Nokea
A patient has undergone a bipolar hip repair (hemiarthroplasty). Which is the appropriate instruction?
- A. Sit in whatever position is most comfortable.
- B. Sit in a firm, straight-backed chair at a 90-degree angle.
- C. Avoid crossing the legs.
- D. Begin full weight-bearing as soon as tolerated.
Correct Answer: C
Rationale: Instructing the patient not to cross the legs is important because crossing the legs can adduct the affected extremity and dislocate the hip. The patient should have the head of the bed elevated to a maximum of 45 degrees to avoid acute flexion of the hip and strain on the fixation device. The patient will have limited weight bearing for the amount of time specified by the surgeon. This may be as long as 3 months post surgery.
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Which foods should the home health nurse suggest for the patient with osteoporosis to help slow the disease?
- A. Leafy green vegetables
- B. Foods high in sodium
- C. Tea and coffee
- D. Vitamin A
Correct Answer: A
Rationale: To slow the bone loss, a patient with osteoporosis should eat green leafy vegetables, such as spinach and turnip greens, foods low in sodium, and avoid caffeine. Vitamin D helps with the absorption of calcium and stimulates bone formation.
Which patient is most likely to develop osteoporosis?
- A. 43-year-old African American woman
- B. 57-year-old white woman
- C. 48-year-old African American man
- D. 62-year-old Latino woman
Correct Answer: B
Rationale: White women have a higher incidence of osteoporosis than Asian women, followed by African American women and Hispanic women.
Which will the home health nurse include monitoring for in the plan of care for an 82-year-old female with severe kyphosis from ankylosis?
- A. Urinary output
- B. Respiratory effort
- C. Sleep cycle
- D. Nutritional status
Correct Answer: B
Rationale: Severe kyphosis may hinder the patient's ability to expand the rib cage and interfere with easy respiration. Severe kyphosis due to ankylosis will not affect the urinary output or the sleep cycle. Nutritional status is not necessarily impaired from severe kyphosis.
When the patient with rheumatoid arthritis reports not liking daily exercise, the nurse encouragingly reminds the patient that exercise has which benefit?
- A. Keeping the joints from 'freezing.'
- B. Ensuring longer and better sleep.
- C. Stimulating joints when done vigorously
- D. When performed weekly, having greater benefits.
Correct Answer: A
Rationale: Daily gentle exercises keep the joints from 'freezing' and keep the muscles from weakening. Exercise does not ensure better sleep. Joint exercises should not be performed vigorously. The patient benefits when gently exercises are performed daily.
The office nurse has noted the presence of an increase in lumbar curvature in a 20-year-old female patient. What is this condition known as?
- A. Scoliosis
- B. Lordosis
- C. Kyphosis
- D. Spondylitis
Correct Answer: B
Rationale: Common deformities include an increase in the curve at the lumbar space region that throws the shoulder back, making the 'lordly or kingly' appearance that is known as lordosis. Scoliosis involves the S curvature of the spine. Kyphosis is the rounding of the thoracic spine. Spondylitis is not explained as an increase in lumbar curvature.