Nokea
A nurse on a patient has been experiencing significant pain in her knee and diagnostic imaging reveals an effusion in the synovial capsule. What intervention should the nurse anticipate?
- A. Arthrography
- B. Knee replacement
- C. Arthrocentesis
- D. Arthroscopy
Correct Answer: C
Rationale: Arthrocentesis (joint aspiration) is carried out to obtain synovial fluid for examination or to relieve pain due to effusion. Arthrography is used to visualize joint structures, not to remove fluid. Arthroscopy is a diagnostic visualization, and knee replacement is not indicated for effusion.
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A patient has been experiencing an unexplained decline in knee function and has consequently been scheduled for arthrography. The nurse should teach the patient about what process?
- A. Injection of a contrast agent into the knee joint prior to ROM exercises
- B. Aspiration of synovial fluid for serologic testing
- C. Injection of corticosteroids into the patient's knee joint to facilitate ROM
- D. Replacement of the patient's synovial fluid with a synthetic substitute
Correct Answer: A
Rationale: During arthrography, a radiopaque contrast agent or air is injected into the joint cavity to visualize the joint structures such as the ligaments, cartilage, tendons, and joint capsule. The joint is put through its range of motion to distribute the contrast agent while a series of x-rays are obtained. Synovial fluid is not aspirated or replaced and corticosteroids are not administered.
A bone biopsy has just been completed on a patient with suspected bone metastases. What assessment should the nurse prioritize in the immediate recovery period?
- A. Assessment for dehiscence at the biopsy site
- B. Assessment for pain
- C. Assessment for hematoma formation
- D. Assessment for infection
Correct Answer: B
Rationale: Bone biopsy can be painful and the nurse should prioritize relevant assessments. Dehiscence is not a possibility, since the incision is not linear. Signs and symptoms of infection would not be evident in the immediate recovery period and hematoma formation is not a common complication.
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.
A patient's fracture is healing and callus is being deposited in the bone matrix. This process characterizes what phase of the bone healing process?
- A. The reparative phase
- B. The reactive phase
- C. The remodeling phase
- D. The revascularization phase
Correct Answer: A
Rationale: Callus formation takes place during the reparative phase of bone healing. The reactive phase occurs immediately after injury and the remodeling phase builds on the reparative phase. There is no discrete revascularization phase.
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.