Nokea
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.
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A nurse is collaborating with the physical therapist to plan the care of a patient with osteomyelitis. What principle should guide the management of activity and mobility in this patient?
- A. Stress on the weakened bone must be avoided.
- B. Increased heart rate enhances perfusion and bone healing.
- C. Bed rest results in improved outcomes in patients with osteomyelitis.
- D. Maintenance of baseline ADLs is the primary goal during osteomyelitis treatment.
Correct Answer: A
Rationale: The patient with osteomyelitis has bone that is weakened by the infective process and must be protected by avoidance of stress on the bone. This risk guides the choice of activity in a patient with osteomyelitis. Bed rest is not normally indicated, however. Maintenance of prediagnosis ADLs may be an unrealistic short-term goal for many patients.
A nurse is providing care for a patient who has a recent diagnosis of Paget's disease. When planning this patient's nursing care, interventions should address what nursing diagnoses?
- A. Impaired Physical Mobility
- B. Acute Pain
- C. Disturbed Auditory Sensory Perception
- D. Risk for Injury
- E. Risk for Unstable Blood Glucose
Correct Answer: A,B,C,D
Rationale: Patients with Paget's disease are at risk of decreased mobility, pain, hearing loss, and injuries resulting from decreased bone density. Paget's disease does not affect blood glucose levels.
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 caring for a patient who is 12 hours postoperative following foot surgery. The nurse assesses the presence of edema in the foot. What nursing measure will the nurse implement to control the edema?
- A. Elevate the foot on several pillows.
- B. Apply warm compresses intermittently to the surgical area.
- C. Administer a loop diuretic as ordered.
- D. Increase circulation through frequent ambulation.
Correct Answer: A
Rationale: To control the edema in the foot of a patient who experienced foot surgery, the nurse will elevate the foot on several pillows when the patient is sitting or lying. Diuretic therapy is not an appropriate intervention for edema related to inflammation. Intermittent ice packs should be applied to the surgical area during the first 24 to 48 hours after surgery to control edema and provide some pain relief. Ambulation will gradually be resumed based on the guidelines provided by the surgeon.
A patient has come to the clinic for a routine annual physical. The nurse practitioner notes a palpable, painless projection of bone at the patient's shoulder. The projection appears to be at the distal end of the humerus. The nurse should suspect the presence of which of the following?
- A. Osteomyelitis
- B. Osteochondroma
- C. Osteomalacia
- D. Paget's disease
Correct Answer: B
Rationale: Osteochondroma is the most common benign bone tumor. It usually occurs as a large projection of bone at the end of long bones (at the knee or shoulder). Osteomyelitis, osteomalacia, and Paget's disease do not involve the development of excess bone tissue.