Nokea
A client had a bunionectomy with osteotomy. The client asks why healing may take up to 3 months. What explanation by the nurse is best?
- A. The feet have less blood flow, so healing is slower
- B. The bones in your feet are hard to operate on
- C. The surrounding bones and tissue are damaged
- D. Healing depends on your overall health
Correct Answer: A
Rationale: The feet, being distal to the heart, have reduced blood flow compared to other areas, which slows healing after surgery like a bunionectomy with osteotomy. The other options are less accurate or incomplete explanations.
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The nurse is assessing a client for chronic osteomyelitis. Which features distinguish this from the acute form of the disease? (Select all that apply.)
- A. Draining sinus tracts
- B. Presence of sequestra
- C. High fever
- D. Presence of foot ulcers
- E. Swelling and redness
Correct Answer: A,B,D
Rationale: Chronic osteomyelitis is characterized by draining sinus tracts, sequestra (dead bone), and foot ulcers. High fever and swelling/redness are more typical of acute osteomyelitis.
The nurse studying osteoporosis learns that which drugs can cause this disorder? (Select all that apply.)
- A. Corticosteroids
- B. Anticonvulsants
- C. Loop diuretics
- D. Proton pump inhibitors
- E. Selective serotonin reuptake inhibitors
Correct Answer: A,B,D,E
Rationale: Corticosteroids, anticonvulsants, proton pump inhibitors, and SSRIs are associated with bone loss and osteoporosis risk. Antibiotics are not typically linked to this condition.
A nurse is assessing an older client and discovers back pain with tenderness along L2 and L3. What action by the nurse is best?
- A. Consult the provider about an X-ray
- B. Encourage the client to use ibuprofen (Motrin)
- C. Have the client perform hip range of motion
- D. Apply a cervical collar
Correct Answer: A
Rationale: Back pain with tenderness at L2 and L3 suggests a spinal compression fracture, common in osteoporosis. Consulting the provider for an X-ray is the priority to confirm the diagnosis. Ibuprofen may be considered post-diagnosis, and hip range of motion is unrelated. A cervical collar is inappropriate for lumbar issues.
The nurse sees several clients with osteoporosis. For which client would bisphosphonates not be a good option?
- A. Client with diabetes who has a serum creatinine of 0.8 mg/dL
- B. Client who recently fell and has vertebral compression fractures
- C. Hypertensive client who takes calcium channel blockers
- D. Client with a spinal cord injury who cannot tolerate sitting up
Correct Answer: D
Rationale: Bisphosphonates require the client to sit upright for 30"?60 minutes after administration to prevent esophageal irritation. A client with a spinal cord injury who cannot tolerate sitting up is not a good candidate. A serum creatinine of 0.8 mg/dL is normal, and neither vertebral fractures nor calcium channel blockers contraindicate bisphosphonates.
A nurse sees clients in an osteoporosis clinic. Which client should the nurse see first?
- A. Client taking calcium with vitamin D (Os-Cal) who reports flank pain 6 weeks ago
- B. Client taking ibandronate (Boniva) who cannot remember when the last dose was
- C. Client taking raloxifene who reports leg swelling 6 weeks ago
- D. Client taking risedronate (Actonel) who reports occasional dyspepsia
Correct Answer: C
Rationale: Leg swelling in a client taking raloxifene suggests possible deep vein thrombosis, a serious adverse effect requiring immediate attention. Flank pain from 6 weeks ago is less urgent, forgetting a dose of ibandronate is not immediately critical, and dyspepsia with risedronate is a common side effect that can be managed later.