med surg 2

Know osteoporosis: Complications. An elderly female with osteoporosis has been hospitalized. Prior to discharge, when teaching the patient, the nurse should include information about which major complication of osteoporosis? A) Bone fracture B) Loss of estrogen C) Negative calcium balance D) Dowagers hump

A) Bone fracture

Know osteoporosis: Medications. An older adult womans current medication regimen includes alendronate (Fosamax). What outcome would indicate successful therapy? A) Increased bone mass B) Resolution of infection C) Relief of bone pain D) Absence of tumor spread

A) Increased bone mass

Know osteomyelitis: Most common causative pathogen. Staphylococcus aureus - a common cause of infection A patient presents to a clinic complaining of a leg ulcer that isnt healing; subsequent diagnostic testing suggests osteomyelitis. The nurse is aware that the most common pathogen to cause osteomyelitis is what? A) Staphylococcus aureus B) Proteus C) Pseudomonas D) Escherichia coli

A) Staphylococcus aureus

Know S/S of avascular osteomyelitis. An 80-year-old man in a long-term care facility has a chronic leg ulcer and states that the area has become increasingly painful in recent days. The nurse notes that the site is now swollen and warm to the touch. The patient should undergo diagnostic testing for what health problem? A. Osteomyelitis B. Osteoporosis C. Osteomalacia D. Septic arthrit

A. Osteomyelitis

Know equivalency of retained fluid and weight gained. The nurse caring for a patient with suspected renal dysfunction calculates that the patients weight has increased by 5 pounds in the past 24 hours. The nurse estimates that the patient has retained approximately how much fluid? A) 1,300 mL of fluid in 24 hours B) 2,300 mL of fluid in 24 hours C) 3,100 mL of fluid in 24 hours D) 5,000 mL of fluid in 24 hours

B) 2,300 mL of fluid in 24 hours An increase in body weight commonly accompanies edema. To calculate the approximate weight gain from fluid retention, remember that 1 kg of weight gain equals approximately 1,000 mL of fluid. Five lbs = 2.27 kg = 2,270 mL.

Which of the following patients should the nurse recognize as being at the highest risk for the development of osteomyelitis? A) A middle-age adult who takes ibuprofen daily for rheumatoid arthritis B) An elderly patient with an infected pressure ulcer in the sacral area C) A 17-year-old football player who had orthopedic surgery 6 weeks prior D) An infant diagnosed with jaundice

B) An elderly patient with an infected pressure ulcer in the sacral area

Know osteomyelitis: Associated diseases. A patient with diabetes is attending a class on the prevention of associated diseases. What action should the patient perform to reduce the risk of osteomyelitis? A) Increase calcium and vitamin intake. B) Perform meticulous foot care. C) Exercise 3 to 4 times weekly for at least 30 minutes. D) Take corticosteroids as ordered.

B) Perform meticulous foot care.

Know osteoarthritis: Risk factors. A nurse is assessing a patient for risk factors known to contribute to osteoarthritis. What assessment finding would the nurse interpret as a risk factor? A) The patient has a 30 pack-year smoking history. B) The patients body mass index is 34 (obese). C) The patient has primary hypertension. D) The patient is 58 years old.

B) The patients body mass index is 34 (obese).

Know amputations: Rationale for the need of a pressure dressing on the end of the residual limb. The nurse is providing care for a patient who has had a below-the-knee amputation. The nurse enters the patient's room and finds him resting in bed with his residual limb supported on a pillow. What is the nurse's most appropriate action? A. Inform the surgeon of this finding. B. Explain the risks of flexion contracture to the patient. C. Transfer the patient to a sitting position. D. Encourage the patient to perform active ROM exercises with the residual limb.

B. Explain the risks of flexion contracture to the patient.

Know osteoarthritis: Joint findings. During a head-to-toe assessment of a patient with osteoarthritis, you note bony outgrowths on the distal interphalangeal joints. You document these findings as: A. Bouchard's Nodes B. Heberden's Nodes C. Neurofibromatosis D. Dermatofibromas

B. Heberden's Nodes

Know crutch gait for patients with amputations: Three-point gait, four-point gait, swing-through gait. While your patient is ambulating with crutches he moves both crutches forward along with the injured leg and then moves the non-injured forward. When you document you will note that the patient used what type of gait while ambulating with crutches? A. Two-point gait B. Three-point gait C. Four-point gait D. Swing-to-gait

B. Three-point gait

Eventually the articular cartilage is completely destroyed. What happens to the bones?

Bone rubs on bone

A nurse is performing a shift assessment on an elderly patient who is recovering after surgery for a hip fracture. The nurse notes that the patient is complaining of chest pain, has an increased heart rate, and increased respiratory rate. The nurse further notes that the patient is febrile and hypoxic, coughing, and producing large amounts of thick, white sputum. The nurse recognizes that this is a medical emergency and calls for assistance, recognizing that this patient is likely demonstrating symptoms of what complication? A) Avascular necrosis of bone B) Compartment syndrome C) Fat embolism syndrome D) Complex regional pain syndrome

C) Fat embolism syndrome

Know complications of hip fracture: S/S. A nurse is caring for a patient who has suffered a hip fracture and who will require an extended hospital stay. The nurse should ensure that the patient does which of the following in order to prevent common complications associated with a hip fracture? A) Avoid requesting analgesia unless pain becomes unbearable. B) Use supplementary oxygen when transferring or mobilizing. C) Increase fluid intake and perform prescribed foot exercises. D) Remain on bed rest for 14 days or until instructed by the orthopedic surgeon.

C) Increase fluid intake and perform prescribed foot exercises.

Know low back pain: Sciatic pain characteristics. A patient presents at a clinic complaining of back pain that goes all the way down the back of the leg to the foot. The nurse should document the presence of what type of pain? A) Bursitis B) Radiculopathy C) Sciatica D) Tendonitis

C) Sciatica

Know osteoporosis: Risk factors. A nursing educator is reviewing the risk factors for osteoporosis with a group of recent graduates. What risk factor of the following should the educator describe? A) Recurrent infections and prolonged use of NSAIDs B) High alcohol intake and low body mass index C) Small frame, female gender, and Caucasian ethnicity D) Male gender, diabetes, and high protein intake

C) Small frame, female gender, and Caucasian ethnicity

Know DVT: Risk factors. Which of the following is the primary risk factor for pulmonary embolism? A)Smoking B)Heart disease C)Deep vein thrombosis D)Malignancy

C)Deep vein thrombosis

While using crutches the patient moves both crutches forward and then moves both legs forward past the placement of the crutches. This is known as the: A. Two-point gait B. Swing-to-gait C. Swing-through-gait D. Three-point gait

C. Swing-through-gait

Know amputations: Phantom limb pain - cause. Six weeks after an above-the-knee amputation (AKA), a patient returns to the outpatient office for a routine postoperative checkup. During the nurse's assessment, the patient reports symptoms of phantom pain. What should the nurse tell the patient to do to reduce the discomfort of the phantom pain? A. Apply intermittent hot compresses to the area of the amputation. B. Avoid activity until the pain subsides. C. Take opioid analgesics as ordered. D. Elevate the level of the amputation site

C. Take opioid analgesics as ordered.

Know osteoporosis: Hormone involved in inhibiting bone resorption and promoting bone formation A nurse is reviewing the pathophysiology that may underlie a patient's decreased bone density. What hormone should the nurse identify as inhibiting bone resorption and promoting bone formation?

Calcitonin

Know low back pain: Treatment for patients non responsive to the traditional approach. A nurse is reviewing the care of a patient who has a long history of lower back pain that has not responded to conservative treatment measures. The nurse should anticipate the administration of what drug? A) Calcitonin B) Prednisone C) Aspirin D) Cyclobenzaprine

D) Cyclobenzaprine

A nurse is caring for a patient who is recovering in the hospital following orthopedic surgery. The nurse is performing frequent assessments for signs and symptoms of infection in the knowledge that the patient faces a high risk of what infectious complication? A. Cellulitis B. Septic arthritis C. Sepsis D. Osteomyelitis

D. Osteomyelitis

How is the articular cartilage affected?

Disruption of the cartilage that lines the articular surfaces

Once the articular cartilage is completely destroyed, bone will rub on bone. What effect will be seen?

Eburnation Polishing' of the bones

Osteophytes are reactive bony outgrowths. Where are two classic locations for these to appear?

PIP (Bouchard nodules) DIP (Heberden nodules) PIP comes before DIP = B comes before H

Know osteoarthritis: Risk factors.

Risk factors Age Obesity Estrogen reduction at menopause Injury Frequent kneeling and stooping