PATHO CH 49 PREP U Questions
Which statement will the nurse impart to the parent of a child with Legg-Calvé-Perthes disease?
"A genetic pattern for this disease has not been established."
Which information is important for the nurse to teach the female client about the development of osteoporosis?
"Estrogen deficiency contributes to the development of osteoporosis."
It is suspected that a client has osteomalacia. What should the nurse teach the client about potential causes of this condition?
"Insufficient calcium absorption and phosphate deficiency are the causes."
What information would the nurse include when teaching potential parents about prevention of congenital deformities? Select all that apply.
"Limit exposure to alcohol." "Do not take any medication without first talking to your health care provider."
A new mother asks, "Why are you examining my baby's hips?" What is the nurse's best response?
"Musculoskeletal screening is important to identify anything that needs intervention."
The nurse is giving a talk to a woman's group on osteoporosis. What should the nurse tell this group concerning the development of osteoporosis?
"Osteoporosis involves a loss of bone mass."
The nursing instructor is teaching about osteoporosis and tells students that reduced physical activity can contribute to the loss of bone mass. What does the nurse tell the students is the rationale for this?
"Reduced physical activity increases the rate of bone loss, as mechanical forces are important stimuli for normal bone remodeling."
The nurse has just finished teaching a client newly diagnosed with rheumatoid arthritis about the disease. The nurse determines that teaching is effective when the client states:
"Rheumatoid arthritis includes joint involvement that is usually symmetric and polyarticular."
A client with osteomalacia asks, "How can I be deficient in vitamin D?" Which of the following is the nurse's best response?
"Tell me about your typical daily food intake."
The parents of a 6-year-old child diagnosed with bilateral genu valgum (knock knees) ask the health care provider when treatment will begin to correct the problem. The best response would be:
"The child's measurements fit within the acceptable assessment period; treatment is not necessary at this time."
Which of the following should the nurse teach a client about syndactyly?
"This is a simple webbing of the fingers or toes."
Which symptoms commonly occur with Osgood-Schlatter disease? Select all that apply.
- Knee pain - Edema of the knee - Tenderness in the knee and tibia
Which groups are at increased risk for decreased bone mass? Select all that apply. - Premature infants - Low-birth-weight infants - Children with cystic fibrosis - An active olympian
- Premature infants - Low-birth-weight infants - Children with cystic fibrosis
Regarding embryonic development, in what week do the paddle-shaped limb buds of the lower extremities begin to appear?
4th week
A physician is providing care for several clients on a hospital-based medical ward. Which client is most likely to experience chronic fatigue?
51-year-old woman admitted for exacerbation of her multiple sclerosis.
When there is a large separation between the knees greater than 15 degrees
A 2-year-old has bowing of the legs (genu varum). When should the health care professional should be concerned?
Cerebral palsy
A child has been diagnosed with myopathic neuromuscular scoliosis. What other concurrent diagnosis may the child have?
Brisk walking three times per week on a flat surface
A client with confirmed low bone density asks the nurse if there is anything she can to decrease the risk of trauma. The best response would be:
"Tell me about your typical daily food intake."
A client with osteomalacia asks, "How can I be deficient in vitamin D?" Which of the following is the nurse's best response?
Calcium/vitamin D supplements to support bone mineral density.
A female athlete has been diagnosed with amenorrhea due to intense training for a spot on the Olympic swimming team. As a health care provider, which of the following should be implemented to prevent premature osteoporosis?
"Exercise can help to keep down the salt levels that cause high blood pressure."
A nurse holds an exercise class for older adults and knows which statement by a class member requires clarification?
"My schedule includes yoga and a weekly club meeting."
A nurse is evaluating the progress of a client with chronic fatigue syndrome. Which statement by the client indicates successful symptom management?
"Osteopenia is a condition that is only common in the elderly."
A nursing instructor is teaching students about metabolic bone diseases. She realizes a need for further instruction when one student states:
A nursing student who is studying about disorders of the skeletal system is heard making the following statement, "Many skeletal disorders of early infancy are caused by intrauterine positions and need to be surgically fixed." Is this statement true or false?
A nursing student who is studying about disorders of the skeletal system is heard making the following statement, "Many skeletal disorders of early infancy are caused by intrauterine positions and need to be surgically fixed." Is this statement true or false? THESE USUALLY RESOLVE AS THE CHILD GROWS
"How old is your daughter?"
A parent asks the nurse, "What is femoral anteversion? I was told my daughter has this." What is the best response by the nurse?
What is the definition of a congenital deformity?
Abnormalities present at birth
Nursing students are studying metabolic disorders of the skeletal system and correctly identify which factor to be the major cause of osteoporosis?
Aging process
Which best describes metatarsus adductus?
An adducted forefoot that gives the foot a kidney-shaped appearance
An adult client with a diagnosis of diabetes mellitus performing isometric exercise to help control his blood glucose level will gain which benefit?
An increase in his basal metabolic level
Which clients should the nurse assess to determine if they have premature osteoporosis?
Anyone with an eating disorder.
A child presents to the emergency room with suspected trauma to the growth plate in the ankle during a soccer game. Which step is the best intervention?
Assess the child for pain and prepare for diagnostic studies.
Which assessment technique/sign should the nurse utilize on a newborn to screen for developmental dysplasia of the hip?
Barlow
A client with confirmed low bone density asks the nurse if there is anything she can to decrease the risk of trauma. The best response would be:
Brisk walking three times per week on a flat surface
A child has been diagnosed with myopathic neuromuscular scoliosis. What other concurrent diagnosis may the child have?
Cerebral palsy
An increase in the level of receptor activator of nuclear factor kappa-Β ligand (RANKL) results in which physiologic activity?
Changes in the rate of bone remodeling
An older adult client presents with an acetabular fracture, an injury that is partially attributable to decreased bone density. What physiologic change can be attributed to this fracture?
Changes in the ratio of bone resorption to bone formation
The nurse is caring for several clents with symptoms of chronic fatigue. Which manifestation does not correlate with a diagnosis of chronic fatigue syndrome (CFS)? Insomnia-fatigue Cough with blood-tinged sputum Pain w/o inflammation
Cough with blood-tinged sputum
The nurse is caring for several clients with symptoms of chronic fatigue. Which manifestation does not correlate with a diagnosis of chronic fatigue syndrome (CFS)?
Cough with blood-tinged sputum
Which of the following is a priority goal for a client with pes planus (flat feet)?
Decreased pain
In contrast to osteoporosis, osteomalacia causes which outcome, without the loss of bone matrix?
Defective mineralization
Osteoporosis is a disease caused by demineralization of bone. What is the clinical method of choice for diagnosing osteoporosis?
Dual-energy x-ray absorptiometry (DXA) of the spine and hip
Which cardiovascular response will the nurse assess in order to determine that a client has activity intolerance?
Dyspnea during activity
(T/F) A nursing student who is studying about disorders of the skeletal system is heard making the following statement, "Many skeletal disorders of early infancy are caused by intrauterine positions and need to be surgically fixed." Is this statement true or false?
False
Formation of lower limb extremities.A woman has recently determined that she is pregnant, and the health care provider believes that conception occurred around 5 weeks prior. The nurse expects that which event in growth and development is taking place?
Formation of lower limb extremities.
A nursing instructor is teaching about osteoporosis and correctly lists which of these to be risk factors? Select all that apply.
Gender Nutrition Activity Genetics Age
The client should understand that activities with higher metabolic equivalents have higher workloads.
How will the nurse teach the client to utilize metabolic equivalents when starting an exercise routine?
The nurse is performing an admission assessment to a rehabilitation unit. Which assessment tools should she utilize to determine an alert client's normal activities, perceived level of activity tolerance, or level of fatigue?
Human Activity Profile
All systems in the body are affected by bed rest or immobility. For the immune system, research has demonstrated that interleukin (IL)-1, IL-6, and tumor necrosis factor-alpha are increased during immobility or bed rest. What are these mediators associated with?
Hyperinflammatory reactions and tissue injury
What should the nurse teach a client who is on bed rest ?
Immobility will lead to deconditioning of muscles.
An older adult is being evaluated for chronic fatigue. Which assessment data by the nurse would support the diagnosis?
Inability to concentrate; awakens after a few hours of sleep and cannot return to sleep
Which assessment finding indicates a positive respiratory response to exercise?
Increased alveolar perfusion
In a client diagnosed with osteomalacia, what would be recommended to aid with improvement of the condition?
Increasing dietary consumption of vitamin D
Which of the following should the nurse teach about secondary osteoporosis?
It is secondary to many conditions.
Which statement is true concerning acute fatigue?
It serves a protective function for the body.
The pediatric nurse is providing teaching to a parent of a child with toeing-out (slew foot). Which statement should the nurse include in the teaching?
It will most likely self-correct as the child becomes proficient in walking.
Disuse of a muscle and muscle atrophy contribute to the weakening and wasting of muscle tissue. What else do they contribute to?
Joint contractures
What are common pharmacologic treatments for Osteoporosis (Select all that apply) ? A) nasal calcitonin B). vitamin D supplements C) calcium supplements. D) Vitamin C supplements
Nasal calcitonin, vitamin D supplements, and calcium supplements.
While getting up out of bed for the first time after surgery, a client reports feeling dizzy and faint. Which condition is the client most likely experiencing?
Orthostatic intolerance
Which statement will the nurse include when teaching about fetal development?
Ossification of the fetal skeleton begins in the ninth week.
Which statement correctly describes osteogenesis imperfecta, or brittle bone disease?
Osteogenesis imperfecta is caused by deficiencies in the synthesis of type I collagen.
A 75-year-old female has been admitted to the hospital with a hip fracture. She states, "All I did was fall into my chair, not even very hard." Upon diagnostic testing, the client's bones shows loss of trabeculae from cancellous bone and thinning of the cortex. Which diagnosis is most likely?
Osteoporosis
A 42-year-old client is admitted to the hospital with severe back pain, intermittent tinnitus, constant headache, and vertigo. He states that the back pain has been a problem for a number of years, but the other symptoms are quite new. Upon further examination, it is noted that he has unexplained hearing loss, and his femur and tibia have begun to bow. What condition does this client most likely have?
Paget disease
A child with Osgood-Schlatter disease most often presents with which assessment finding?
Pain in front of the knee
After a week in which a client worked four 12-hour shifts and went home to two children with the flu, the client is feeling fatigued. How should this client's fatigue be categorized?
Physiologic
The nurse has just finished teaching a client newly diagnosed with rheumatoid arthritis about the disease. The nurse determines that teaching is effective when the client states:
Rheumatoid arthritis includes joint involvement that is usually symmetric and polyarticular."
A 16-month-old boy has a normal weight for his age but a height far below the normal range. His list of symptoms includes a protruding abdomen, lethargy, bow legs, muscle weakness, and irritability. His teeth have not yet developed and he has difficulty standing. What is the child's most likely diagnosis?
Rickets
The nurse caring for a child with a deficiency of vitamin D knows that the deficiency places the child at risk for:
Rickets
An infant is born with a clubfoot. The nurse should anticipate which treatment measures will be instituted?
Serial manipulation and casting
The health care provider is explaining the course of treatment to the parents of a 2-day-old infant born with congenital clubfoot. Which treatment options will likely be discussed?
Serial manipulations and casting of the affected extremity
How will the nurse teach the client to utilize metabolic equivalents when starting an exercise routine?
The client should understand that activities with higher metabolic equivalents have higher workloads.
Which client needs screening for osteoporosis?
The client who seems to have "shrunk" in height
Which assessment finding is a negative cardiac response to exercise?
The client's diastolic blood pressure increases.
Osteogenesis imperfecta
The nurse is caring for a child who presented to the emergency department with multiple fractures in various stages of healing all over the body. The nurse collaborates with the physician on care for a client with which potential condition?
bone density testing on a scheduled basis.
The nurse is providing care for an adult client whose current medication regimen includes calcitonin and a bisphosphonate. The nurse should recognize the likely need for:
Uneven shoulders or iliac crest
The nurse suspects idiopathic scoliosis in a client based on which assessment finding?
It will most likely self-correct as the child becomes proficient in walking.
The pediatric nurse is providing teaching to a parent of a child with toeing-out (slew foot). Which statement should the nurse include in the teaching?
A postmenopausal client questions the nurse about the diagnosis of osteoporosis. Which statement describes the pathology of osteoporosis?
The process of bone renewal after menopause is slowed in relation to the occurrence of bone breakdown.
If a child with genu valgum does not self-correct after he or she begins weight-bearing, what condition could result?
Uneven shoulders or iliac crest
The nurse suspects idiopathic scoliosis in a client based on which assessment finding?
Uneven shoulders or iliac crest
A 2-year-old has bowing of the legs (genu varum). When should the health care professional should be concerned?
When there is a large separation between the knees greater than 15 degrees
Rotational deformity of the proximal tibia
Which assessment finding leads the nurse to suspect a child has Blount disease?
Anyone with an eating disorder.
Which clients should the nurse assess to determine if they have premature osteoporosis?
Orthostatic intolerance
While getting up out of bed for the first time after surgery, a client reports feeling dizzy and faint. Which condition is the client most likely experiencing?
The nurse knows which teaching statement listed below best captures an aspect of chronic fatigue syndrome (CFS)?There are no: A) definite Diagnosis for the condition B) biological markers for the diagnosis of CFS. C) medications to manage CFS long term
biological markers for the diagnosis of CFS.
The nurse is providing care for an adult client whose current medication regimen includes calcitonin and a bisphosphonate. The nurse should recognize the likely need for:
bone density testing on a scheduled basis.
The older adult client tells the nurse that she believes she is getting shorter. The nurse explains to the client that height loss is caused by which occurance with aging?
compression of vertebral column
What is a cause(s) of congenital musculoskeletal deformities? Select all that apply. A) heredity B) radiation C) consumption of alcohol by the mother D) consumption of certain drugs by the mother E) consumption of alcohol by the father
heredity radiation consumption of alcohol by the mother consumption of certain drugs by the mother
A daughter is concerned because her elderly parent has been diagnosed with osteomalacia. The daughter asks the nurse why this happened. The best response would be that:
intestinal absorption slows as natural aging occurs.
The nurse is assessing a female client's risk for osteoporosis. Which factor places this client at greatest risk?
menopause
The nurse is assessing an 8-year-old child who is diagnosed with genu valgum. The nurse educates the family about the risk for developing which complication if the genu valgum is left untreated?
osteoarthritis
An older adult client is admitted for the treatment of pneumonia. The nurse notes the home medications include nasal calcitonin, vitamin D, and calcium chloride. Which disease process is this client likely treating with these medications?
osteoporosis
A child with Osgood-Schlatter disease most often presents with which assessment finding?
pain in front of knee
A major complication of prolonged bed rest is an increased risk of kidney stones. The nurse knows that this is most likely related to:
saturation of urine with calcium salts.
The nurse is providing teaching for parents of a 2-week-old infant just diagnosed with clubfoot. The nurse includes that the first treatment option is:
serial manipulations and casting.
Which statement is true about treatment of developmental dysplasia of the hip?
treatment needs to be individualized
