Nokea
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.
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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.
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 patient with diabetes is attending a class on the prevention of associated diseases. What action should the patient perform to reduce the risk of osteomyelitis?
- A. Increase calcium and vitamin intake.
- B. Perform meticulous foot care.
- C. Exercise 3 to 4 times weekly for at least 30 minutes.
- D. Take corticosteroids as ordered.
Correct Answer: B
Rationale: Diabetic foot ulcers have a high potential for progressing to osteomyelitis. Meticulous foot care can help mitigate this risk. Corticosteroids can exacerbate the risk of osteomyelitis. Increased intake of calcium and vitamins as well as regular exercise are beneficial health promotion exercises, but they do not directly reduce the risk of osteomyelitis.
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.
A patient's electronic health record notes that the patient has hallux valgus. What signs and symptoms would the nurse expect this patient to manifest?
- A. Deviation of a great toe laterally
- B. Abnormal flexion of the great toe
- C. An exaggerated arch of the foot
- D. Fusion of the toe joints
Correct Answer: A
Rationale: A deformity in which the great toe deviates laterally and there is a marked prominence of the medial aspect of the first metatarsal-phalangeal joint and exostosis is referred to as hallux valgus (bunion). Hallux valgus does not result in abnormal flexion, abnormalities of the arch, or joint fusion.