Nokea
A nurse is assessing a community group for dietary factors that contribute to osteoporosis. In addition to inquiring about calcium, the nurse also assesses for which other dietary components? (Select all that apply.)
- A. Alcohol
- B. Caffeine
- C. Fat
- D. Carbonated beverages
- E. Vitamin D
Correct Answer: A,B,D,E
Rationale: Alcohol, caffeine, carbonated beverages (high in phosphorus), and low vitamin D intake contribute to osteoporosis risk. Fat intake does not directly affect bone density.
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A client has an ingrown toenail. About what self-management measure does the nurse teach the client?
- A. Long-term antibiotic use
- B. Shoe padding
- C. Toenail trimming by the client
- D. Warm moist soaks and proper nail trimming by a podiatrist
Correct Answer: D
Rationale: Proper treatment for an ingrown toenail includes warm moist soaks and professional nail trimming by a podiatrist to prevent recurrence. Long-term antibiotics are unnecessary, shoe padding does not treat the condition, and self-trimming can worsen it.
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.
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 with Paget's disease is hospitalized for an unrelated issue. The client reports pain and it is not yet time for more medication. What comfort measures can the nurse delegate to the unlicensed assistive personnel (UAP)? (Select all that apply.)
- A. Administering pain medication
- B. Applying a heating pad
- C. Providing a massage
- D. Referring the client to a support group
- E. Using a bed cradle to lift sheets off the feet
Correct Answer: B,C
Rationale: Heat and massage are nonpharmacologic comfort measures for Paget's disease pain that can be delegated to a UAP. Administering medication and referrals are nursing responsibilities, and a bed cradle is unnecessary.
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.