Nokea
A nurse's assessment of a teenage girl reveals that her shoulders are not level and that she has one prominent scapula that is accentuated by bending forward. The nurse should expect to read about what health problem in the patient's electronic health record?
- A. Lordosis
- B. Kyphosis
- C. Scoliosis
- D. Muscular dystrophy
Correct Answer: C
Rationale: Scoliosis is evidenced by an abnormal lateral curve in the spine, shoulders that are not level, an asymmetric waistline, and a prominent scapula, accentuated by bending forward. Lordosis is the curvature in the lower back; kyphosis is an exaggerated curvature of the upper back. This finding is not suggestive of muscular dystrophy.
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The nurse's musculoskeletal assessment of a patient reveals involuntary twitching of muscle groups. How would the nurse document this observation in the patient's chart?
- A. Tetany
- B. Atony
- C. Clonus
- D. Fasciculations
Correct Answer: D
Rationale: Fasciculation is involuntary twitching of muscle fiber groups. Clonus is a series of involuntary, rhythmic, muscular contractions and tetany is involuntary muscle contraction, but neither is characterized as twitching. Atony is a loss of muscle strength.
A nurse is providing care for a patient whose pattern of laboratory testing reveals longstanding hypocalcemia. What other laboratory result is most consistent with this finding?
- A. An elevated parathyroid hormone level
- B. An increased calcitonin level
- C. An elevated potassium level
- D. A decreased vitamin D level
Correct Answer: A
Rationale: In the response to low calcium levels in the blood, increased levels of parathyroid hormone prompt the mobilization of calcium and the demineralization of bone. Increased calcitonin levels would exacerbate hypocalcemia. Vitamin D levels do not increase in response to low calcium levels. Potassium levels would likely be unaffected.
The nurse is assessing a patient for dietary factors that may influence her risk for osteoporosis. What nutrients should the nurse question the patient about her intake of?
- A. Calcium
- B. Simple carbohydrates
- C. Vitamin D
- D. Protein
- E. Soluble fiber
Correct Answer: A,C
Rationale: A patient's risk for osteoporosis is strongly influenced by vitamin D and calcium intake. Carbohydrate, protein, and fiber intake do not have direct effect on the development of osteoporosis.
The results of a nurse's musculoskeletal examination show an increase in the lumbar curvature of the spine. The nurse should recognize the presence of what health problem?
- A. Osteoporosis
- B. Kyphosis
- C. Lordosis
- D. Scoliosis
Correct Answer: C
Rationale: The nurse documents the spinal abnormality as lordosis. Lordosis is an increase in lumbar curvature of the spine. Kyphosis is an increase in the convex curvature of the spine. Scoliosis is a lateral curvature of the spine. Osteoporosis is the significant loss of bone mass and strength with an increased risk for fracture.
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.