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.
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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.
An orthopedic nurse is caring for a patient who is postoperative day one following foot surgery. What nursing intervention should be included in the patient's subsequent care?
- A. Dressing changes should not be performed unless there are clear signs of infection.
- B. The surgical site can be soaked in warm bath water for up to 5 minutes.
- C. The surgical site should be cleansed with hydrogen peroxide once daily.
- D. The foot should be elevated in order to prevent edema.
Correct Answer: D
Rationale: Pain experienced by patients who undergo foot surgery is related to inflammation and edema. To control the anticipated edema, the foot should be elevated on several pillows when the patient is sitting or lying. Regular dressing changes are performed and the wound should be kept dry. Hydrogen peroxide is not used to cleanse surgical wounds.
A patient tells the nurse that he has pain and numbness to his thumb, first finger, and second finger of the right hand. The nurse discovers that the patient is employed as an auto mechanic, and that the pain is increased while working. This may indicate that the patient could possibly have what health problem?
- A. Carpel tunnel syndrome
- B. Tendonitis
- C. Impingement syndrome
- D. Dupuytren's contracture
Correct Answer: A
Rationale: Carpel tunnel syndrome may be manifested by numbness, pain, paresthesia, and weakness along the median nerve. Tendonitis is inflammation of muscle tendons. Impingement syndrome is a general term that describes all lesions that involve the rotator cuff of the shoulder. Dupuytren's contracture is a slowly progressive contracture of the palmar fascia.
The health care team is caring for a patient with osteomalacia. It has been determined that the osteomalacia is caused by malabsorption. What is the usual treatment for osteomalacia caused by malabsorption?
- A. Supplemental calcium and increased doses of vitamin D
- B. Exogenous parathyroid hormone and multivitamins
- C. Colony-stimulating factors and calcitonin
- D. Supplemental potassium and pancreatic enzymes
Correct Answer: A
Rationale: If osteomalacia is caused by malabsorption, increased doses of vitamin D, along with supplemental calcium, are usually prescribed.
A nurse is reviewing the pathophysiology that may underlie a patient's decreased bone density. What hormone should the nurse identify as inhibiting bone resorption and promoting bone formation?
- A. Estrogen
- B. Parathyroid hormone (PTH)
- C. Calcitonin
- D. Progesterone
Correct Answer: C
Rationale: Calcitonin inhibits bone resorption and promotes bone formation, estrogen inhibits bone breakdown, and parathyroid increases bone resorption. Estrogen, which inhibits bone breakdown, decreases with aging. Parathyroid hormone (PTH) increases with aging, increasing bone turnover and resorption. Progesterone is the major naturally occurring human progestogen and plays a role in the female menstrual cycle.
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