Nokea
A patient has been admitted to the hospital with a spontaneous vertebral fracture related to osteoporosis. Which of the following nursing diagnoses must be addressed in the plan of care?
- A. Risk for Aspiration Related to Vertebral Fracture
- B. Constipation Related to Vertebral Fracture
- C. Impaired Swallowing Related to Vertebral Fracture
- D. Decreased Cardiac Output Related to Vertebral Fracture
Correct Answer: B
Rationale: Constipation is a problem related to immobility and medications used to treat vertebral fractures. The patient's risks of aspiration, dysphagia, and decreased cardiac output are not necessarily heightened.
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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.
A nurse is collaborating with the physical therapist to plan the care of a patient with osteomyelitis. What principle should guide the management of activity and mobility in this patient?
- A. Stress on the weakened bone must be avoided.
- B. Increased heart rate enhances perfusion and bone healing.
- C. Bed rest results in improved outcomes in patients with osteomyelitis.
- D. Maintenance of baseline ADLs is the primary goal during osteomyelitis treatment.
Correct Answer: A
Rationale: The patient with osteomyelitis has bone that is weakened by the infective process and must be protected by avoidance of stress on the bone. This risk guides the choice of activity in a patient with osteomyelitis. Bed rest is not normally indicated, however. Maintenance of prediagnosis ADLs may be an unrealistic short-term goal for many patients.
An elderly female with osteoporosis has been hospitalized. Prior to discharge, when teaching the patient, the nurse should include information about which major complication of osteoporosis?
- A. Bone fracture
- B. Loss of estrogen
- C. Negative calcium balance
- D. Dowager's hump
Correct Answer: A
Rationale: Bone fracture is a major complication of osteoporosis that results when loss of calcium and phosphate increases the fragility of bones. Estrogen deficiencies result from menopause, not osteoporosis. Calcium and vitamin D supplements may be used to support normal bone metabolism, but a negative calcium balance is not a complication of osteoporosis. Dowager's hump results from bone fractures. It develops when repeated vertebral fractures increase spinal curvature.
A nurse is discussing conservative management of tendonitis with a patient. Which of the following may be an effective approach to managing tendonitis?
- A. Weight reduction
- B. Use of oral opioid analgesics
- C. Intermittent application of ice and heat
- D. Passive range of motion exercises
Correct Answer: C
Rationale: Conservative management of tendonitis includes rest of the extremity, intermittent ice and heat to the joint, and NSAIDs. Weight reduction may prevent future injuries but will not relieve existing tendonitis. Range-of-motion exercises may exacerbate pain. Opioids would not be considered a conservative treatment measure.
A patient presents at a clinic complaining of back pain that goes all the way down the back of the leg to the foot. The nurse should document the presence of what type of pain?
- A. Bursitis
- B. Radiculopathy
- C. Sciatica
- D. Tendonitis
Correct Answer: C
Rationale: Sciatica nerve pain travels down the back of the thigh to the foot of the affected leg. Bursitis is inflammation of a fluid-filled sac in a joint. Radiculopathy is disease of a nerve root. Tendonitis is inflammation of muscle tendons.