Nokea
A client is scheduled for a bone biopsy. What action by the nurse takes priority?
- A. Administering the prescribed oral medication
- B. Answering any questions about the procedure
- C. Ensuring that informed consent is on the chart
- D. Showing the client's family where to wait
Correct Answer: C
Rationale: Ensuring informed consent is on the chart is the priority before a bone biopsy to confirm the client's understanding and agreement to the procedure. Medications, answering questions, and guiding the family are important but secondary.
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A client with chronic osteomyelitis is being discharged from the hospital. What information is important for the nurse to teach this client and family? (Select all that apply.)
- A. Administering the antibiotic regimen
- B. Correct intramuscular injection technique
- C. Eating high-protein and high-carbohydrate foods
- D. Keeping daily follow-up appointments
- E. Proper use of the intravenous equipment
Correct Answer: A,C,E
Rationale: Chronic osteomyelitis requires long-term IV or oral antibiotics, proper IV equipment use, and a high-protein, high-carbohydrate diet to promote healing. IM injections are not typically used, and daily follow-up is unnecessary.
A client is admitted with a bone tumor. The nurse finds the client weak and lethargic with decreased deep tendon reflexes. What actions by the nurse are best? (Select all that apply.)
- A. Assess the daily serum calcium level
- B. Consult the provider about a loop diuretic
- C. Institute seizure precautions for the client
- D. Raise the head of the bed
- E. Place the client on a 1500 mL fluid restriction
Correct Answer: A,B,D
Rationale: Weakness, lethargy, and decreased reflexes suggest hypercalcemia, common in bone tumors. Assessing serum calcium, consulting for loop diuretics, and raising the head of the bed to promote safety are appropriate. Seizure precautions and fluid restrictions are not indicated.
A client has a bone density score of 2.8. What action by the nurse is best?
- A. Asking the client to keep a food diary
- B. Planning to teach about bisphosphonates
- C. Scheduling another scan in 2 years
- D. Scheduling another scan in 2 months
Correct Answer: B
Rationale: A T-score of 2.5 or lower indicates osteoporosis. The nurse should plan to teach about medications used to treat this disease, such as bisphosphonates. A food diary may help assess calcium and vitamin D intake, but dietary changes alone are insufficient at this stage. Scheduling another scan does not address immediate treatment needs.
A client with bone cancer is hospitalized for a limb salvage procedure. How can the nurse best address the client's psychosocial needs?
- A. Assess coping skills and support systems
- B. Explain that the surgery leads to a longer life expectancy
- C. Refer the client to the social worker or hospital chaplain
- D. Reinforce physical therapy to aid with ambulating normally
Correct Answer: A
Rationale: Assessing coping skills and support systems is the first step in addressing psychosocial needs, as it identifies the client's resources and challenges. Explaining life expectancy does not address psychosocial needs directly, referrals may follow assessment, and physical therapy focuses on physical rather than psychosocial needs.
A client has scoliosis with a 65-degree curve to the spine. What action by the nurse takes priority?
- A. Allow the client to rest in a position of comfort
- B. Assess the client's cardiac and respiratory systems
- C. Assist the client with ambulating and position changes
- D. Position the client on one side propped with pillows
Correct Answer: B
Rationale: A 65-degree spinal curve in scoliosis can impair cardiac and respiratory function due to chest deformity. Assessing these systems is the priority to ensure the client's safety. Comfort, ambulation, and positioning are important but secondary.