Nokea
A nurse is providing an educational class to a group of older adults at a community senior center. In an effort to prevent osteoporosis, the nurse should encourage participants to ensure that they consume the recommended adequate intake of what nutrients?
- A. Vitamin B12
- B. Potassium
- C. Calcitonin
- D. Calcium
- E. Vitamin D
Correct Answer: D,E
Rationale: A diet rich in calcium and vitamin D protects against skeletal demineralization. Intake of vitamin B12 and potassium does not directly influence the risk for osteoporosis. Calcitonin is not considered to be a dietary nutrient.
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Which of the following patients should the nurse recognize as being at the highest risk for the development of osteomyelitis?
- A. A middle-age adult who takes ibuprofen daily for rheumatoid arthritis
- B. An elderly patient with an infected pressure ulcer in the sacral area
- C. A 17-year-old football player who had orthopedic surgery 6 weeks prior
- D. An infant diagnosed with jaundice
Correct Answer: B
Rationale: Patients who are at high risk of osteomyelitis include those who are poorly nourished, elderly, and obese. The elderly patient with an infected sacral pressure ulcer is at the greatest risk for the development of osteomyelitis, as this patient has two risk factors: age and the presence of a soft-tissue infection that has the potential to extend into the bone. The patient with rheumatoid arthritis has one risk factor and the infant with jaundice has no identifiable risk factors. The patient 6 weeks postsurgery is beyond the usual window of time for the development of a postoperative surgical wound infection.
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.
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 nursing educator is reviewing the risk factors for osteoporosis with a group of recent graduates. What risk factor of the following should the educator describe?
- A. Recurrent infections and prolonged use of NSAIDs
- B. High alcohol intake and low body mass index
- C. Small frame, female gender, and Caucasian ethnicity
- D. Male gender, diabetes, and high protein intake
Correct Answer: C
Rationale: Small-framed, nonobese Caucasian women are at greatest risk for osteoporosis. Diabetes, high protein intake, alcohol use, and infections are not among the most salient risk factors for osteoporosis.
A patient presents to a clinic complaining of a leg ulcer that isn't healing; subsequent diagnostic testing suggests osteomyelitis. The nurse is aware that the most common pathogen to cause osteomyelitis is what?
- A. Staphylococcus aureus
- B. Proteus
- C. Pseudomonas
- D. Escherichia coli
Correct Answer: A
Rationale: S. aureus causes over 50% of bone infections. Proteus, Pseudomonas, and E. coli are also causes, but to a lesser extent.