Nokea
A 16-year-old male patient presents in the emergency room with a pathologic fracture of the left femur and complains of pain on weight-bearing. These are common indicators of which disorder?
- A. osteogenic sarcoma.
- B. osteoporosis.
- C. rheumatoid arthritis.
- D. osteochondroma.
Correct Answer: A
Rationale: Osteogenic sarcoma occurs in young men aged 10 to 25. They are malignant bone tumors that can cause a pathologic fracture and they are accompanied by pain on weight-bearing. Osteoporosis is a disorder that results in loss of bone density. Rheumatoid arthritis is a systemic inflammatory autoimmune disease. Osteochondromas are benign and usually do not cause fractures.
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Which action should the nurse take when a patient with osteomyelitis of the right forearm is admitted with an open wound that is draining?
- A. Enforce a low-calorie diet.
- B. Initiate drainage and secretion precautions.
- C. Frequently do passive ROM on the elbow.
- D. Ambulate several times daily.
Correct Answer: B
Rationale: The patient with osteomyelitis should be at least in drainage and secretion precaution. The limb should be positioned for maximum comfort and left at rest. These patients are usually on bed rest and require a high-calorie, high-protein diet.
A patient's patellar-femoral cartilage has deteriorated due to arthritis. The medial and lateral cartilage is undamaged. This patient is likely to undergo partial or knee replacement surgery.
Correct Answer: unicompartmental
Rationale: Unicompartmental knee arthroplasty is also referred to as partial knee replacement and is performed on patients who have only one of the compartments of the knee affected by arthritis.
Which will the nurse stress to a patient, who recently had a hip replacement, in quadriceps setting exercises?
- A. Push knee down to mattress and raise heel off the bed.
- B. Flex knee and extend foot.
- C. Adduct leg and flex foot.
- D. Lift leg and heel off the bed.
Correct Answer: A
Rationale: Pushing the knee down into the mattress and raising the heel will strengthen the quadriceps muscles. Flexing the knee and extending the foot will not strengthen the quadriceps muscles. Likewise, adducting the legs and flexing the knee will not strengthen the quadriceps muscles.
Certain foods may increase the pain associated with gout. Which foods have the highest concentration of purines?
- A. Brain, liver, kidney
- B. Lettuce, corn, potatoes
- C. Beef, pork, chicken
- D. Fruits and fruit juices
Correct Answer: A
Rationale: Foods high in purines, such as brain, kidney, liver, and heart should be avoided, as well as alcohol. Lettuce, meat that does not include organ meats, and fruits do not have a high concentration of purines.
The nurse clarifies to a patient who is being evaluated for possible rheumatoid arthritis that the elevated erythrocyte sedimentation rate (ESR) indicates the presence of which process?
- A. A chronic infection
- B. Poor protein intake
- C. Increased inflammatory reaction in the body.
- D. A poor immune response to a microorganism
Correct Answer: C
Rationale: The ESR indicates an increase in the inflammatory reactions in the body. An elevated ESR does not indicate a chronic infection, poor protein intake or a poor immune response to a microorganism.