Nokea
A client suffered a significant ankle fracture several months ago. Which indicator would the nurse use to determine that the client is exhibiting signs and symptoms of chronic osteomyelitis?
- A. High fever
- B. Persistent draining sinus
- C. Rapid pulse
- D. Tenderness over the affected area
Correct Answer: B
Rationale: Persistent draining sinus indicates a chronic infection in a client with osteomyelitis. This is the symptom the nurse would use to differentiate between an acute and chronic infection. High fever, rapid pulse, and tenderness or pain over the affected area is evidence of an acute infection.
You may also like to solve these questions
The nurse is conducting a new-patient assessment on a patient who reports having fibromyalgia. Which of the following would the nurse expect to assess as the most common finding associated with this condition?
- A. Heberden nodes
- B. Jaw locking
- C. Widespread chronic pain
- D. Butterfly facial rash
Correct Answer: C
Rationale: The most common finding associated with fibromyalgia is widespread and chronic pain, as clients experience an increased sensitivity to pain signals. Heberden nodes are associated with osteoarthritis. Jaw locking is a manifestation of temporomandibular joint dislocation. A butterfly facial rash is associated with systemic lupus erythematosus.
A client has had several diagnostic tests to determine systemic lupus erythematosus (SLE). What result is very specific indicator of this diagnosis?
- A. Positive Anti-dsDNA antibody test
- B. Positive Anti-Sm antibodies
- C. Positive ANA titer
- D. Elevated ESR
Correct Answer: A
Rationale: Anti-double-stranded DNA (anti-dsDNA) antibody test is a test that shows high titers of antibodies against native DNA. This is very specific for SLE because this test is not positive for other autoimmune disorders. Anti-Smith (anti-Sm) antibodies are specific for SLE, but are found in only 20% to 30% of clients with SLE. ANA titer shows the presence of an autoimmune disease but is not specific to SLE. The other lab studies may also indicate multisystem involvement.
A client has been diagnosed with temporomandibular disorder and has not been able to eat. What is an appropriate action for the nurse to take?
- A. Have the client's food pureed
- B. Have the client placed on a liquid diet.
- C. Have the client eat soft rather than coarse food.
- D. Give the client clear liquids as well as intravenous fluids.
Correct Answer: C
Rationale: The nurse modifies the diet to include soft rather than coarse food, which is easier to chew. The nurse also provides nutritional liquid supplements and assists the client to acquire skills that control pain, such as using a bite guard during sleep. The client does not require pureed food or clear liquids. Pureed and clear liquids are not warranted because these are too extreme and may interfere with nutrition.
In osteoporosis, which of the following is the most common complication?
- A. Diabetes
- B. Hypertension
- C. Compression fractures of the vertebrae
- D. Cardiac disease
Correct Answer: C
Rationale: In osteoporosis, loss of bone substance exceeds bone formation. The total bone mass and density is reduced, resulting in bones that become progressively porous, brittle, and fragile. Compression fractures of the vertebrae are common. Diabetes, hypertension, and cardiac disease may occur in response to the aging process but are not the result of osteoporosis.
A client with suspected osteomalacia has a fractured tibia and fibula. What test would give a definitive diagnosis of osteomalacia?
- A. A bone biopsy
- B. Demineralization of the bone
- C. Increased and decreased areas of bone metabolism
- D. Elevated levels of alkaline phosphatase
Correct Answer: A
Rationale: A definitive diagnosis is obtained by bone biopsy. Radiographic studies demonstrate demineralization of the bone. A bone scan detects increased and decreased areas of bone metabolism. Alkaline phosphatase levels are detected from a blood sample.