CH 36 Prepu
A client with suspected osteomalacia has a fractured tibia and fibula. What test would give a definitive diagnosis of osteomalacia?
A bone biopsy
A patient is diagnosed with osteogenic sarcoma. What laboratory studies should the nurse monitor for the presence of elevation?
Alkaline phosphatase
A client is evaluated for a diagnosis of Paget's disease. Which laboratory value would the nurse find to confirm the diagnosis?
Alkaline phosphate of 165 IU/L (2750 mmol/L)
Which of the following is the first-line medication that would be used to treat and prevent osteoporosis?
Bisphosphonates
A home care nurse assesses for disease complications in a client with bone cancer. Which laboratory value may indicate the presence of a disease complication?
Calcium level of 11.6 mg/dl
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 health care provider diagnoses primary osteoporosis in a client who has lost bone mass. For which client is primary osteoporosis most common?
Elderly postmenopausal woman
A patient is having low back pain. What position can the nurse suggest to relieve this discomfort?
Supine, with the knees slightly flexed and the head of the bed elevated 30 degrees
A client with low back pain is being seen in the clinic. In planning care, which teaching point should the nurse include?
Use the large muscles of the leg when lifting items.
A client with diabetes punctured the foot with a sharp object. 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?
At least 4 weeks
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
To help minimize calcium loss from a hospitalized client's bones, the nurse should:
Encourage the client to walk in the hall
Dupuytren contracture causes flexion of which area(s)?
Fourth and fifth fingers
Dupuytren's contracture causes flexion of which area(s)?
Fourth and fifth fingers
In which deformity does the great toe deviate laterally?
Hallux valgus
Which of the following was formerly called a bunion?
Hallux valgus
During a routine physical examination of a client, the nurse observes a flexion deformity of the proximal interphalangeal (PIP) joint of two toes on the right foot. How would the nurse document this finding?
Hammer toe
Which should be included in the teaching plan for a client diagnosed with plantar fasciitis?
Management of plantar fasciitis includes stretching exercises.
Which classic symptom will the nurse assess for to detect the development of plantar fasciitis?
Morning heel pain
Localized rapid bone turnover, most commonly affecting the skull, femur, tibia, pelvic bones, and vertebrae, is characterized by which bone disorder?
Paget disease
A patient had hand surgery to correct a Dupuytren's contracture. What nursing intervention is a priority postoperatively?
Performing hourly neurovascular assessments for the first 24 hours
Which of the following positions should be avoided in severe back pain?
Prone
Which of the following is the only selective estrogen receptor modulator approved for osteoporosis in post menopausal women?
Raloxifene
A client with osteoporosis is prescribed a selective estrogen receptor modifier (SERM) as treatment. The nurse would identify which drug as belonging to this class?
Raloxifene (Evista)
A client with Paget's disease comes to the hospital and reports difficulty urinating. The emergency department health care provider consults urology. What should the nurse suspect is the most likely cause of the client's urination problem?
Renal Calculi
A nurse is planning discharge teaching regarding exercise for a client at risk for osteoporosis. Which exercise would the nurse be most likely to suggest?
Walking
Health education for a woman over age 50 includes providing information about the importance of adequate amounts of calcium and vitamin D to prevent osteoporosis. Select the daily dosage of calcium and vitamin D that the nurse should recommend.
1,200 mg; 1,000 IU
A nurse is performing foot care for a client with chronic osteomyelitis and the client asks the nurse about the next treatment. What is the specific treatment for a client with chronic osteomyelitis?
Surgical removal of sequestrum
A nurse is performing discharge teaching for an elderly client with osteoporosis. Which instruction about a calcium supplement should the nurse include?
Take the supplement with meals or with orange juice.
The nurse is assisting a client with removing shoes prior to an examination and observes that the client has a flexion deformity of several toes on both feet of the proximal interphalangeal (PIP) joints. What can the nurse encourage the client to do?
Wear properly fitting shoes.
When teaching a client how to prevent low back pain as a result of lifting, the nurse should instruct the client to:
avoid overreaching.