Chapter 50 - Musculoskeletal

The nurse is caring for a client who is diagnosed with osteopenia. Which T-score will the nurse expect to see for this client after a bone mineral density (BMD) test? - +1.5 - 0 to -1 - -2 - -3

-2

A 55 year-old female client has a high familial risk for osteoporosis and tells the nurse that her mother and an older sister both developed spine and hip fractures as a result of the disease. Which diagnostic test will be appropriate to help determine this client's risk for spine and hip fractures? - CT-based absorptiometry - Magnetic resonance spectroscopy (MRS) - Vertebral imaging studies - Dual x-ray absorptiometry (DXA)

CT-based absorptiometry

The nurse is caring for an older adult client diagnosed with osteomalacia. The nurse anticipates that the health care provider will request which supplement? - Vitamin C - Vitamin D3 - Phosphorus - Calcium

Vitamin D3

A client has had a sequestrectomy of the right fibula for osteomyelitis 1 day ago. Which assessment finding requires the nurse to immediately contact the surgeon? - Swelling of the right lower extremity - 1+ to 2+ bilateral palpable pedal pulses - Pain of right lower extremity on movement - Decreased sensation of right lower extremity

decreased sensation of right lower extremity

An older client who lives at home has been receiving intravenous linezolid to treat methicillin-resistant Staphylococcus aureus (MRSA) osteomyelitis for 2 weeks and is ready to be discharged from the hospital to undergo continued treatment. The client does not want to go to a skilled nursing facility (SNF). What will the nurse do? - Discuss administering oral linezolid at home with the provider. - Explain to the client that intravenous medications require skilled nursing care. - Arrange for a home health aide to administer intravenous antibiotics at home. - Tell the client that the SNF stay will only need to be for one week.

discuss administering oral linezoid at home with the provider

Which risk factors are shared by male clients who have osteoporosis or osteopenemia? (Select all that apply.) - High alcohol intake - A history of smoking - Inadequate exposure to sunlight - Homelessness - Low BMI

high alcohol intake, a history of smoking

A client experiencing kyphosis appears withdrawn and does not initiate any conversation with the nurse when medications are given each day. Which statement by the nurse is most supportive of this client? - "It is normal to feel depressed at times about your condition. You have my support." - "You could exercise more often to build up your strength and endurance." - "How do you feel about the pain in your spine? I am here if you want to talk." - "What does your family say to you? Try talking to them."

how do you feel about the pain in your spine? I am here if you want to talk

The nurse is assessing a client with osteomalacia. Which findings does the nurse expect to observe? (Select all that apply.) - Hyperparathyroidism - Hyperuricemia - Hypophosphatemia - Looser's lines or zones - Unsteady gait

hypophosphatemia, looser's lines or zones, unsteady gait

Which nursing intervention helps to reduce the incidence of osteomyelitis for a client receiving hemodialysis? - Instructing the client to brush teeth after every meal - Maintaining clean dressing change technique for long-term IV catheters - Using clean technique - Using Standard Precautions

instructing the client to brush teeth after every meal

An older adult client who has osteoporosis is discharged from the hospital. What does the nurse include in client teaching related to the client's home safety? - "Use area rugs on tile floors." - "Keep walkways free of clutter." - "Walk slowly on wet floor areas after mopping." - "Keep light low to prevent glare."

keep walkways free of clutter

The nurse is assessing a client with Ewing's sarcoma. Which finding does the nurse expect to observe? - Bradycardia - High fever - Leukocytosis - Migraine headaches

leukocytosis

The nurse plans to refer a client diagnosed with osteoporosis to which community resource? - American Bone Society - CanSurmount - I Can Cope - National Osteoporosis Foundation

national osteoporosis foundation

A 25-year-old female client whose mother and grandmother have osteoporosis asks whether she needs to take steps to prevent this disease in herself. What will the nurse tell this client? - "You do not have to worry about symptoms at your age." - "You should begin to take steps to prevent disease at age 30." - "Now is the time to begin building strong bones." - "Your risk isn't present until age 50; we can talk about it then."

now is the time to begin building strong bones

The nurse is caring for a client with prostate cancer who has bone metastasis. The nurse anticipates that the health care provider will prescribe which medication? - Calcitonin (Calcimar) - Medroxyprogesterone (Prempro) - Pamidronate (Aredia) - Tamsulosin hydrochloride (Flomax)

pamidronate (Aredia)

Which is a priority problem for the older adult client diagnosed with bone cancer? - Potential for injury related to weakness and drug therapy - Altered self-esteem related to fear of death and dying - Reduced mobility related to weakness and fatigue - Pain of a chronic nature related to tumor invasion of other organs

potential for injury related to weakness and drug therapy

The nurse suspects that a client may have plantar fasciitis if the client has which assessment finding? - Lateral deviation of the great toe; first metatarsal head becomes enlarged - Dorsiflexion of any metatarsophalangeal (MTP) joint, with plantar flexion of the adjacent proximal interphalangeal (PIP) joint - Severe pain in the arch of the foot, especially when getting out of bed - A small tumor in a digital nerve of the foot

severe pain in the arch of the foot, especially when getting out of bed

The nurse is instructing a client who has been prescribed calcium citrate (Citracal). Which instruction does the nurse include? - "Take Citracal with food." - "For best absorption, take Citracal with a carbonated beverage." - "One-third of the daily dose is best taken during the day." - "Milk of Magnesia (MOM) should be taken with Citracal."

take citracal with food

Which finding does the nurse expect to observe in a client with suspected common chronic osteomyelitis? - Erythema of the affected area - Fever; temperature usually above 101° F (38° C) - Ulceration of the skin - Constant, localized, and pulsating bone pain

ulceration of the skin

Which is the best way to decrease the risk for osteoporosis in a client who has just been determined to be at high risk for the disease? - Increase nutritional intake of calcium. - Engage in high-impact exercise, such as running. - Increase nutritional intake of phosphorus. - Walk for 30 minutes three times a week

walk for 30 minutes three times a week

The nurse is taking the history of an adult female client. Which factor places the client at risk for osteoporosis? - Consuming 12 ounces (355 mL) of carbonated beverages daily - Working at a desk and playing the piano for a hobby - Having a hysterectomy and taking estrogen replacement therapy - Consuming one alcoholic drink per week

working at a desk and playing the piano for a hobby

A 50-year-old woman has osteoporosis and is at risk for developing vertebral fractures. She asks the nurse about exercises to help minimize this risk. Which exercise will the nurse recommend? - Cycling - Running - Walking - Yoga

yoga