does this patient most likely have?
callus
Which category of osteomyelitis is related to a bone infection that is caused by a skin infection of the adjacent tissues?
contiguous
What is a Dupuytren's contracture?
contracture of the hand due to palmar fibromatosis
An 80-year-old patient with uncontrolled hypertension reports pain in the right foot and is diagnosed with a hallux valgus deformity. What is the most appropriate treatment?
custom-made shoes
Which is one of the causes of secondary osteoporosis?
diabetes mellitus
A patient with plantar fasciitis reports increasing pain. Inflammation is observed during the patient's physical assessment of the foot. According to the patient and the medical record, the patient has tried treating the condition with nonsteroidal antiinflammatory drugs and steroids, but all measures have been unsuccessful. The patient does not want endoscopic surgery to remove the inflamed tissue. What else can the nurse suggest to the patient for possible relief and comfort? Select all that apply.
doing stretching exercises, resting and icing the foot, and wearing shoes with orthodotics
Which is the most commonly used screening and diagnostic tool for measuring bone mineral density?
dual x-ray absorptiometry
Which disorder affects the hand or part of the hand?
dupuytren contracture
Upon performing a physical examination of a patient, the nurse observes that the ring finger and the little finger are bent toward the palm and cannot be extended. What condition does this finding indicate?
dupuytrens contracture
Arrange in the correct order the process of sequestrum formation as it occurs in osteomyelitis.
invasion of pathogenic microorganisms, stimulation of antiflammatory response, vascular thrombosis, release of exudate into the bone tissue, ischemia of bone tissue, and sequestrum formation
Which term describes a benign tumor arising from cartilage?
endochondroma
The nurse is caring for a patient with an open wound from chronic osteomyelitis. How does the nurse ensure that this patient receives increased tissue perfusion?
exposing the affected area to a high concentration of oxygen
which is a key feature of acute osteomyelitis
fever
Which part of the body does the hallux valgus deformity affect?
foot
What complication of osteomyelitis is the most likely to occur?
formation of bone abscesses
Which fingers are affected by Dupuytren contracture?
fourth and fifth fingers
what causes corns?
friction
The nurse meets with a patient who reports having a ganglion. Which part of the body will the nurse inspect?
ganglion
What is a round, benign cyst that is often found on the wrist?
ganglion
Which term is used to describe a round, benign cyst, often found on a wrist or foot joint or tendon?
ganglion
Which statement is true regarding a ganglion cyst? Select all that apply.
ganglion cysts can rapidly disappear and recur, treatment includes the aspiration of cystic fluid with a fine needle, and ganglion cysts form due to the degeneration of synovium surrounding the tendon
The nurse is discussing treatment options with a patient who has a bunion. The patient is not a candidate for surgery. What does the nurse discuss with the patient?
getting custom shoes made to fit the deformity
A nurse notices the lateral drift of the greater toe at the first metatarsophalangeal joint. What would be the expected diagnosis by the primary health care provider?
hallux vagus
Which musculoskeletal disorder is the dorsiflexion of any metatarsophalangeal (MTP) joint that has plantar flexion of the proximal interphalangeal joint next to it?
hammertoe
Which term is related to the presence of excess serum calcium?
hypercalcemia
The nurse is developing a plan of care for a patient with metastatic bone cancer. What is an appropriate goal of treatment to include in the plan of care for this patient?
improve the quality of life and promote pain relief
How is Dowager's hump formed?
kyphosis of the spine
What is the generic name for the bisphosphonate drug zoledronic acid?
reclast
The nurse is caring for a patient with hypertrophic ungual labium. The nurse prepares to teach the patient about treatment for the condition. Which actions will the nurse include? Select all that apply.
removing the necrotic nail; taking antibiotics for secondary infections
The patient's blood test shows a count of 12,000 white blood cells (WBCs) per microliter. Which finding does the nurse suspect is causing this laboratory value?
the patient has an inflamed ingrown toe nail
The nurse is reviewing the risk factors for Dupuytren contracture with a patient. Which finding causes the nurse to believe the patient may be at risk for developing this condition?
the patient has diabetes
The nurse is caring for a preoperative patient who is about to undergo a partial fasciectomy to treat Dupuytren contracture. The nurse ensures that the patient understands the procedure. Which statement made by the patient causes the nurse to do additional teaching?
this surgery will tighten the fascia in my hand
As part of the treatment plan for a patient with decreased bone density, the nurse administers zoledronic acid. The nurse infuses the medication slowly over 20 minutes. Why is the medication given slowly?
to prevent atrial fibrillation
Where does the nurse expect to find a conical mass, or corn, on the patient's body?
toe
Which finding does the nurse expect to observe in a patient with suspected common chronic osteomyelitis?
ulceration of the skin
a patient is diagnosed with chronic osteomyelitis. What feature does the nurse expect to assess in the patient?
ulceration resulting in the sinus tract
Which is the best way to decrease the risk for osteoporosis in a patient who has just been diagnosed with the disease
walk for 30 minutes three times a week
Which lifestyle change would benefit a patient who has osteoporosis?
walking
the nurse is taking the history of an adult female patient. which factor places the patient at risk for osteoporosis
working at a desk and playing the piano for a hobby
The nurse meets with a patient who reports having a ganglion. Which part of the body will the nurse inspect?
wrist
The nurse is providing postoperative care to a patient immediately following an osteotomy for the correction of hammertoe. What information does the nurse tell the patient?
you can put all of your weight on your foot in a few weeks