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A nurse is caring for an adult patient diagnosed with a back strain. What health education should the nurse provide to this patient?
- A. Avoid lifting more than one-third of body weight without assistance.
- B. Focus on using back muscles efficiently when lifting heavy objects.
- C. Lift objects while holding the object a safe distance from the body.
- D. Tighten the abdominal muscles and lock the knees when lifting of an object.
Correct Answer: A
Rationale: The nurse will instruct the patient on the safe and correct way to lift objects using the strong quadriceps muscles of the thighs, with minimal use of the weak back muscles. To prevent recurrence of acute low back pain, the nurse may instruct the patient to avoid lifting more than one-third of his weight without help. The patient should be informed to place the feet a hip-width apart to provide a wide base of support, the person should bend the knees, tighten the abdominal muscles, and lift the object close to the body with a smooth motion, avoiding twisting and jerking.
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A nurse is providing discharge teaching for a patient who underwent foot surgery. The nurse is collaborating with the occupational therapist and discussing the use of assistive devices. On what variables does the choice of assistive devices primarily depend?
- A. Patient's general condition, balance, and weight-bearing prescription
- B. Patient's general condition, strength, and gender
- C. Patient's motivation, age, and weight-bearing prescription
- D. Patient's occupation, motivation, and age
Correct Answer: A
Rationale: Assistive devices (e.g., crutches, walker) may be needed. The choice of the devices depends on the patient's general condition and balance, and on the weight-bearing prescription. The patient's strength, motivation, and weight restrictions are not what the choice of assistive devices is based on.
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 providing a class on osteoporosis at the local seniors center. Which of the following statements related to osteoporosis is most accurate?
- A. Osteoporosis is categorized as a disease of the elderly.
- B. A nonmodifiable risk factor for osteoporosis is a person's level of activity.
- C. Secondary osteoporosis occurs in women after menopause.
- D. Slow discontinuation of corticosteroid therapy can halt the progression of the osteoporosis.
Correct Answer: D
Rationale: When corticosteroid therapy is discontinued, the progression of osteoporosis is halted, but restoration of lost bone mass does not occur. Osteoporosis is not a disease of the elderly because its onset occurs earlier in life, when bone mass peaks and then begins to decline. A person's level of physical activity is a modifiable factor that influences peak bone mass. Lack of activity increases the risk for the development of osteoporosis. Primary osteoporosis occurs in women after menopause.
A nurse is assessing a patient who reports a throbbing, burning sensation in the right foot. The patient states that the pain is worst during the day but notes that the pain is relieved with rest. The nurse should recognize the signs and symptoms of what health problem?
- A. Morton's neuroma
- B. Pescavus
- C. Hallux valgus
- D. Onychocryptosis
Correct Answer: A
Rationale: Morton's neuroma is a swelling of the third (lateral) branch of the median plantar nerve, which causes a throbbing, burning pain, usually relieved with rest. Pescavus refers to a foot with an abnormally high arch and a fixed equinus deformity of the forefoot. Hallux valgus (bunion) is a deformity in which the great toe deviates laterally and there is a marked prominence of the medial aspect of the first metatarsal-phalangeal joint and exostosis. Onychocryptosis (ingrown toenail) occurs when the free edge of a nail plate penetrates the surrounding skin, laterally or anteriorly.
A patient presents at the clinic with complaints of morning numbness, cramping, and stiffness in his fourth and fifth fingers. What disease process should the nurse suspect?
- A. Tendonitis
- B. A ganglion
- C. Carpal tunnel syndrome
- D. Dupuytren's disease
Correct Answer: D
Rationale: In cases of Dupuytren's disease, the patient may experience dull, aching discomfort, morning numbness, cramping, and stiffness in the affected fingers. This condition starts in one hand, but eventually both hands are affected. This clinical scenario does not describe tendonitis, a ganglion, or carpal tunnel syndrome.