Nokea
A nurse is caring for a patient with a bone tumor. The nurse is providing education to help the patient reduce the risk for pathologic fractures. What should the nurse teach the patient?
- A. Strive to achieve maximum weight-bearing capabilities.
- B. Gradually strengthen the affected muscles through weight training.
- C. Support the affected extremity with external supports such as splints.
- D. Limit reliance on assistive devices in order to build strength.
Correct Answer: C
Rationale: During nursing care, the affected extremities must be supported and handled gently. External supports (splints) may be used for additional protection. Prescribed weight-bearing restrictions must be followed. Assistive devices should be used to strengthen the unaffected extremities.
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A patient presents at a clinic complaining of back pain that goes all the way down the back of the leg to the foot. The nurse should document the presence of what type of pain?
- A. Bursitis
- B. Radiculopathy
- C. Sciatica
- D. Tendonitis
Correct Answer: C
Rationale: Sciatica nerve pain travels down the back of the thigh to the foot of the affected leg. Bursitis is inflammation of a fluid-filled sac in a joint. Radiculopathy is disease of a nerve root. Tendonitis is inflammation of muscle tendons.
A nurse is discussing conservative management of tendonitis with a patient. Which of the following may be an effective approach to managing tendonitis?
- A. Weight reduction
- B. Use of oral opioid analgesics
- C. Intermittent application of ice and heat
- D. Passive range of motion exercises
Correct Answer: C
Rationale: Conservative management of tendonitis includes rest of the extremity, intermittent ice and heat to the joint, and NSAIDs. Weight reduction may prevent future injuries but will not relieve existing tendonitis. Range-of-motion exercises may exacerbate pain. Opioids would not be considered a conservative treatment measure.
A nurse is providing care for a patient who has osteomalacia. What major goal will guide the choice of medical and nursing interventions?
- A. Maintenance of skin integrity
- B. Prevention of bone metastasis
- C. Maintenance of adequate levels of activated vitamin D
- D. Maintenance of adequate parathyroid hormone function
Correct Answer: C
Rationale: The primary defect in osteomalacia is a deficiency of activated vitamin D, which promotes calcium absorption from the gastrointestinal tract and facilitates mineralization of bone. Interventions are aimed at resolving the processes underlying this deficiency. Maintenance of skin integrity is important, but is not the primary goal in care. Osteomalacia is not a malignant process. Overproduction (not underproduction) of PTH can cause the disease.
A patient has been admitted to the hospital with a spontaneous vertebral fracture related to osteoporosis. Which of the following nursing diagnoses must be addressed in the plan of care?
- A. Risk for Aspiration Related to Vertebral Fracture
- B. Constipation Related to Vertebral Fracture
- C. Impaired Swallowing Related to Vertebral Fracture
- D. Decreased Cardiac Output Related to Vertebral Fracture
Correct Answer: B
Rationale: Constipation is a problem related to immobility and medications used to treat vertebral fractures. The patient's risks of aspiration, dysphagia, and decreased cardiac output are not necessarily heightened.
A nurse is reviewing the care of a patient who has a long history of lower back pain that has not responded to conservative treatment measures. The nurse should anticipate the administration of what drug?
- A. Calcitonin
- B. Prednisone
- C. Aspirin
- D. Cyclobenzaprine
Correct Answer: D
Rationale: Short-term prescription muscle relaxants (e.g., cyclobenzaprine [Flexeril]) are effective in relieving acute low back pain. ASA is not normally used for pain control, due to its antiplatelet action and associated risk for bleeding. Calcitonin and corticosteroids are not used in the treatment of lower back pain.