Nokea
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.
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A nurse is teaching a patient with osteomalacia about the role of diet. What would be the best choice for breakfast for a patient with osteomalacia?
- A. Cereal with milk, a scrambled egg, and grapefruit
- B. Poached eggs with sausage and toast
- C. Waffles with fresh strawberries and powdered sugar
- D. A bagel topped with butter and jam with a side dish of grapes
Correct Answer: A
Rationale: The best meal option is the one that contains the highest dietary sources of calcium and vitamin D. The best selection among those listed is cereal with milk, and eggs, as these foods contain calcium and vitamin D in a higher quantity over the other menu options.
An 80-year-old man in a long-term care facility has a chronic leg ulcer and states that the area has become increasingly painful in recent days. The nurse notes that the site is now swollen and warm to the touch. The patient should undergo diagnostic testing for what health problem?
- A. Osteomyelitis
- B. Osteoporosis
- C. Osteomalacia
- D. Septic arthritis
Correct Answer: A
Rationale: When osteomyelitis develops from the spread of an adjacent infection, no signs of septicemia are present, but the area becomes swollen, warm, painful, and tender to touch. Osteoporosis is the most prevalent bone disease in the world. Osteomalacia is a metabolic bone disease characterized by inadequate mineralization of bone. Septic arthritis occurs when joints become infected through spread of infection from other parts of the body (hematogenous spread) or directly through trauma or surgical instrumentation.
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 nurse is caring for a patient who is being assessed following complaints of severe and persistent low back pain. The patient is scheduled for diagnostic testing in the morning. Which of the following are appropriate diagnostic tests for assessing low back pain?
- A. Computed tomography (CT)
- B. Angiography
- C. Magnetic resonance imaging (MRI)
- D. Ultrasound
- E. X-ray
Correct Answer: A,C,D,E
Rationale: A variety of diagnostic tests can be used to address lower back pain, including CT, MRI, ultrasound, and X-rays. Angiography is not related to the etiology of back pain.
A patient has returned to the unit after undergoing limb-sparing surgery to remove a metastatic bone tumor. The nurse providing postoperative care in the days following surgery assesses for what complication from surgery?
- A. Deficient fluid volume
- B. Delayed wound healing
- C. Hypocalcemia
- D. Pathologic fractures
Correct Answer: B
Rationale: Delayed wound healing is a complication of surgery due to tissue trauma from the surgery. Nutritional deficiency is usually due to the effects of chemotherapy and radiation therapy, which may cause weight loss. Pathologic fractures are not a complication of surgery.