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A nurse is caring for a patient who has an MRI scheduled. What is the priority safety action prior to this diagnostic procedure?
- A. Assessing the patient for signs and symptoms of active infection
- B. Ensuring that the patient can remain immobile for up to 3 hours
- C. Assessing the patient for a history of nut allergies
- D. Ensuring that there are no metal objects on or in the patient
Correct Answer: D
Rationale: Absolutely no metal objects can be present during MRI their presence constitutes a serious safety risk. The procedure takes up to 90 minutes. Nut allergies and infection are not contraindications to MRI.
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A nurse is explaining a patient's decreasing bone density in terms of the balance between bone resorption and formation. What dietary nutrients and hormones play a role in the resorption and formation of adult bones?
- A. Thyroid hormone
- B. Growth hormone
- C. Estrogen
- D. Vitamin B12
- E. Luteinizing hormone
Correct Answer: A,B,C
Rationale: The balance between bone resorption and formation is influenced by the following factors: physical activity; dietary intake of certain nutrients, especially calcium; and several hormones, including calcitriol (i.e., activated vitamin D), parathyroid hormone (PTH), calcitonin, thyroid hormone, cortisol, growth hormone, and the sex hormones estrogen and testosterone. Luteinizing hormone and vitamin B12 do not play a role in bone formation or resorption.
An older adult patient has come to the clinic for a regular check-up. The nurse's initial inspection reveals an increased thoracic curvature of the patient's spine. The nurse should document the presence of which of the following?
- A. Scoliosis
- B. Epiphyses
- C. Lordosis
- D. Kyphosis
Correct Answer: D
Rationale: Kyphosis is the increase in thoracic curvature of the spine. Scoliosis is a deviation in the lateral curvature of the spine. Epiphyses are the ends of the long bones. Lordosis is the exaggerated curvature of the lumbar spine.
The human body is designed to protect its vital parts. A fracture of what type of bone may interfere with the protection of vital organs?
- A. Long bones
- B. Short bones
- C. Flat bones
- D. Irregular bones
Correct Answer: C
Rationale: Flat bones, such as the sternum, provide vital organ protection. Fractures of the flat bones may lead to puncturing of the vital organs or may interfere with the protection of the vital organs. Long, short, and irregular bones do not usually have this physiologic function.
A nurse is taking a health history on a patient with musculoskeletal dysfunction. What is the primary focus of this phase of the nurse's assessment?
- A. Evaluating the effects of the musculoskeletal disorder on the patient's function
- B. Evaluating the patient's adherence to the existing treatment regimen
- C. Evaluating the presence of genetic risk factors for further musculoskeletal disorders
- D. Evaluating the patient's active and passive range of motion
Correct Answer: A
Rationale: The nursing assessment of the patient with musculoskeletal dysfunction includes an evaluation of the effects of the musculoskeletal disorder on the patient. This is a vital focus of the health history and supersedes the assessment of genetic risk factors and adherence to treatment, though these are both valid inclusions to the interview. Assessment of ROM occurs during the physical assessment, not the interview.
While assessing a patient, the patient tells the nurse that she is experiencing rhythmic muscle contractions when the nurse performs passive extension of her wrist. What is this pattern of muscle contraction referred to as?
- A. Fasciculations
- B. Contractures
- C. Effusion
- D. Clonus
Correct Answer: D
Rationale: Clonus may occur when the ankle is dorsiflexed or the wrist is extended. It is characterized as rhythmic contractions of the muscle. Fasciculation is involuntary twitching of muscle fiber groups. Contractures are prolonged tightening of muscle groups and an effusion is the pathologic escape of body fluid.