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A nurse is taking a health history on a new patient who has been experiencing unexplained paresthesia. What question should guide the nurse's assessment of the patient's altered sensations?
- A. How does the strength in the affected extremity compare to the strength in the unaffected extremity?
- B. Does the color in the affected extremity match the color in the unaffected extremity?
- C. How does the feeling in the affected extremity compare with the feeling in the unaffected extremity?
- D. Does the patient have a family history of paresthesia or other forms of altered sensation?
Correct Answer: C
Rationale: Questions that the nurse should ask regarding altered sensations include How does this feeling compare to sensation in the unaffected extremity? Asking questions about strength and color are not relevant and a family history is unlikely.
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The nurse is performing an assessment of a patient's musculoskeletal system and is appraising the patient's bone integrity. What action should the nurse perform during this phase of assessment?
- A. Compare parts of the body symmetrically.
- B. Assess extremities when in motion rather than at rest.
- C. Percuss as many joints as accessible.
- D. Administer analgesia 30 to 60 minutes before assessment.
Correct Answer: A
Rationale: When assessing bone integrity, symmetric parts of the body, such as extremities, are compared. Analgesia should not be necessary and percussion is not a clinically useful assessment technique. Bone integrity is best assessed when the patient is not moving.
A clinic nurse is caring for a patient with a history of osteoporosis. Which of the following diagnostic tests best allows the care team to assess the patient's risk of fracture?
- A. Arthrography
- B. Bone scan
- C. Bone densitometry
- D. Arthroscopy
Correct Answer: C
Rationale: Bone densitometry is used to detect bone density and can be used to assess the risk of fracture in osteoporosis. Arthrography is used to detect acute or chronic tears of joint capsule or supporting ligaments. Bone scans can be used to detect metastatic and primary bone tumors, osteomyelitis, certain fractures, and aseptic necrosis. Arthroscopy is used to visualize a joint.
Diagnostic tests show that a patient's bone density has decreased over the past several years. The patient asks the nurse what factors contribute to bone density decreasing. What would be the nurse's best response?
- A. For many people, lack of nutrition can cause a loss of bone density.
- B. Progressive loss of bone density is mostly related to your genes.
- C. Stress is known to have many unhealthy effects, including reduced bone density.
- D. Bone density decreases with age, but scientists are not exactly sure why this is the case.
Correct Answer: A
Rationale: Nutrition has a profound effect on bone density, especially later life. Genetics are also an important factor, but nutrition has a more pronounced effect. The pathophysiology of bone density is well understood and psychosocial stress has a minimal effect.
A nurse is caring for a patient who has been scheduled for a bone scan. What should the nurse teach the patient about this diagnostic test?
- A. The test is brief and requires that you drink a calcium solution 2 hours before the test.
- B. You will not be allowed fluid for 2 hours before and 3 hours after the test.
- C. You'll be encouraged to drink water after the administration of the radioisotope injection.
- D. This is a common test that can be safely performed on anyone.
Correct Answer: C
Rationale: It is important to encourage the patient to drink plenty of fluids to help distribute and eliminate the isotopic after it is injected. There are important contraindications to the procedure, include pregnancy or an allergy to the radioisotope. The test requires the injection of an intravenous radioisotope and the scan is preformed 2 to 3 hours after the isotope is injected. A calcium solution is not utilized.
A patient is scheduled for a bone scan to rule out osteosarcoma of the pelvic bones. What would be most important for the nurse to assess before the patient's scan?
- A. That the patient completed the bowel cleansing regimen
- B. That the patient emptied the bladder
- C. That the patient is not allergic to penicillins
- D. That the patient has fasted for at least 8 hours
Correct Answer: B
Rationale: Before the scan, the nurse asks the patient to empty the bladder, because a full bladder interferes with accurate scanning of the pelvic bones. Bowel cleansing and fasting are not indicated for a bone scan and an allergy to penicillins is not a contraindication.