PP1 MOBILITY

Which change in the joint may result in joint pain for older adults? 1. Dehydration of disks 2. loss of muscle mass 3. decrease elasticity in the ligaments 4. increase cartilage erosion

4. increase cartilage erosion Rationale: A loss and height in shortening of the trunk is due to loss of water from the disk. A decrease in muscle cells cause a decrease in muscle strength. And increased rigidity in the neck shoulders back hips and knees are due to loss of elasticity in the ligaments

Which position would the nurse utilize to assess the client's hip joint extension and buttocks? A. Supine with knees bent B. Prone C. Side Lying D. Supine

B. Prone

which synovial joint movement is ascribed as turning the soul away from the midline of the body?

Eversion

Which synovial joint movement is involved in turning a client's palm downward? Eversion Inversion Pronation Supination

Pronation Pronation is the movement involved in turning the palm downward. Eversion involves turning the sole outward away from the midline of the body. Inversion involves turning the sole inward towards the midline of the body. Supination involves turning the palm upward.

41. Which findings are consistent with hypercalcemia after prolonged immobility? Select all that apply. One, some, or all responses may be correct. a. Bone pain b. Convulsions c. Muscle spasms d. Tingling of extremities e. Depressed deep tendon reflexes

a. Bone pain e. Depressed deep tendon reflexes Increase serum calcium comes from bone demineralization which results in bone pain. depressed or absent deep tendon reflexes are associated with hypercalcemia. The bodies excitable tissues are affected most conversions are not a sign of hypercalcemia they are a sign of hypocalcemia. muscle spasms can occur with hypocalcemia and hypokalemia. tingling of extremities are associated with hypocalcemia and hyperkalemia.

Which activities would be encouraged of a child with juvenile idiopathic arthritis to prevent loss of joint function? 1. Riding a bike 2. walking to school 3. watching videos after school 4. swimming in the community pool 5. playing computer games after school

1, 2, 4

Which joint surgery is used as a prophylactic measure and as a palliative treatment for clients with rheumatoid arthritis (RA)? 1Osteotomy 2Arthrodesis 3Synovectomy 4Debridement

3Synovectomy Synovectomy is a type of joint surgery that involves the removal of thickened synovial membrane. It is used as a prophylactic measure and as a palliative treatment for rheumatoid arthritis (RA) because it prevents the serious destruction of joint surfaces. Osteotomy involves removing a wedge of bone to correct deformity and relieve pain. Arthrodesis is the surgical fusion of a joint. Debridement involves the surgical removal of degenerative debris from a joint.

Which physiologic changes of the musculoskeletal system are related to aging? Select all that apply. A. Slowed movement B. Cartilage degeneration C. Increased bone density D. Increased range of motion E. Increased bone prominence

A,B,E The physiologic changes of the musculoskeletal system related to aging are slowed movements, cartilage degeneration, increased bone prominence, decreased bone density, and decreased range of motion.

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 Loss of high in deformity and shortening of the trunk are common in older adults because of vertebral compression and degeneration. Rigidity in the neck, shoulders, and back knees increases with age because of loss of elasticity and ligaments, tendons, and cartilage. A decline in fine motor dexterity occurs in the older adult because of slow impulse conduction along motor units. ROM is limited in the older adult because of cartilage erosion increased friction between the bones and overgrowth of bone around joint margins.

How would the nurse explain that the skeletal system of toddlers differs from older adults? 1. Bones of toddlers are less pliable than those of older persons. 2. Bones of toddlers can withstand falls better than those of older adults. 3. Bones of toddlers are more susceptible to osteoporosis than those of older adults. 4. Bones of toddlers are more susceptible to bone loss than the bones of older persons

2. Bones of toddlers can withstand falls better than those of older adults. The bones of toddlers can better withstand falls than the bones of older adults. Toddlers' bones are more pliable than those of older people. Older adults, especially women, are more prone to developing osteoporosis, which increases the risk of fractures. Older adults, especially women, are more susceptible to bone loss.

An assessment of an 89-year-old client yields a history of severe congenital spinal deformity. Which condition would most likely describe the nurse's finding? 1Lordosis 2Kyphosis 3Presbycusis 4Osteoporosis

2Kyphosis Kyphosis is an increase in the curvature of the thoracic spine and may result from a congenital abnormality. Lordosis, also known as swayback, is an increased lumbar curvature and may not be a congenital abnormality. Presbycusis is the loss of acuity for high-frequency tones and is not related to the spine. Osteoporosis is a condition in which the bones become brittle and fragile from the loss of tissue and bone mass.

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

Which hormone promotes bone resorption in a client and potentially leads to decreased bone densities? 1Estrogen 2Calcitonin 3Growth hormone 4Parathyroid hormone (PTH)

4 When serum calcium levels lower, secretion of PTH increases and stimulates bones to promote osteoclastic activity, which promotes bone resorption. Estrogens stimulate osteoblastic (bone-building) activity and inhibit PTH. Calcitonin inhibits bone resorption and increases the renal excretion of calcium and phosphorus as needed to maintain balance in the body. Growth hormones secreted by the anterior lobe of the pituitary gland are responsible for increasing bone length.

While assessing an immobilized client, the nurse notes that the client has shortened muscles over a joint, preventing full extension. This condition is known as: 1 Osteoarthritis 2 Osteoporosis 3 Muscle atrophy 4 Contracture

4 Contacture Immobilized clients are at high risk for the development of contractures. Contractures are characterized by permanent shortening of the muscle covering a joint. Osteoarthritis is a disease process of the weight-bearing joints due to wear and tear. Osteoporosis is a metabolic disease process where the bones lose calcium. Muscle atrophy is a wasting and/or decrease in the strength and size of muscles due to a lack of physical activity or a neurological or musculoskeletal disorder.

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 Zoledronic acid is a bisphosphonate used to treat osteoporosis that can cause maxillary osteonecrosis. The client should have a dental examination before starting the medication therapy to prevent maxillary osteonecrosis. The client's serum creatinine should be checked before and after administration of the medication to prevent kidney failure. To prevent atrial fibrillation, the medication should not be infused too quickly. The medication should not be given to a client who is sensitive to aspirin as it may cause

Which structure connects the client's tibia to the femur at the knee joint? 1Fascia 2Bursae 3Tendons 4Ligaments

4Ligaments

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. - Area rugs on the floor - Clogged, dirty fireplace - Multiple electrical cords - Multiple prescribed medications - Wheeled walker with uneven legs

ALL

At which joint would the nurse be able to palpate spongy swelling caused by excess synovial fluid? Biaxial joint Pivotal joint Synovial joint Temporomandibular joint

Temporomandibular joint The temporomandibular joint is palpated by asking the client to open his or her mouth; the nurse checks for any pain or weakness in the face. Common abnormal findings include tenderness, crepitus (a grating sound), and a spongy swelling caused by excess synovial fluid. Biaxial joints help in the gliding movement of the wrist. Pivot joints permit rotation in the radioulnar area. Synovial joints provide movement at the point of contact of articulating bones such as the hip, shoulders, and knees.

Which condition is consistent with a client's report of posterior leg pain while walking that worsens upon rest?

Tendonitis

After completing physical assessments and review of laboratory data, which client would the nurse identify as having findings consistent with rheumatoid arthritis? Client A: Uric acid- 8.5 MG/DL Client B: C reactive protein- 800 mcg/dl Client C: anti deoxyribonucleic acid antibody- 90 IU/ml Client D: erythrocyte sedimentation rate- 65 mm/hr

Client D: erythrocyte sedimentation rate- 65 mm/hr A worth row site sedimentation rate is a nonspecific index of inflammation. It's normal values is less than 30mm/hr. client D who has elevated levels of ESR to 65 mm/hr, may be present with rheumatoid arthritis osteomyelitis rheumatic fever or respiratory tract infections.

which type of synovial joint movement is involved in the moving clients' first and fifth metacarpals anteriorly from flattened palm? -Flexion -Extension -Abduction -Opposition

"opposition" Opposition is a synovial movement that involves moving the first and fifth metacarpals anteriorly from the flattened palm (cupping position). Flexion involves bending the joint as a result of muscle contractions that result in decreasing the angle between two bones. Extension involves the straightening of the joint that increases the angle between two bones. Abduction involves the movement of a part away from the midline of the body.

A nurse is caring for a client whose mobility is restricted to a wheelchair following a motor vehicle accident. The client has been prescribed physiotherapy as a part of rehabilitation care. What interventions should the nurse consider when the client is discharged from the healthcare facility? Select all that apply. 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 The nurse would assist the family in identifying support within the community. The family may need assistance with meals, physiotherapy exercises and care for younger children.

The nurse provides moist heat to a client with cartilage degeneration. What is the rationale for this nursing intervention? 1To slow bone loss 2To prevent skin breakdown 3To increase muscle strength 4To increase blood flow to the area

4To increase blood flow to the area Cartilage degeneration is a physiologic change of the musculoskeletal system that can be treated by providing moist heat, which increases blood flow to the area. Weight-bearing exercises are taught to slow bone loss. The client is instructed to prevent pressure on the bony prominences to prevent skin breakdown. The client is taught isometric exercises to increase muscle strength.

A nurse is creating a plan of care for a client with RA who has severe pain and swelling of the joints. Which details about ROM exercises would the plan of care include?

Applying heat or cold before the exercises heat and cold applications reduce inflammation and discomfort. Avoid exercise will increase the destructive effects of immobility.

which diagnostic test would be used for the direct visualization of ligaments menisci and articular surfaces of joints?

Arthroscopy

The nurse is assessing a client with a "moon-shaped" face and thinner arms and legs. Which other assessment findings would the nurse suspect to be present in this client? Select all that apply. Weight loss Gastric ulcer Pain in bones Poor appetite Muscle weakness

Gastric ulcer Pain in bones Muscle weakness Rationale The presence of such symptoms as "moon" face and thinner arms and legs indicates Cushing's syndrome. In Cushing's syndrome, the cortisol level rises resulting in gastric ulcer formation caused by increased hydrochloric acid secretion and decreased production of protective gastric mucus. Osteoporosis is common in Cushing's syndrome; therefore, bone pain is common. Clients may also feel muscle weakness. Clients with Cushing's syndrome experience increased appetite and weight gain, therefore, they display truncal obesity and a "buffalo hump."

A pregnant client is prescribed heparin to prevent the risk of thromboembolism. Which adverse effects should the nurse anticipate with this medication? Select all that apply. Osteoporosis Suppression of contractions in labor Compression fractures of the spine Stimulation of uterine contraction Increased risk of serious bleeding

Osteoporosis Compression fractures of the spine Increased risk of serious bleeding Heparin is an anticoagulant. When heparin is taken concurrently during pregnancy, it may cause osteoporosis. This in turn can cause compression fractures of the spine. The use of aspirin in the near term of pregnancy can suppress contractions in labor. The increased risk of serious bleeding also occurs with use of aspirin during pregnancy. The use of prostaglandin during pregnancy can cause stimulation of uterine contraction and can cause abortion.

Which structure protects a client's internal organs, supports blood cell production, and stores minerals? 1Joints 2Bones 3Muscles 4Cartilages

2. bones

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." Clients using a nasal form of calcitonin should spray the medication daily into alternate nostrils. The client's statement regarding the medication should not be sprayed into the same nostril on 2 consecutive days indicates effective learning. Nausea does not occur with the nasal spray. Clients should use the spray as directed and not stop the treatment without informing the primary health care provider. Clients should take calcium supplements during the course of the therapy to prevent secondary hyperparathyroidism.)

The nurse is completing the health history of a client admitted to the hospital with osteoarthritis. Which joints would the nurse expect the client will report as having been involved first? Select all that apply. One, some, or all responses may be correct. a. Hips b. Knees c. Ankles d. Shoulders e. Metacarpals

a. Hips b. Knees osteoarthritis affects weight bearing joints first. the resulting joint damage causes a series of physiologic responses (release of cytokines and proteolytic enzymes) that lead to more damage although the ankles are weight bearing joints and eventually are affected, the motion in the ankles is not as great as it is in the hips and knees; thus there is less degeneration. Shoulder joints are not the most likely to be involved first because they're not weight bearing joints. Although the distal interphalangeal joints are commonly affected the remaining interphalangeal joints and metacarpals are 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?

Acknowledge that the client's withdrawal is an expected and necessary part of initial grieving.

The nurse teaches a premenopausal obese client 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 Joins a tennis league and practices every day 3 Takes 1200 International Units of vitamin D a day 4 Signs up for a swimming class three times a week

2 Joins a tennis league and practices every day High-impact exercises are best for building bone mass. Weight loss should be slow and reasonable; Restricting calories promotes the production of the hormone leptin which stimulates bone loss period; the recommended intake for vitamin D adults younger than 50 years of age (premenopausal women) is 800 international units; 1200 MG is the recommended daily dose of calcium for adults older than 50 years of age (postmenopausal women). Signing up for a swimming class three times a week may promote overall health and vigor, but it would not increase strength or mass of bone.

The health care provider prescribed Raloxifene for a client with osteoporosis. Which manifestation would the nurse monitor in this client? 1. Check serum creatine 2. monitor urinary calcium 3. monitor liver function tests 4. observe for anxiety and drowsiness

3. monitor liver function tests Raloxifene increases the risk of hepatic disease. The nurse should monitor the client's liver function tests when prescribed this medication. check serum creatine for clients prescribed zoledronic acid. Monitor urinary calcium in clients prescribed calcium supplements. Observe for anxiety and drowsiness in clients prescribed risedronate.

A client with a diagnosis of malabsorption syndrome exhibits a symptom of spastic muscle spasms. Which electrolyte is responsible for this symptom? A. Sodium B. Calcium C. Potassium D. Phosphorous

B. Calcium Rationale: The muscle contraction-relaxation cycle requires an adequate serum calcium/phosphorous ratio; the reduction of the ionized serum calcium level associated with malabsorption syndrome causes tetany (spastic muscle spasms). Sodium is the major extracellular cation. The major route of sodium excretion is the kidneys, under the control of aldosterone. Although it plays a part in neuromuscular transmission, potassium is not related to the development of tetany. Potassium is the major intracellular cation. Potassium is part of the sodium-potassium pump and helps balance the response of nerves to stimulation. Potassium is not related to the development of tetany. Although phosphorous is closely related to calcium, because they exist in a specific ratio, phosphorous is not related to the development of tetany.

which factor in the client's history increases the risk for osteoporosis? 1Estrogen therapy 2Hypoparathyroidism 3Prolonged immobility 4Excessive calcium intake

3Prolonged immobility Prolonged immobility results in bone demineralization because there is decreased bone production by osteoblasts and increased resorption by osteoclasts. Estrogen helps prevent bone demineralization. Hypoparathyroidism decreases mobilization of calcium from the bones, thereby reducing the serum level of calcium. Decreased calcium intake or absorption may precipitate osteoporosis.

Which nursing intervention would the nurse include in the plan of care for an older adult client with decrease bone density? 1. Teaching the client isometric exercises 2. advising the client to take a warm shower 3. providing support armchairs to the client 4. demonstrating weight bearing exercises to the client

4. demonstrating weight-bearing exercises to the client Decreased bone density leads to osteoporosis; Weight-bearing exercises help build and maintain bone density. Isometric exercises are indicated for clients of muscular atrophy. Clients with cartilaginous degeneration are advised to take moist heat showers to increase blood flow to the region. Correction of posture problems by sitting in a supportive arm chair provides support to the bony structures for a client with kyphosis

To prevent thrombophlebitis in the immediate postoperative period, which action is most important for a 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. In the immediate postoperative period, mobility is encouraged because veins require the assistance of the surrounding muscle beds to help pump blood toward the heart. This reduces venous stasis and the risk of thrombophlebitis. Increased fluid intake, if not contradicted, will prevent dehydration and venous stasis. Restriction of fluids may promote venous stasis and increase risk. Elevating the foot of the bed will prevent thrombophlebitis.

Which injury would the nurse suspect in a young adult client who reports that a knee occasionally gives away sometimes locked and clicks when walking? 1. Cracked Patella 2. ruptured Achilles tendon 3. torn cartilage 4. stress fracture

3. torn cartilage These adaptations are consistent with torn cartilage; this injury is common among basketball players. A fractured patella will cause pain and usually manifests itself at the time of the injury. A ruptured Achilles tendon is painful and prevents plantar flexion of the foot; adaptations usually are manifested at the time of the injury. A stress fracture is associated with pain, not with clicking or locking of the knee.

A nurse is reviewing the treatment charts of four clients. Which treatment chart needs revision? Client A: condition- shin splints Treatment- use of proper shoes and gradual increase in the activity Client B: Condition- rotator cuff tear treatment- rest and gradually add strengthening exercises Client C: Condition- ligament injury treatment- protection of affected extremity by use of a brace Client D: Condition- anterior cruciate ligament tear (ACL) Treatment- apply cool ice compresses and perform balance exercises

Client D: Condition- anterior cruciate ligament tear (ACL) Treatment- apply cool ice compresses and perform balance exercises An anterior cruciate ligament (ACL) tear is a traumatic tearing of a ligament by deceleration forces to the legs and knees. Client D, who has an ACL tear, is treated with physical therapy, rehabilitation, and a knee brace. Ice compresses may not completely relieve the client's pain, and the pain may be elevated upon performing balancing exercises. Inflammation along the anterior aspect of the calf from periostitis due to improper shoes is known as shin splints. Client A, who has shin splints, can be treated with rest, cool ice compresses, proper shoes, and a gradual increase in activity. A tear within a muscle or in the tendinoligamentous structures around the shoulder is known as a rotator cuff tear. Client B, who has a rotator cuff tear, should be treated with gradual mobilization with a range-of-motion (ROM) and strengthening exercises. A ligament injury indicates tearing and stretching of a ligament. Client C, who has a ligament injury, must rest adequately and protect the affected extremity by using a brace.

The nurse is assessing a client with arthritis. Which statement made by the client indicates a precipitating factor that is an intellectual standard for critical thinking? Multiple choice question "The pain is usually present in my fingers and knees." "I observed swelling and redness near the pain area." "I feel the pain in each and every joint of my hands and legs." "I run for 30 minutes every day; this exercise increases my pain."

"I run for 30 minutes every day; this exercise increases my pain." A precipitating factor is an activity or factor that worsens the symptoms. If running for 30 minutes each day increases the client's pain, this action is a precipitating factor. By saying, "The pain is usually present in my fingers and knees," the client is providing information about the location. Swelling and redness are concomitant symptoms of pain. The quality factor indicates the description of the symptom; this is exemplified by the statement, "I feel the pain in each and every joint of my hands and legs."

A primary health care provider schedules a bone scan for a client with osteoporosis. Which nursing actions are beneficial for the client?

1. Placing the client in the supine position 2. Instructing the client to empty their bladder before the scan A bone scan is done to assess osteomyelitis, osteoporosis, primary and metastatic malignant lesions of bone, and certain fractures. The nurse has to place that client in the supine position for 1 hour for easy assessment while performing the bone scan. The nurse should instruct the client to empty the bladder before scanning. The client undergoing a computed tomography (CT) scan must be screened for a shellfish allergy to reduce the incidences of anaphylactic shock associated with the radiocontrast agent. Radio waves and a magnetic field are used during magnetic resonance imaging (MRI); therefore, the nurse should ensure that the client has no metal on the clothing before the procedure. The main risk of a myelogram is a spinal headache that usually resolves within 2 days of the procedure.

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. Allow 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. Flexion contractures of the hips and knees can develop unless some periods of full extension are maintained. The most comfortable position that usually is assumed is one of flexion, which leads to contractures and should be avoided. Placing a pillow under the knees can cause flexion contractures of the hips and knees. Remaining in the semi-Fowler's position can cause flexion contractures of the hips.

The plan of care for a client with osteoporosis includes active and passive exercises, calcium supplements, and daily vitamins. How does a nurse determine that the desired effect of therapy has been achieved? 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. This regimen limits bone demineralization and reduces bone pain, which promotes increased activity. The occurrence of fewer muscle spasms is unrelated to osteoporosis; It would be an expected outcome of the client received calcium for hypokalemia. A more regular heartbeat is unrelated to osteoporosis, or it's therapy. The occurrence of fewer bruises than before therapy is unrelated; It would be expected of the client word receiving vitamin C for capillary fragility.

A postmenopausal woman has been administered raloxifene for osteoporosis. Which parameter should be assessed to ensure the efficacy of the drug and thus its continuation of use? 1 Body weight 2 Bone density 3 Calcium levels in urine 4 Esophageal functioning

2 Bone density An increase in bone density indicates a good therapeutic response to raloxifene. Thus this parameter should be assessed during therapy for osteoporosis. Body weight may or may not increase with bone weight, and this parameter should not be used to assess a positive response to the drug. Calcium levels in the blood indicate response to the therapy rather than calcium levels in urine. Esophageal dysfunction is a contraindication to bisphosphonate therapy

The nurse teaches a client about wearing thigh-high anti-embolism elastic stockings. What would be appropriate to include in the instructions? 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 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. 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 hypertension history and suffers from Lightheadedness and dizziness 4. I assessed weakness and hunger in a client with a history of diabetes who suffers with Lightheadedness and blurred vision

2. identified impaired skin integrity in a pressure ulcer document upon finding redness in the client's hip Clinical decision making is a problem-solving activity that focuses on defining a problem and selecting an appropriate action. So as a part of clinical decision making, the nurse identified impaired skin integrity in a pressure ulcer form upon finding redness in the client's hip. Diagnostic reasoning and inference is an analytical process that involves determining the client's health problems. An example is the nurse palpating and observing a warm sensation in the client's right hip that has turned red. Another example is a nurse who finds that a client who has hypotension history now feels light-headedness and dizziness. A further example is a nurse who assesses symptoms of diabetes in a client who has a history of the disease and now suffers blurred vision.

Which population-level action would the nurse used 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 Tertiary-level prevention includes those aimed at rehabilitation or support, including the development of low-impact physical activity options in the community for osteoporosis. Campaigns that support early identification and screening for osteoporosis are secondary preventions discussion of strategies would support primary prevention efforts.

Which advice will the nurse provide to the client after a healthcare provider prescribes aspirin for a client with severe arthritis? 1Take the medicine with meals. 2See a dentist if bleeding gums develop. 3Switch to acetaminophen if tinnitus occurs. 4Avoid spicy foods while taking the medication.

ANS: Take medicine with meals Rationale: Acetylsalicylic acid is irritating to the stomach lining and can cause ulceration; the presence of food, fluid, or antacids decreases this response. Bleeding gums should be reported to the healthcare provider, not the dentist. Acetaminophen does not contain the antiinflammatory properties present in aspirin; tinnitus should be reported to the healthcare provider. Avoiding spicy foods is unnecessary as long as aspirin is taken with food.

The primary health care providers prescribed medications to four clients with osteoporosis. Which client would the nurse instruct to remain upright for 30 minutes after receiving the medication? Client A: Alendronate Client B: zoledronic Client C: calcium supplements Client D: Raloxifene

Alendronate The nurse instructs client A to remain upright for 30 minutes after medication to prevent esophageal ulcers. Standing upright for 30 minutes after medication administration will move the medication fast into the stomach. Client B who is prescribed zoledronic acid is instructed to have a dental examination before medication administration. Client C who was prescribed calcium supplements as advised to take a third of the daily dose at bedtime. Client D who was prescribed are Raloxifene is advised to have a liver function test done.

The nurse is teaching an elderly client isometric exercises. Which physiologic condition does the client have?

Muscle atrophy Muscle atrophy occurs due to muscular weakness; isometric exercises can help increase muscular strength. Kyphosis can be reduced by introducing the client to proper body mechanics and instructing the client to sit in supportive chairs with arms. Complications associated with decreased bone density can be reduced by teaching safety tips to prevent falls and by reinforcing the need to exercise. The nurse should assess the client's ability to perform activities of daily living and mobility in a client with a decreased ROM.