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A nursing educator is reviewing the risk factors for osteoporosis with a group of recent graduates. What risk factor of the following should the educator describe?
- A. Recurrent infections and prolonged use of NSAIDs
- B. High alcohol intake and low body mass index
- C. Small frame, female gender, and Caucasian ethnicity
- D. Male gender, diabetes, and high protein intake
Correct Answer: C
Rationale: Small-framed, nonobese Caucasian women are at greatest risk for osteoporosis. Diabetes, high protein intake, alcohol use, and infections are not among the most salient risk factors for osteoporosis.
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A nurse is caring for a patient with a bone tumor. The nurse is providing education to help the patient reduce the risk for pathologic fractures. What should the nurse teach the patient?
- A. Strive to achieve maximum weight-bearing capabilities.
- B. Gradually strengthen the affected muscles through weight training.
- C. Support the affected extremity with external supports such as splints.
- D. Limit reliance on assistive devices in order to build strength.
Correct Answer: C
Rationale: During nursing care, the affected extremities must be supported and handled gently. External supports (splints) may be used for additional protection. Prescribed weight-bearing restrictions must be followed. Assistive devices should be used to strengthen the unaffected extremities.
A nurse is reviewing the pathophysiology that may underlie a patient's decreased bone density. What hormone should the nurse identify as inhibiting bone resorption and promoting bone formation?
- A. Estrogen
- B. Parathyroid hormone (PTH)
- C. Calcitonin
- D. Progesterone
Correct Answer: C
Rationale: Calcitonin inhibits bone resorption and promotes bone formation, estrogen inhibits bone breakdown, and parathyroid increases bone resorption. Estrogen, which inhibits bone breakdown, decreases with aging. Parathyroid hormone (PTH) increases with aging, increasing bone turnover and resorption. Progesterone is the major naturally occurring human progestogen and plays a role in the female menstrual cycle.
An orthopedic nurse is caring for a patient who is postoperative day one following foot surgery. What nursing intervention should be included in the patient's subsequent care?
- A. Dressing changes should not be performed unless there are clear signs of infection.
- B. The surgical site can be soaked in warm bath water for up to 5 minutes.
- C. The surgical site should be cleansed with hydrogen peroxide once daily.
- D. The foot should be elevated in order to prevent edema.
Correct Answer: D
Rationale: Pain experienced by patients who undergo foot surgery is related to inflammation and edema. To control the anticipated edema, the foot should be elevated on several pillows when the patient is sitting or lying. Regular dressing changes are performed and the wound should be kept dry. Hydrogen peroxide is not used to cleanse surgical wounds.
A nurse is providing a class on osteoporosis at the local seniors center. Which of the following statements related to osteoporosis is most accurate?
- A. Osteoporosis is categorized as a disease of the elderly.
- B. A nonmodifiable risk factor for osteoporosis is a person's level of activity.
- C. Secondary osteoporosis occurs in women after menopause.
- D. Slow discontinuation of corticosteroid therapy can halt the progression of the osteoporosis.
Correct Answer: D
Rationale: When corticosteroid therapy is discontinued, the progression of osteoporosis is halted, but restoration of lost bone mass does not occur. Osteoporosis is not a disease of the elderly because its onset occurs earlier in life, when bone mass peaks and then begins to decline. A person's level of physical activity is a modifiable factor that influences peak bone mass. Lack of activity increases the risk for the development of osteoporosis. Primary osteoporosis occurs in women after menopause.
A patient is undergoing diagnostic testing for osteomalacia. Which of the following laboratory results is most suggestive of this diagnosis?
- A. High chloride, calcium, and magnesium
- B. High parathyroid and calcitonin levels
- C. Low serum calcium and magnesium levels
- D. Low serum calcium and low phosphorus level
Correct Answer: D
Rationale: Laboratory studies will reveal a low serum calcium and low phosphorus level.