Med/Surg Chp 42

Which group is at the greatest risk for osteoporosis?

Caucasian women

The client diagnosed with osteosarcoma is scheduled for a surgical amputation. Which nursing diagnosis would be a priority for this client compared with other surgical clients?

Disturbed body image

Which is a flexion deformity caused by a slowly progressive contracture of the palmar fascia?

Dupuytren's contracture

The nurse is planning an education program for women of childbearing years. The nurse recognizes that primary prevention of osteoporosis includes:

Ensuring adequate calcium and vitamin D intake

Which of the following was formerly called a bunion?

Hallux valgus

The provider asks a nurse to test a patient for Tinel's sign to diagnose carpal tunnel syndrome. The nurse asked the patient to:

Hold his palm up while the nurse percussed over the median nerve

A patient visits an orthopedic specialist because of pain that he feels beginning in his low back and radiating behind his right thigh and down below his right knee. The doctor suspects a diagnosis of sciatica. The nurse knows that the origin of the pain is between these intervertebral disks:

L4, L5, and S1

Which assessment findings would the nurse expect in a client diagnosed with osteomyelitis?

Leukocytosis and localized bone pain

Which of the following presents with an onset of heel pain with the first steps of the morning?

Plantar fasciitis

Which of the following terms refers to disease of a nerve root?

Radiculopathy

Which is a risk-lowering strategy for osteoporosis?

Smoking cessation

The nurse advises a patient that the best position to ease low back pain is:

Supine, with the knees slightly flexed and the head of the bed elevated 30 degrees.

A patient with chronic osteomyelitis has undergone 6 weeks of antibiotic therapy. There is no improvement in the wound appearance. What action would the nurse anticipate to promote healing?

Surgical debridement

In chronic osteomyelitis, antibiotics are adjunctive therapy in which of the following situations?

Surgical debridement

Morton's neuroma is exhibited by which of the following clinical manifestations?

Swelling of the third (lateral) branch of the median plantar nerve

A nurse is caring for a client who's experiencing septic arthritis. This client has a history of immunosuppressive therapy and his immune system is currently depressed. Which assignment is the most appropriate for the nurse caring for this client?

The nurse is caring for this client on the intensive care unit.

A nurse is teaching a female client about preventing osteoporosis. Which teaching point is correct?

The recommended daily allowance of calcium may be found in a wide variety of foods.

The nurse teaches the patient with a high risk for osteoporosis about risk-lowering strategies including which of the following actions?

Walk or perform weight-bearing exercises

Which of the following classic symptoms would the nurse assess for to detect the development of plantar fasciitis?

morning heel pain

Which sign may be helpful in identifying carpal tunnel syndrome?

tinel's

A client is admitted with acute osteomyelitis that developed after an open fracture of the right femur. When planning this client's care, the nurse should anticipate which measure?

Administering large doses of I.V. antibiotics as ordered

During a routine physical examination on a 75-year-old female client, a nurse notes that the client is 5 feet, 3/8 inches (1.6 m) tall. The client states, "How is that possible? I was always 5 feet and 1/2? (1.7 m) tall." Which statement is the best response by the nurse?

After menopause, the body's bone density declines, resulting in a gradual loss of height.

The nurse is caring for patient with a hip fracture. The physician orders the patient to start on a bisphosphonate. Which medication would the nurse document as given?

Alendronate (Fosamax)

A male client is to have an amputation. He is acutely ill and diagnosed with a gangrenous limb and related fever, disorientation, and electrolyte imbalances. Which of the following would be most important for the nurse to monitor in this client?

Signs of sepsis

On a visit to the family physician, a client is diagnosed with a bunion on the lateral side of the great toe, at the metatarsophalangeal joint. Which statement should the nurse include in the teaching session?

Some bunions are congenital; others are caused by wearing shoes that are too short or narrow."

Most cases of osteomyelitis are caused by which of the following microorganisms?

Staphylococcus

A client is diagnosed with osteomyelitis. This is most commonly caused by which of the following?

Staphylococcus aureus

Which of the following clinical manifestations would the nurse expect to find in a client who has had osteoporosis for several years?

decreased height

A client has Paget's disease. An appropriate nursing diagnosis for this client is:

risk for falls

A provider asks the nurse to teach a patient with low back pain how to sit in order to minimize pressure on the spine. Which of the following teaching points would the nurse include? Select all that apply.

• Sit in a straight-backed chair with arm rests. • Avoid hip extension. • Place feet flat on the floor. • Sit with the buttocks "tucked under."

Using proper body mechanics to lift objects is essential to prevent exacerbations of low back pain. Which of the following is the most important teaching point?

Lift with the large leg muscles (quadriceps), not the back muscles.

Which area of the spinal column is subject to the greatest mechanical stress and degenerative changes?

Lower lumbar

Which of the following is a metabolic bone disease that is characterized by inadequate mineralization of bone?

Osteomalacia

A patient stepped on an acorn while walking barefoot in the backyard and developed an infection progressing to osteomyelitis. What microorganism does the nurse understand is most often the cause of the development of osteomyelitis?

Staphylococcus aureus

A client has been treated for migraine headaches for several months and comes to the clinic stating he is getting no better. The nurse is talking with the client and hears an audible click when the client is moving his jaw. What does the nurse suspect may be happening?

Temporomandibular disorder

The nurse is assessing the feet of a patient and observes an overgrowth of the horny layer of the epidermis. What does the nurse recognize this condition as?

corn

A patient comes to the clinic complaining of low back pain radiating down the left leg. After diagnostic studies rule out any pathology, the physician orders a serotonin-norepinephrine reuptake inhibitor (SNRI). Which medication does the nurse anticipate educating the patient about?

cymbalta

A nurse is teaching a client who was recently diagnosed with carpal tunnel syndrome. Which statement should the nurse include?

"Ergonomic changes can be incorporated into your workday to reduce stress on your wrist."

The nurse has educated a patient with low back pain about techniques to relieve the back pain and prevent further complications. What statement by the patient shows understanding of the education the nurse provided?

"I will avoid prolonged sitting or walking."

A patient with a musculoskeletal injury is instructed to increase dietary calcium. Which of the following statements by the nurse is appropriate?

"You need to increase the amount of vitamin D in your diet."

A client with osteoporosis is prescribed calcitonin (Miacalcin) 100 units subcutaneously. The medication is available 200 units per ml. How many milliliters will the nurse administer to the client?

0.5

A patient is diagnosed with osteogenic sarcoma. What laboratory studies should the nurse monitor for the presence of elevation?

Alkaline phosphatase

A patient is evaluated for a diagnosis of Paget's disease. Which of the following is a diagnostic finding for this disease?

Alkaline phosphate of 165 IU/L

The nurse is preparing a client for a surgical procedure that will allow visualization of the extent of joint damage of the knee for a client with rheumatoid arthritis and also obtain a sample of synovial fluid. What procedure will the nurse prepare the client for?

Arthroscopy

Of the following, which is not a risk factor for osteoporosis?

Being male

A provider prescribes a subcutaneous anabolic agent for an elderly patient to prevent fractures associated with osteoporosis. Which of the following is the most likely prescribed drug?

Forteo

A family member is caring for an older adult client with osteomalacia in the home. When the home health nurse comes to evaluate the client, what should be a focus point of the visit?

Observing for safety hazards that could be a fall risk

Which of the following is the most common and most fatal primary malignant bone tumor?

Osteogenic sarcoma (osteosarcoma)

The nurse is caring for a client following foot surgery. Which nursing intervention is most important for the nurse to include in the nursing care plan?

Perform neuromuscular assessment every hour.

The nurse recognizes that goal of treatment for metastatic bone cancer is to:

Promote pain relief and quality of life

The nurse is educating the patient with low back pain about the proper way to lift objects. What muscle should the nurse encourage the patient to maximize?

Quadriceps

A nurse is planning discharge teaching regarding exercise for a client at risk for osteoporosis. Which of the following exercises would be appropriate?

Walking

The nurse is planning discharge instructions for the client with osteomyelitis. What instructions should the nurse include in the discharge teaching?

You will receive IV antibiotics for 3 to 6 weeks."

Which medication classification is prescribed when allergy is a factor causing the skin disorder?

antihistamines

Assessment of a client reveals signs and symptoms of Paget's disease. Which of the following would be most likely?

long bone bowing

A client with diabetes punctured hisfoot with a broken acorn in the yard. Within a week, the client developed osteomyelitis of the foot. The client was admitted for IV antibiotic therapy. How long does the nurse anticipate the client will receive IV antibiotics?

3 to 6 weeks

Which client would the nurse identify as having the greatest risk for osteoporosis?

A small-framed, thin 45-year-old white woman

When performing a physical assessment of a client, the client reports numbness, tingling, and pain when the nurse percusses lightly over the median nerve. The nurse recognizes that this finding is consistent with:

Carpal tunnel syndrome

When an infection is blood borne the manifestations include which of the following symptoms?

Chills

An older adult female has a bone density test that reveals severe osteoporosis. What does the nurse understand can be a problem for this client due to the decrease in bone mass and density?

Compression fractures

A female client is at risk for developing osteoporosis. Which action will reduce the client's risk?

Initiating weight-bearing exercise routines

Which of the following is the only selective estrogen receptor modulator approved for osteoporosis in post menopausal women?

Raloxifene

A nurse is caring for an elderly female client with osteoporosis. When teaching the client, the nurse should include information about which major complication?

bone fracture

Treatment of metastatic bone cancer includes which of the following?

palliation