Quiz 2

What can a nurse tell a 21-year-old patient who asks about bone loss? "Bone loss can be attributed to smoking and alcohol intake." "Bone loss leads to stronger muscles to compensate for loss." "Bone loss is generally caused by not eating enough meat as a child." "Bone loss only happens to older patients so you do not need to worry yet."

"Bone loss can be attributed to smoking and alcohol intake." Bone loss in both genders is related to smoking and alcohol intake, among other factors. Bone mass is more closely related to the intake of calcium and other nutrients than protein, so bone loss cannot be attributed to not eating enough meat as a child. Though bone loss is most common as the body ages, female patients may prevent the onset by increasing their calcium intake and physical activity levels at younger ages. Men experience bone loss also but at later ages and much slower rates than women. p. 986-987

A student nurse is learning about the effects of aging on muscle and bone mass. Which statement by the student nurse reflects a misunderstanding and the need for further teaching? "Muscles lose strength and mass rapidly." "Joints have cartilage that becomes frayed with age." "Bones in joints develop more evidence of osteoporosis." "Muscle function remains trainable even into advanced age."

"Muscles lose strength and mass rapidly." Muscle mass and strength decline slowly; with aging, cartilage becomes more rigid, fragile, and susceptible to fraying. Bones in joints are more likely to develop evidence of osteoporosis because they have fewer trabeculae and are thinner, less dense, making them prone to fractures. Muscle function remains trainable even into advanced age. p. 986-988

A nurse is caring for a client with a greenstick fracture. The nurse is most likely caring for which client? A boy, age 8 A man, age 34 A young woman, age 19 A young woman, age 23

A boy, age 8 Greenstick fractures occur primarily in children and older (elderly) adults. Young or middle-aged adults, male or female, are not at a high risk for greenstick fracture. p. 992

A nurse is asked what a melanocyte is. How should the nurse respond? A cartilage-building cell in a joint A pigment-producing cell in the skin A bone-resorbing cell near a ruffled border A sebum-secreting cell in a sebaceous gland

A pigment-producing cell in the skin A melanocyte is a pigment-producing cell in the skin (it produces melanin). Chondrocytes compose cartilage. Osteoclasts are bone-resorbing cells. Melanocytes do not secrete sebum. p. 1072

A nurse is teaching a client about the bone. Which portion of the bone (see diagram) should the nurse choose to illustrate the narrow tubular portion that merges into the neck? Area 1 Area 2 Area 3 Area 4

Area 2 The diaphysis is the narrow tubular midportion that merges into the neck (metaphysis). The broad end of a bone is the epiphysis. Articular cartilage is the layer of hyaline cartilage that covers the end of each bone. All bones are covered with a double-layered connective tissue called the periosteum. pp. 974

A client has Kaposi sarcoma. Upon assessment by the nurse, which finding is typical of the lesion? Whitish patch in the mouth Brownish purple skin lesion Black spot in the visual field Flaky raised lesion on the scalp

Brownish purple skin lesion The lesions emerge as purplish brownish macules and develop into plaques and nodules with angioproliferation. Whitish patches in the mouth are associated with thrush. Black spots in the visual field are associated not with Kaposi sarcoma but with ocular problems. Flaky raised lesions on the scalp are not associated with Kaposi sarcoma. p. 1073

A client has shingles. What will the nurse typically find in the history? Prior infection of measles Earlier infection of mumps Recent infection of rubella Childhood incidence of chickenpox

Childhood incidence of chickenpox Shingles is caused by the chickenpox virus. Mumps, measles, and rubella are not associated with shingles. Rubella is a common communicable disease of children and young adults caused by a ribonucleic acid (RNA) virus that enters the bloodstream through the respiratory route. Rubeola (red measles) is a highly contagious, acute viral disease of childhood. p. 1067

Which cells compose a client's articular cartilage? Myoglobin Osteoblasts Osteoclasts Chondrocytes

Chondrocytes Chondrocytes compose articular cartilage. Osteoblasts produce bone. Osteoclasts break down bone. Myoglobin is a protein found primarily in skeletal and heart muscles. Test-Taking Tip: The following are crucial requisites for doing well on the NCLEX exam: (1) A sound understanding of the subject; (2) The ability to follow explicitly the directions given at the beginning of the test; (3) The ability to comprehend what is read; (4) The patience to read each question and set of options carefully before deciding how to answer the question; (5) The ability to use the computer correctly to record answers; (6) The determination to do well; (7) A degree of confidence. p. 977

A client has a temporary but total displacement of a bone from its normal position. Which term should the nurse use to describe this type of injury? Fracture Nonunion Dislocation Subluxation

Dislocation Dislocation is the displacement of one or more bones in a joint in which the opposing joint surfaces entirely lose contact. A fracture is a break in the bone, and nonunion is the failure of bone ends to grow together after a fracture. If the contact is only partially lost between the two surfaces, it is called a subluxation. p. 994

A nurse is using the "rule of nines." What is the nurse assessing in a client? Extent of edema in extremities Extent of psychological damage Extent of skin infections from burns Extent of total body surface area (TBSA) burned

Extent of total body surface area (TBSA) burned The extent of TBSA burned is estimated using either the "rule of nines" or Lund and Browder chart. It does not assess edema, psychological damage, or skin infections. p. 1075

Which term should the nurse use to describe the composition of epimysium, perimysium, and endomysium in a client's skeletal muscles? Fascia Simple epithelial tissue Thin sheets of cartilage Stratified epithelial tissue

Fascia The epimysium, perimysium, and endomysium are made of a type of connective tissue called fascia. Simple epithelial tissues are found lining visceral organs or forming diffusional membranes. Cartilage is associated primarily with the skeleton. Stratified epithelial tissues are found only on the outside of the body or lining the inside of body orifices. p. 979

A client has an infection from Candida albicans. Which type of microorganism caused this infection? Virus Fungus Parasite Bacteria

Fungus C. albicans is a yeast-like fungus that under certain circumstances changes from normal flora to a pathogen. A herpes-like virus is associated with pityriasis rosea, and herpes simplex virus can cterm-17ause skin infections. Parasites can make burrows. Bacteria, like staphylococcus and streptococcus, can cause skin infections. p. 1068

Which assessment finding may the nurse observe in a client with malignant hyperthermia? High fever Hypometabolism Sinus bradycardia Volkmann contracture

High fever Malignant hyperthermia can cause hypermetabolism with extremely high body temperature, muscle rigidity, rhabdomyolysis, and death if not treated quickly with dantrolene infusion. Sinus tachycardia, not bradycardia, is common. A condition known as Volkmann ischemic contracture can develop when the muscles of the forearm are affected by increased pressure within the forearm muscle compartments (compartment syndrome), not from malignant hyperthermia. p. 999

In what location is a client's actin located? I band A band H band M band

I band The I band, which contains actin, is divided at the midpoint of each sarcomere by the Z band. The A band contains the thick myosin filaments. Included in the A band is a lighter zone called the H band, and in the center of the H band is the dark M band, or M line. p. 982

Which factor increases peak bone mass during adolescence? The "all or nothing" factor Calcium intake after puberty Genetic transcription factors Insulin-like growth factor 1 (IGF-1)

Insulin-like growth factor 1 (IGF-1) Insulin-like growth factor 1 (IGF-1) increases peak bone mass during adolescence. It also decreases osteoblast apoptosis and maintains bone matrix. Bone mass is not determined by calcium intake after puberty, but is related to calcium intake throughout childhood, among other factors. Genetic transcription factors induce skeletal muscle differentiation, but do not affect peak bone mass. Muscle strength, not bone mass, is graded by the all-or-nothing phenomenon. pp. 988

Which manifestation would the nurse expect to observe in the client diagnosed with rheumatoid arthritis? Weight gain Increased appetite Low body temperature Joint stiffness in the morning

Joint stiffness in the morning Stiffness usually lasts for about 1 hour after the client rises in the morning and is thought to be related to synovitis. Clients with rheumatoid arthritis experience anorexia (not increased appetite), weight loss (not weight gain), and fever (not low body temperature). p. 1012

A nurse is talking about an essential mineral that is stored in human bone. Which mineral is the nurse describing? Silicate Fluoride Chloride Magnesium

Magnesium Bones mostly store calcium, carbonate, phosphate, and magnesium. Silicate, fluoride, and chloride are not stored in bone. p. 983

Whiterm-18ch structural element of bone mineralizes the osteoid matrix? Osteocytes Osteoclasts Osteoblasts Bone morphogenic proteins

Osteoblasts Osteoblasts are bone cells that synthesize collagen and proteoglycan, mineralize the osteoid matrix, and produce osteoprotegerin. Osteocytes are bone cells that transform osteoblasts trapped in osteoid, signal both osteoblasts and osteocytes, and maintain the bone matrix. Osteoclasts are also bone cells and play a major role in bone homeostasis. Bone morphogenic proteins are a part of the bone matrix; they induce formation and regulation of the bone and cartilage. p. 970

Which element of bone acts as mechanosensory receptors to reduce or augment bone mass? Osteocytes Osteoclasts Osteoblasts Osteocalcin

Osteocytes Osteocytes are bone cells that act as mechanosensory receptors to reduce or augment bone mass. They produce sclerostin (SOST), which inhibits bone growth. Osteoclasts are bone cells that play a major role in bone homeostasis. Osteoblasts are bone cells that synthesize collagen and proteoglycans, mineralize the osteoid matrix, and also produce osteoprotegerin. Osteocalcin is a vitamin K-dependent protein that promotes bone resorption. p. 969

A teenager has the most common malignant bone-forming tumor in the metaphyseal region of the femur. During an interdisciplinary team meeting, which term will the primary healthcare provider use to describe this condition? Chondroma Osteosarcoma Giant cell tumor Osteoid osteoma

Osteosarcoma Osteosarcoma is the most common malignant bone-forming tumor. It occurs in puberty in persons younger than 20 years or in adults 50 to 60 years of age. It occurs in the metaphyseal region of long bones. Chondroma is a cartilage-forming tumor located within the bone that is benign. Osteoid osteoma is benign; these arise from the osteoblast. Giant cell tumors are benign but aggressive. They commonly occur between the ages of 20 and 40 years. p. 1029

Which term should the nurse use when talking about the most common malignant bone-forming tumor? Fibrosarcoma Osteosarcoma Chondrosarcoma Leiomyosarcoma

Osteosarcoma The most common malignant bone-forming tumor is osteosarcoma. Leiomyosarcoma is a smooth muscle tumor. Fibrosarcoma is a fibrogenic tumor that often produces collagen but does not have a mineralizing matrix. Chondrosarcoma is classified as a cartilage tumor. pp. 1029

Which assessment finding will the nurse observe in a client who fractured a femur? Chest pain and bradycardia Pain and swelling in the thigh Low blood glucose and seizures Limb paralysis and referred pain

Pain and swelling in the thigh The signs and symptoms of a fracture include unnatural alignment (deformity), swelling, muscle spasm, tenderness, pain, impaired sensation, and decreased mobility. Chest pain, bradycardia, low blood glucose, and seizures are not characteristic of a fracture. A fracture does not necessarily cause limb paralysis and referred pain. p. 980

A client has tinea capitis. Which area should the nurse assess first? Feet Groin Scalp Abdomen

Scalp Tinea capitis is a fungal infection of the scalp. Tinea cruris is a fungal infection in the groin, also known as "jock itch." Tinea pedis is athlete's foot. Tinea corporis is a fungal infection of the body, also known as ringworm. p. 1068

A nurse is asked what the largest organ of the body is called. How should the nurse respond? Skin Liver Kidneys Pancreas

Skin The largest organ of the body is the skin. The liver is the largest solid organ. The kidneys are not considered to be large organs. The pancreas is a gland, not an organ. p. 1053

A client has ankylosing spondylitis. Which area should the nurse assess first? Hips Spine Knees Fingers

Spine Ankylosing spondylitis is a disease characterized by stiffening and fusion of the spine and sacroiliac joints. Osteoarthritis affects the hips. Rheumatoid arthritis affects the knees and fingers. p. 1017

A nurse is teaching an adult community group about skin cancer. Which information should the nurse include? Sunbathing is safe from 10 AM to 3 PM. Sun protection should begin in childhood. Tanning salons do not lead to skin cancer. Outdoor workers are at a low risk for cancer.

Sun protection should begin in childhood. Protection from the sun, particularly during the childhood years of life, significantly reduces the risk of skin cancer in later years. Sunbathing should be avoided from 10 AM to 3 PM (because of the sun angle). Excessive exposure to ultraviolet radiation from the sun or tanning salons is a risk factor for skin cancer. Outdoor workers are a population at high risk for skin cancer. p. 1071

A nurse is talking about a client's most movable joints. Which type of joint is the nurse describing? Synarthrosis Fibrous joints Synovial joints Amphiarthrosis

Synovial joints Synovial joints (diarthroses) are the most movable and the most complex joints in the body. A synarthrosis is an immovable joint, whereas an amphiarthrosis is a slightly movable joint. Fibrous joints are united directly to a bone by fibrous connective tissue and have no joint cavity; they allow little, if any, movement. p. 977

Which information from the client indicates teaching by the nurse was successful about the primary function of the skin? The primary function is protection. The primary function is immune surveillance. The primary function is activation of Vitamin D. The primary function is regulation of body temperature.

The primary function is protection. Although activation of Vitamin D, immune surveillance, and regulation of body temperature are functions of the skin, the primary function of the skin is protection. p. 1053

The nurse is working on an orthopedic floor and is teaching students about bone formation. What does the nurse explain about osteoblasts? They are the primary bone-producing cells. They are active in the innermost layers of bone. They are unresponsive to parathyroid hormone (PTH). They are the major resorptive cells of bone.

They are the primary bone-producing cells. Osteoblasts cells are the primary bone-producing cells. These cells are active on the outer surfaces of bones, where they form a single layer. Osteoblasts are responsive to parathyroid hormone (PTH). Osteoclterm-17asts, not osteoblasts, are the major resorptive cells term-17of bone. p. 970

A nurse is asked how uric acid is eliminated from the body. How should the nurse respond? Through sweat Through the kidneys Through crystals of tophi Through metabolism of protein

Through the kidneys Most uric acid is eliminated from the body through the kidneys. It is not eliminated through sweat. Uric acid is a breakdown product of purine nucleotides; it is not eliminated in this method. When uric acid reaches a certain concentration in fluids, it crystallizes, forming insoluble precipitates that are deposited in connective tissues throughout the body, forming tophi. p. 1016