PathoPharm 1 mobility EAQ
A female client asks the nurse whether she should be tested for osteoporosis. Which statements reflect current advice regarding the prevention of osteoporosis? Select all that apply. One, some, or all responses may be correct. Some correct answers were not selected 1. "A bone mineral density test is the only way to diagnose osteoporosis." 2. "Everyone with osteoporosis should be treated with bisphosphonates." 3. "All adults need 1000 mg calcium and 400 to 800 IU of vitamin D each day." 4. "Women should be evaluated clinically for risk of osteoporosis annually after age 70." 5. "Postmenopausal women and all adults over the age of 65 should be tested for osteoporosis."
1. "A bone mineral density test is the only way to diagnose osteoporosis." 5. "Postmenopausal women and all adults over the age of 65 should be tested for osteoporosis."
Which client statement supports the nurse's conclusion that teaching about osteoporosis was effective? 1. "I know that certain illnesses can affect my body's calcium level." 2. "I think I can eat all the calcium I need rather than taking medication." 3. "I will begin to actively monitor my risk for this disease after menopause." 4. "I'm glad that drinking a little wine every day is advised to maintain calcium levels."
1. "I know that certain illnesses can affect my body's calcium level."
Which statement by the nurse explains the reason clients prescribed corticosteroid therapy for a chronic health problem develop frequent infections? 1. "They affect antigen-antibody immunity." 2. "They enhance the inflammatory process." 3. "The medication makes the white blood cells work harder." 4. "They increase the number of inflammatory chemicals in the blood."
1. "They affect antigen-antibody immunity."
Which statement regarding mealtime administration by a client who has arthritis and is prescribed corticosteroid medication indicates that the teaching was effective? 1. "This will decrease gastric irritation." 2. "This will serve as a reminder to take the medication." 3. "The presence of food will enhance absorption." 4. "The medication is ineffective in an acid medium."
1. "This will decrease gastric irritation."
Which finding during a home health visit would prompt the nurse to provide a client with home safety instructions? Select all that apply. One, some, or all responses may be correct. 1. Area rugs on the floor 2. Clogged, dirty fireplace 3. Multiple electrical cords 4. Multiple prescribed medications 5. Wheeled walker with uneven legs
1. Area rugs on the floor 2. Clogged, dirty fireplace 3. Multiple electrical cords 4. Multiple prescribed medications 5. Wheeled walker with uneven legs
Which diagnostic test would be used for the direct visualization of ligaments, menisci, and articular surfaces of joints? 1. Arthroscopy 2. Muscle biopsy 3. Ultrasonography 4. Electromyography
1. Arthroscopy
Which medication increases the risk for upper gastrointestinal (GI) bleeding? Select all that apply. One, some, or all responses may be correct. 1. Aspirin 2. Ibuprofen 3. Ciprofloxacin 4. Acetaminophen 5. Methylprednisolone
1. Aspirin 2. Ibuprofen 5.Methylprednisolone
Which findings are consistent with hypercalcemia after prolonged immobility? Select all that apply. One, some, or all responses may be correct. 1. Bone pain 2. Convulsions 3. Muscle spasms 4. Tingling of extremities 5. Depressed deep tendon reflexes
1. Bone pain 5. Depressed deep tendon reflexes
Which finding in older adult clients is associated with aging? 1. Decrease in height 2. Decreased neck rigidity 3. Increased fine-motor dexterity 4. Increased range of motion (ROM)
1. Decrease in height
Which complication is a client with rheumatoid arthritis at risk for due to prolonged use of corticosteroids? 1. Decreased white blood cells 2. Increased C-reactive protein 3. Increased sedimentation rate 4. Decreased serum glucose levels
1. Decreased white blood cells
When teaching a client about their disease process, which term would the nurse use to describe bone loss greater than normal but less than that caused by osteoporosis? 1. Osteopenia 2. Osteomyelitis 3. Osteomalacia 4. Osteoarthritis
1. Osteopenia
A pregnant client is prescribed heparin to prevent the risk of thromboembolism. Which is a possible adverse effect of this medication when used during pregnancy? Select all that apply. One, some, or all responses may be correct. 1. Osteoporosis 2. Suppression of contractions in labor 3. Increased risk of serious bleeding 4. Stimulation of uterine contraction 5. Compression fractures of the spine
1. Osteoporosis 3. Increased risk of serious bleeding 5. Compression fractures of the spine
Which hormone regulates blood levels of calcium? 1. Parathyroid hormone (PTH) 2. Luteinizing hormone (LH) 3. Thyroid-stimulating hormone (TSH) 4. Adrenocorticotropic hormone (ACTH)
1. Parathyroid hormone (PTH)
Which action indicates the need for additional teaching when the nurse is educating a client on the use of heat and cold for osteoarthritis (OA) pain? 1. Places ice pack on skin 2. Uses ice pack for 20 minutes 3. Applies lightweight heating pad 4. Tests water before getting into shower
1. Places ice pack on skin
Which medication is derived from a natural source and may be prescribed for the treatment of osteoporosis? 1. Calcitonin 2. Raloxifene 3. Clomiphene 4. Bisphosphonates
1. calcitonin
The primary health care provider prescribed medications to four clients with osteoporosis. Which client would the nurse instruct to remain upright for 30 minutes after receiving the medication? 1. client a-alendronate 2. client b-zoledronic acid 3. client c-calcium supplements 4. client d-raloxifene
1. client a-alendronate
Which example demonstrates clinical decision-making by the nurse? 1. "I palpated the right hip of the client, which appeared red, and noted a warm feeling." 2. "I identified impaired skin integrity in a pressure ulcer document upon finding redness in the client's hip." 3. "I discussed the use of salt with a client who has a history of hypotension history and suffers from light-headedness and dizziness." 4. "I assessed weakness and hunger in a client with a history of diabetes history who suffers with light-headedness and blurred vision."
2. "I identified impaired skin integrity in a pressure ulcer document upon finding redness in the client's hip."
The nurse teaches a client who is premenopausal and obese about strategies to prevent osteoporosis. Which strategy identified by the client indicates that the teaching is effective? 1. Start a rapid, strict weight-reduction diet 2. Join a tennis league and practice every day 3. Take 1200 international units of vitamin D a day 4. Sign up for a swimming class three times a week
2. Join a tennis league and practice every day
An assessment of an 89-year-old client yeilds a history of severe congenital spinal deformity. Which condition would describe the nurse's finding? 1. Lordosis 2. Kyphosis 3. Presbycusis 4. Osteoporosis
2. Kyphosis
For which physiological condition would the nurse teach an older adult client about the use of isometric exercises? 1. Kyphosis 2. Muscle atrophy 3. Decreased bone density 4. Decreased range of motion (ROM)
2. Muscle atrophy
Which therapeutic outcome is expected after administering ibuprofen? Select all that apply. One, some, or all responses may be correct. 1. Diuresis 2. Pain relief 3. Temperature reduction 4. Bronchodilation 5. Anticoagulation 6. Reduced inflammation
2. Pain relief 3. Temperature reduction 6. Reduced inflammation
Which information from the client's history would the nurse identify as a risk factor for developing osteoporosis? 1. Takes estrogen therapy 2. Receives long-term steroid therapy 3. Has a history of hypoparathyroidism 4. Engages in strenuous physical activity
2. Receives long-term steroid therapy
Which physiological change occurs in older adults and warrants the nurse teaching the client about safety tips to prevent falls? 1. Slowed movement 2. Cartilage degeneration 3. Decreased bone density 4. Decreased range of motion (ROM)
3. Decreased bone density
To prevent thrombophlebitis in the immediate postoperative period, which action is important for the nurse to include in the client's plan of care? 1. Increase fluid intake. 2. Restrict fluids. 3. Encourage early mobility. 4. Elevate the foot of the bed.
3. Encourage early mobility.
A client with a history of osteoporosis and vertebral compression has been coming to the clinic more frequently for prescription refills of hydrocodone/acetaminophen. Which inference will the nurse make? 1. The half-life of the medication has decreased. 2. An idiosyncratic reaction has occurred. 3. Higher doses are needed to achieve pain relief. 4. An emotional dependence on the medication has developed.
3. Higher doses are needed to achieve pain relief.
Which times for the medication schedule would a nurse teach when corticosteroid therapy is prescribed for a client with an exacerbation of ulcerative colitis? 1. At bedtime with a snack 2. Three times a day with meals 3. In the early morning with food 4. One hour before or 2 hours after eating
3. In the early morning with food
Which medication is safe to take for pain in the week before a surgical procedure? 1. Naproxen 2. Aspirin 3. Ketorolac 4. Acetaminophen
4. Acetaminophen
Which nursing intervention would the nurse include in the plan of care for an older adult client with decreased bone density? 1. Teaching the client isometric exercises 2. Advising the client to take a warm shower 3. Providing supportive armchairs to the client 4. Demonstrating weight-bearing exercises to the client
4. Demonstrating weight-bearing exercises to the client
Which increased risk would the nurse consider when assessing a client with diabetes who is receiving long-term corticosteroid therapy and is admitted with leg ulcers? 1. Weight loss 2. Hypoglycemia 3. decreased blood pressure 4. Inadequate wound healing
4. Inadequate wound healing
Which change in the joint may result in joint pain for older adults? 1. Dehydration of discs 2. Loss of muscle mass 3. Decreased elasticity in the ligaments 4. Increased cartilage erosion
4. Increased cartilage erosion
Which response would be given by a nurse caring for a client receiving corticosteroid therapy who states, "I have difficulty controlling my temper, which is so unlike me, and I don't know why this is happening."? 1. Tell the client it is nothing to worry about. 2. Reassure that everyone does this at times. 3. Instruct the client to attempt to avoid situations that cause irritation. 4. Inquire about mood swings.
4. Inquire about mood swings.
Which definition would the nurse use to explain osteoporosis? 1.It is avascular necrosis. 2. It is caused by pathological fractures. 3. It is hyperplasia of osteoblasts. 4. It involves a decrease in bone substance.
4. It involves a decrease in bone substance.
When treating clients for osteoporosis, which medication has a side effect of atrial fibrillation when infused too quickly? 1. Calcium-Vitamin D3-Vitamin K combination 2. Raloxifene 3. Alendronate 4. Zoledronic acid
4. Zoledronic acid
Which client's plan of care needs revision? 1. client A-shin splints-use of proper shoes and gradual increase in the activity 2. client B-rotator cuff tear- rest and gradually add strengthening exercises 3. client C-ligament injury- protection of affected extremity by use of brace 4. client D- anterior cruciate ligament (ACL) tears- apply cool ice compresses and perform balance exercises
4. client D- anterior cruciate ligament (ACL) tears- apply cool ice compresses and perform balance exercises
After completing physical assessments and review of laboratory data, which client would the nurse identify as having findings consistent with rheumatoid arthritis? 1. client A-uric acid-8.5mg/dL 2. client B-cReactive protein (CRP)-800mcg/dL (8000 mcg/L) 3. client C-anti-deoxyribonucleic acid (DNA) antibody-90 IU/mL 4. client D-erythrocyte sedimentation rate (ESR)-65mm/hour
4. client D-erythrocyte sedimentation rate (ESR)-65mm/hour
Which tissue connects the client's tibia to the femur at the knee joint? 1. Fascia 2. Bursae 3. Tendons 4. Ligaments
4. ligaments
Which medication may have caused a client's admission to the hospital for treatment of a peptic ulcer, osteoporosis, and hypertension? 1. Everolimus 2. Azathioprine 3. Mycophenolate acid 4. Methylprednisolone
4.Methylprednisolone
Which hormone promotes bone resorption in a client and potentially leads to decreased bone densities? 1. Estrogen 2. Calcitonin 3. Growth hormone 4.Parathyroid hormone (PTH)
4.Parathyroid hormone (PTH)
At which joint would the nurse be able to palpate spongy swelling caused by excess synovial fluid? 1. Biaxial joint 2. Pivotal joint 3. Synovial joint 4. Temporomandibular joint
4.Temporomandibular joint
Which intervention would the nurse provide to an older adult client with a low body mass index (BMI) with osteoporosis? 1. Encourage continuous, steady weight gain. 2. Monitor for decreased urine calcium. 3. Provide instructions relative to diet and exercise. 4. Teach about safety factors in the use of opioids and nonsteroidal anti- inflammatory drugs.
3. Provide instructions relative to diet and exercise.
Which rationale describes why the nurse would advise a client to have a dental examination before beginning prescribed therapy with zoledronic acid? 1. To prevent kidney failure 2. To prevent atrial fibrillation 3. To prevent bronchoconstriction 4. To prevent maxillary osteonecrosis
4. To prevent maxillary osteonecrosis
Which factors contribute to development of osteoporosis in female clients? Select all that apply. One, some, or all responses may be correct. 1. Cigarette smoking 2. Moderate exercise 3. Use of street drugs 4. Familial predisposition 5. Inadequate intake of dietary calcium
1. Cigarette smoking 4. Familial predisposition 5. Inadequate intake of dietary calcium
A client who has severe back pain is found to have a vertebral compression fracture. Which cause of fracture would the nurse consider when planning interventions? 1. Collapse of the vertebral bodies 2. Demineralization of the spinal cord 3. Wear and tear of the spinous processes 4. Bulging of the spinal cord from the vertebra
1. Collapse of the vertebral bodies
Initial examination of a client reveals moon face, buffalo hump, and truncal obesity. The laboratory report reveals salivary cortisol level of 3.0 ng/mL (9.54 nmol/L). Which manifestation would the nurse expect to find upon further assessment? Select all that apply. One, some, or all responses may be correct. 1. Edema 2. Osteoporosis 3. Hypogonadism 4. Muscle atrophy 5. Barrel-shaped chest
1. Edema 2. Osteoporosis 4. muscle atrophy
The nurse recommends that, when in bed, a client who has osteoarthritis should lie in the supine or prone position. The client states that these positions are uncomfortable for the knees and hips. Which action would the nurse take? 1. Encourage the client to maintain extension for specific periods of time. 2. Urge the client to lie in whatever position is most comfortable. 3. Insert a pillow under the client's knees to relieve discomfort. 4. Place the client in the semi-Fowler position most of the time.
1. Encourage the client to maintain extension for specific periods of time.
The nurse is completing the health history of a client admitted to the hospital with osteoarthritis. Which joint would the nurse expect the client to report as having been involved first? Select all that apply. One, some, or all responses may be correct. 1. Hips 2. Knees 3. Ankles 4. Shoulders 5. Metacarpals
1. Hips 2. Knees
The plan of care for a client with osteoporosis includes active and passive exercises, calcium supplements, and daily vitamins. Which finding would indicate that the therapy is helping? 1. Mobility increases. 2. Fewer muscle spasms occur. 3. The heartbeat is more regular. 4. There are fewer bruises than before therapy.
1. Mobility increases.
A primary health care provider schedules a bone scan for a client with osteoporosis. Which nursing action is beneficial for the client? Select all that apply. One, some, or all responses may be correct. 1. Placing the client in the supine position 2. Verifying presence or absence of a shellfish allergy 3. Ensuring the client does not have metal on their clothing 4. instructing the client to empty their bladder before the scan 5. Informing the client that the postprocedure headache resolves in 2 days
1. Placing the client in the supine position 4. instructing the client to empty their bladder before the scan
Which intervention would the nurse anticipate incorporating into the plan of care for a client with bursitis of the left knee? Select all that apply. One, some, or all responses may be correct. 1. Rest the affected joint. 2. Apply a heat pack. 3. Use a compression splint. 4. Do gentle range-of-motion exercises. 5. Take nonsteroidal anti-inflammatory drugs (NSAIDs) as needed for pain.
1. Rest the affected joint. 3. Use a compression splint. 5. Take nonsteroidal anti-inflammatory drugs (NSAIDs) as needed for pain.
Which activities would be encouraged of a child with juvenile idiopathic arthritis to prevent loss of joint function? Select all that apply. One, some, or all responses may be correct. 1. Riding a bicycle 2. Walking to school 3. Watching videos after school 4. Swimming in the community pool 5. Playing computer games after school
1. Riding a bicycle 2. Walking to school 4. Swimming in the community pool
Which physiological change of the musculoskeletal system would the nurse associate with aging? Select all that apply. One, some, or all responses may be correct. Some correct answers were not selected 1. Slowed movement 2. Cartilage degeneration 3. Increased bone density 4. Increased range of motion 5. Increased bone prominence
1. Slowed movement 2. Cartilage degeneration 5. increased bone prominence
Which advice will the nurse provide to the client after a health care provider prescribes aspirin for a client with severe arthritis? 1. Take the medicine with meals. 2. See a dentist if bleeding gums develop. 3. Switch to acetaminophen if tinnitus occurs. 4. Avoid spicy foods while taking the medication.
1. Take the medicine with meals.
Which action by a client taking alendronate requires correction? Select all that apply. One, some, or all responses may be correct. 1. Taking medication twice a week 2. Taking medication before rising 3. Taking medication with breakfast 4. Taking medication before bedtime 5. Taking medication with apple juice
1. Taking medication twice a week 2. Taking medication before rising 3. Taking medication with breakfast 4. Taking medication before bedtime 5. Taking medication with apple juice
Which action by a 70-year-old female client would best limit further progression of osteoporosis? 1. Taking supplemental calcium and vitamin D 2. Increasing the consumption of eggs and cheese 3. Taking supplemental magnesium and vitamin E 4. Increasing the consumption of milk products
1. Taking supplemental calcium and vitamin D
A 7-year-old child sustains a fractured femur in a bicycle accident. The admission x-ray films reveal evidence of fractures of other long bones in various stages of healing. Which would the nurse suspect as the cause of the fracture? 1. Child abuse 2. Vitamin D deficiency 3. Osteogenesis imperfecta 4. Inadequate calcium intake
1. child abuse
The nurse teaches a student nurse about caring for a client with decreased bone density. Which statements made by the student nurse indicate effective learning? Select all that apply. One, some, or all responses may be correct. 1. "I will instruct the client to refrain from running as exercise." 2. "I will instruct the client to be very careful to prevent injuries." 3. "I will instruct the client to perform weight-bearing activities." 4. "I will instruct the client to drink at least 2 L of water daily." 5. "I will instruct the client to change positions every 2 hours."
2. "I will instruct the client to be very careful to prevent injuries." 3. "I will instruct the client to perform weight-bearing activities."
Which facts would the nurse share with a client expressing interest in menopausal hormone therapy? Select all that apply. One, some, or all responses may be correct. 1. "The risk of breast cancer is no higher while using hormone therapy." 2. "There is an increase in heart disease risk from the use of continuous combined estrogen plus progestin." 3. "The North American Menopause Society supports the use of estrogen therapy beyond 3 to 5 years to prevent osteoporosis in menopausal women." 4. "The U.S. Preventive Services Task Force recommends combined estrogen and progestin therapy for postmenopausal women." 5. "The American College of Obstetricians and Gynecologists encourages nonhormonal alternatives such as selective serotonin reuptake inhibitors."
2. "There is an increase in heart disease risk from the use of continuous combined estrogen plus progestin." 3. "The North American Menopause Society supports the use of estrogen therapy beyond 3 to 5 years to prevent osteoporosis in menopausal women." 5. "The American College of Obstetricians and Gynecologists encourages nonhormonal alternatives such as selective serotonin reuptake inhibitors."
The nurse teaches a client about wearing thigh-high antiembolism elastic stockings. Which instruction would be correct to include? 1. "You do not need to wear them while you are awake, but it is important to wear them at night." 2. "You will need to apply them in the morning before you lower your legs from the bed to the floor." 3. "If they bother you, you can roll them down to your knees while you are resting or sitting down." 4. "You can apply them either in the morning or at bedtime, but only after the legs are lowered to the floor."
2. "You will need to apply them in the morning before you lower your legs from the bed to the floor."
Which client is most at risk for osteoporosis? 1. A nonsmoking 60-year-old woman, body mass index (BMI) 27.1 2. A 66-year-old white woman, body mass index (BMI) 18, who is a paralegal 3. A 68-year-old black woman, body mass index (BMI) 23.3, who is a retired receptionist 4. A 62-year-old woman, body mass index (BMI 23.2), who takes calcium carbonate daily
2. A 66-year-old white woman, body mass index (BMI) 18, who is a paralegal
A postmenopausal woman has been administered raloxifene for osteoporosis. Which parameter would the nurse assess to ensure the efficacy of the medication and continuation of use? 1. Body weight 2. Bone density 3. Calcium levels in urine 4. Esophageal functioning
2. Bone density
Which synovial joint movement is described as turning the sole away from the midline of the body? 1. Pronation 2. Eversion 3. Adduction 4. Supination
2. Eversion
The nurse is assessing a client with a moon-shaped face and thin arms and legs. The nurse expects which other assessment findings? Select all that apply. One, some, or all responses may be correct. 1. Weight loss 2. Gastric ulcer 3. Pain in bones 4. Poor appetite 5. Muscle weakness
2. Gastric ulcer 3. Pain in bones 5. Muscle weakness
Which finding would the nurse expect to identify in a client who has osteoarthritis that would not be present in clients with rheumatoid arthritis? 1. Ulnar drift 2. Heberden nodes 3. Swan-neck deformity 4. Boutonnière deformity
2. Heberden nodes
Which statements accurately describe the different medications available for the treatment of osteoporosis? Select all that apply. One, some, or all responses may be correct. 1. Denosumab acts by stimulating bone formation. 2. Individuals with an allergy to salmon can't take calcitonin. 3. Bisphosphonates inhibit osteoclast-mediated bone resorption. 4. Denosumab is a subcutaneous injection given once every 6 months. 5. Teriparatide is used for the prevention of postmenopausal osteoporosis.
2. Individuals with an allergy to salmon can't take calcitonin. 3. Bisphosphonates inhibit osteoclast-mediated bone resorption. 4. Denosumab is a subcutaneous injection given once every 6 months.
Which reason would the nurse provide for the gradual reduction in dosage to a client who recently started receiving oral corticosteroids for a severe allergic reaction and is instructed that the dosage will be reduced gradually until all medication is stopped at the end of 2 weeks? 1. Discontinuing the medication too fast will cause the allergic reaction to reappear. 2. Slow reduction of the medication will prevent a physiological crisis because the adrenal glands are suppressed. 3. The health care provider is attempting to determine the minimal dose that will be effective for the allergy. 4. Sudden cessation of the medication will cause development of serious side effects, such as moon face and fluid retention.
2. Slow reduction of the medication will prevent a physiological crisis because the adrenal glands are suppressed.
The nurse is teaching a group of parents about the bones of toddlers. Which information would the nurse include? Select all that apply. One, some, or all responses may be correct. 1. The bones of toddlers are less pliable than those of older persons. 2. The bones of toddlers have more cartilage than do those of young adults. 3. The bones of toddlers can better withstand falls than can those of older adults. 4. The bones of toddlers are more susceptible to bone loss than are those of old people. 5. The bones of toddlers are more susceptible to osteoporosis than are those of women.
2. The bones of toddlers have more cartilage than do those of young adults. 3. The bones of toddlers can better withstand falls than can those of older adults.
How does the skeletal system of a toddler differ from that of an older adult? 1. Toddlers' bones are less pliable than the bones of older persons. 2. Toddlers' bones can withstand falls better than the bones of older adults. 3. Toddlers' bones are more susceptible to osteoporosis than the bones of older adults. 4. Toddlers' bones are more susceptible to bone loss than the bones of older persons.
2. Toddlers' bones can withstand falls better than the bones of older adults.
Which structure protects a client's internal organs, supports blood cell production, and stores minerals? 1. Joints 2. Bones 3. Muscles 4. Cartilages
2. bones
A client with a diagnosis of malabsorption syndrome exhibits a symptom of spastic muscle spasms. Which electrolyte is responsible for this symptom? 1. Sodium 2. Calcium 3. Potassium 4. Phosphorus
2. calcium
Which client receiving antibiotic therapy would the nurse identify as being at risk for Achilles tendon rupture? 1. client A-gentamicin 2. client B-Ciprofloxacin 3. client C- Cefazolin 4. client D-tobramycin
2. client B-Ciprofloxacin
Which factor would the nurse recognize as a cause of neck pain in a client? 1. Headache 2. Poor posture 3. Low body weight 4. Sedentary lifestyle
2. poor posture
A client with osteoporosis is encouraged to drink milk. The client refuses the milk, explaining that it causes gas and bloating. Which calcium-rich food would the nurse suggest for clients who do not tolerate milk? 1. Oats 2. Yogurt 3. Potatoes 4. Applesauce
2. yogurt
A nurse is creating a plan of care for a client with rheumatoid arthritis who has severe pain and swelling of the hand joints. Which details about range-of-motion exercises would the plan include? 1. Passively performing the exercises for the client 2. Discontinuing the exercises if the client reports discomfort 3. Applying heat or cold before the exercises 4. Increasing the vigor of the exercises to restore mobility
3. Applying heat or cold before the exercises
The nurse is caring for a client whose mobility is restricted to a wheelchair after a motor vehicle accident. The client has been prescribed physiotherapy as a part of rehabilitation care. Which interventions would the nurse consider when the client is discharged from the health care facility? Select all that apply. One, some, or all responses may be correct. 1. Focus firmly on the challenges faced by the client. 2. Refrain from including children in the support system. 3. Assist the family in identifying community support systems. 4. Encourage the primary caregiver to set a routine time for respite. 5. Consider the primary caregiver's experience in the discharge plan.
3. Assist the family in identifying community support systems. 4. Encourage the primary caregiver to set a routine time for respite. 5. Consider the primary caregiver's experience in the discharge plan.
Which food would the nurse recommend for a client who is at risk for developing osteoporosis? Select all that apply. One, some, or all responses may be correct. 1. Canned tuna 2. Scrambled eggs 3. Chicken breast 4. Broiled beef steak 5. Baked sweet potato
3. Chicken breast 4. Broiled beef steak
A client with a femoral fracture and osteomyelitis is immobilized for 3 weeks. Which rationale explains the nurse's plan to assess for the development of renal calculi? 1. The client's dietary patterns have changed since admission. 2. The client has more difficulty urinating in a supine position. 3. Lack of weight-bearing activity promotes bone demineralization. 4. Fracture healing requires more calcium, which increases calcium metabolism.
3. Lack of weight-bearing activity promotes bone demineralization.
The health care provider prescribed raloxifene for a client with osteoporosis. Which manifestation would the nurse monitor in this client? 1. Check serum creatinine 2. Monitor urinary calcium 3. Monitor liver function tests 4. Observe for anxiety and drowsiness
3. Monitor liver function tests
Which factor in the client's history increases the risk for osteoporosis? 1. Estrogen therapy 2. Hypoparathyroidism 3. Prolonged immobility 4. Excessive calcium intake
3. Prolonged immobility
Which population-level action would the nurse use to support tertiary prevention for clients with osteoporosis? 1. Develop an educational campaign to support early identification of osteoporosis. 2. Provide routine screening for osteoporosis at local health fairs and community sites. 3. Support development of low-impact physical activity options for those diagnosed with osteoporosis. 4. Encourage local providers to include discussion of strategies that reduce osteoporosis risk during annual wellness visits.
3. Support development of low-impact physical activity options for those diagnosed with osteoporosis.
Which surgery is used as a prophylactic measure and as a palliative treatment for clients with rheumatoid arthritis (RA)? 1. Osteotomy 2. Arthrodesis 3. Synovectomy 4. Debridement
3. Synovectomy
Which statement is true about the skeletal system of toddlers? 1. The bones of toddlers are less pliable than those of older persons. 2. The bones of toddlers have less cartilage than those of young adults. 3. The bones of toddlers can better withstand falls than those of older adults. 4. The bones of toddlers are more susceptible to osteoporosis than those of women.
3. The bones of toddlers can better withstand falls than those of older adults.
Which injury would the nurse suspect in a young adult client who reports that a knee occasionally gives way, sometimes locks, and "clicks" when walking? 1. Cracked patella 2. Ruptured Achilles tendon 3. Torn cartilage 4. Stress fracture
3. Torn cartilage
Which food selection by the client with osteoporosis indicates that the nurse's dietary instruction was effective? 1. Red meat 2. Coffee 3. Turnip greens 4. Wheat bran
3. Turnip greens
Which term refers to the exaggerated posterior curvature of a client's thoracic spine? 1. Lordosis 2. Scoliosis 3. Kyphosis 4. Osteoporosis
3. kyphosis
Which synovial joint movement is involved in turning a client's palm downward? 1. Eversion 2. Inversion 3. Pronation 4. Supination
3. pronation
Which factor may have led to the development of flexion contractures in a client with osteoarthritis (OA)? 1. Wearing shoes without insoles 2. Elevating the legs 8 to 12 inches 3. using large pillows under the knees or head 4. Placing a small pillow under the head in the supine position
3. using large pillows under the knees or head
Which part of the client's body would the nurse assess to identify osteoporotic changes? 1. Long bones 2. Facial bones 3. Vertebral column 4. Joints of the hands
3. vertebral column
The nurse is assessing a client with arthritis. Which statement made by the client indicates a precipitating factor? 1. "The pain is usually present in my fingers and knees." 2. "I observed swelling and redness near the pain area." 3. "I feel the pain in each and every joint of my hands and legs." 4. "I run for 30 minutes every day; this exercise increases my pain.
4. "I run for 30 minutes every day; this exercise increases my pain.
After teaching a client about the use of calcitonin (nasal route) as treatment for osteoporosis, which client statement indicates effective learning? 1. "I should expect some nausea when taking this medication." 2. "I should stop the medication when the symptoms subside." 3. "I should not take calcium supplements when taking calcitonin." 4. "I should not spray the medication into the same nostril on 2 consecutive days."
4. "I should not spray the medication into the same nostril on 2 consecutive days."
Which response would the nurse give to a client taking ibuprofen for rheumatoid arthritis who asks the nurse if acetaminophen can be substituted? 1. "Yes, both are antipyretics and have the same effect." 2. "Acetaminophen irritates the stomach more than ibuprofen does." 3. "Acetaminophen is the preferred treatment for rheumatoid arthritis." 4. "Ibuprofen has anti-inflammatory properties, and acetaminophen does not."
4. "Ibuprofen has anti-inflammatory properties, and acetaminophen does not."
After a below-the-knee amputation, a client is refusing to eat, talk, or perform any rehabilitative activities. Which approach would the nurse take when interacting with this client? 1. Explain why there is a need to increase activity. 2. Emphasize that with a prosthesis, there will be a return to the previous lifestyle. 3. Appear cheerful and noncritical regardless of the client's response to attempts at intervention. 4. Acknowledge that the client's withdrawal is an expected and necessary part of initial grieving.
4. Acknowledge that the client's withdrawal is an expected and necessary part of initial grieving.
While assessing an immobilized client, the nurse notes that the client has shortened muscles over a joint, preventing full extension. Which is this condition known as? 1. Osteoarthritis 2. Osteoporosis 3. Muscle atrophy 4. Contracture
4. Contracture
Which reason for a decrease in height is common in older females? 1. Older adults have lower levels of growth hormone. 2. Older adults are not active enough, so they lose bone mass. 3. Older adults have poor posture, so they are shorter. 4. Older adults may have osteoporosis-related height changes.
4. Older adults may have osteoporosis-related height changes.
Which type of synovial joint movement is involved in moving the client's first and fifth metacarpals anteriorly from the flattened palm? 1. Flexion 2. Extension 3. Abduction 4. Opposition
4. Opposition
Which condition would the nurse suspect in the client who reports a burning, sharp pain along the sole of the foot in the morning? 1. Kyphosis 2. Pes planus 3. Tenosynovitis 4. Plantar fasciitis
4. Plantar fasciitis
A 25-year-old woman on estrogen therapy has a history of smoking. Which is a potential complication for this individual? 1. Osteoporosis 2. Hypermenorrhea 3. Endometrial cancer 4. Pulmonary embolism
4. Pulmonary embolism
Which condition is consistent with a client's report of posterior leg pain while walking that worsens upon rest? 1. Crepitus 2. Ankylosis 3. Contracture 4. Tendonitis
4. Tendonitis
The nurse provides moist heat for a client with cartilage degeneration. Which rational explains the use of this nursing intervention? 1. To slow bone loss 2. To prevent skin breakdown 3. To increase muscle strength 4. To increase blood flow to the area
4. To increase blood flow to the area
