Nokea
A nurse sees clients in an osteoporosis clinic. Which client should the nurse see first?
- A. Client taking calcium with vitamin D (Os-Cal) who reports flank pain 6 weeks ago
- B. Client taking ibandronate (Boniva) who cannot remember when the last dose was
- C. Client taking raloxifene who reports leg swelling 6 weeks ago
- D. Client taking risedronate (Actonel) who reports occasional dyspepsia
Correct Answer: C
Rationale: Leg swelling in a client taking raloxifene suggests possible deep vein thrombosis, a serious adverse effect requiring immediate attention. Flank pain from 6 weeks ago is less urgent, forgetting a dose of ibandronate is not immediately critical, and dyspepsia with risedronate is a common side effect that can be managed later.
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A nurse is assessing a community group for dietary factors that contribute to osteoporosis. In addition to inquiring about calcium, the nurse also assesses for which other dietary components? (Select all that apply.)
- A. Alcohol
- B. Caffeine
- C. Fat
- D. Carbonated beverages
- E. Vitamin D
Correct Answer: A,B,D,E
Rationale: Alcohol, caffeine, carbonated beverages (high in phosphorus), and low vitamin D intake contribute to osteoporosis risk. Fat intake does not directly affect bone density.
An older client with diabetes is admitted with a heavily draining leg wound. The client's white blood cell count is 38,000/mm³ but the client is afebrile. What action does the nurse take first?
- A. Administer acetaminophen (Tylenol)
- B. Place the client on contact isolation
- C. Refer the client to the wound care nurse
- D. Obtain wound cultures
Correct Answer: C
Rationale: A heavily draining wound suggests potential infection, and the elevated white blood cell count supports this. Placing the client on contact isolation is the priority to prevent the spread of infection. Acetaminophen is unnecessary without fever, wound cultures follow isolation, and referral to a wound care nurse is secondary.
What information does the nurse teach a women's group about osteoporosis?
- A. After menopause, women lose about 2% of bone mass yearly
- B. Men actually have higher rates of the disease but are underdiagnosed
- C. There is no way to prevent or slow osteoporosis after menopause
- D. Bone loss stops 5 years after menopause
Correct Answer: A
Rationale: Women lose approximately 2% of bone mass annually after menopause due to decreased estrogen levels. Men have lower rates of osteoporosis, and treatments like calcium, vitamin D, and medications can slow bone loss post-menopause.
A nurse is providing education to a community women's group about lifestyle changes helpful in preventing osteoporosis. What topics does the nurse cover? (Select all that apply.)
- A. Cut down on tobacco product use
- B. Limit intake of alcohol
- C. Strengthening exercises are important
- D. Take recommended calcium and vitamin D
- E. Walk 30 minutes at least 3 times a week
Correct Answer: C,D,E
Rationale: Strengthening and weight-bearing exercises (like walking 30 minutes 3 times a week) and adequate calcium and vitamin D intake help prevent osteoporosis. Tobacco should be avoided entirely, and women should limit alcohol to one drink per day.
The nurse studying osteoporosis learns that which drugs can cause this disorder? (Select all that apply.)
- A. Corticosteroids
- B. Anticonvulsants
- C. Loop diuretics
- D. Proton pump inhibitors
- E. Selective serotonin reuptake inhibitors
Correct Answer: A,B,D,E
Rationale: Corticosteroids, anticonvulsants, proton pump inhibitors, and SSRIs are associated with bone loss and osteoporosis risk. Antibiotics are not typically linked to this condition.