A client with osteoporosis is going home, where the client lives alone. What action by the nurse is best?
- A. Arrange a home safety evaluation
- B. Ensure the client has a walker at home
- C. Schedule daily nursing visits
- D. Refer the client to a support group
Correct Answer: A
Rationale: A home safety evaluation is critical for a client with osteoporosis living alone to reduce fall risks, which can lead to fractures. A walker may not be necessary without assessment, daily visits are excessive, and a support group is secondary to safety.
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A client has been advised to perform weight-bearing exercises to help minimize osteoporosis. The client admits to not doing the prescribed exercises. What action by the nurse is best?
- A. Ask the client about fear of falling
- B. Encourage more calcium intake
- C. Suggest alternative exercises
- D. Teach about weight-lifting techniques
Correct Answer: A
Rationale: Fear of falling can deter clients from performing weight-bearing exercises. Assessing this fear is the first step to address barriers to compliance. Calcium intake, alternative exercises, or weight-lifting techniques may be relevant but are secondary to understanding the client's reluctance.
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.
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.
Which diagnostic tests are used to confirm muscular dystrophy? (Select all that apply.)
- A. Electromyography
- B. Muscle biopsy
- C. Nerve conduction studies
- D. Serum aldolase
- E. Creatinine kinase levels
Correct Answer: A,B,D,E
Rationale: Electromyography, muscle biopsy, serum aldolase, and creatinine kinase levels are used to diagnose muscular dystrophy. Nerve conduction studies are not relevant to this condition.
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.
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