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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.
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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 patient with diabetes has been diagnosed with osteomyelitis. The nurse notes that the patient's right foot is pale and mottled, cool to touch, with a capillary refill of greater than 3 seconds. The nurse should suspect what type of osteomyelitis?
- A. Hematogenous osteomyelitis
- B. Osteomyelitis with vascular insufficiency
- C. Contiguous-focus osteomyelitis
- D. Osteomyelitis with muscular deterioration
Correct Answer: B
Rationale: Osteomyelitis is classified as hematogenous osteomyelitis (i.e., due to blood-borne spread of infection); contiguous-focus osteomyelitis, from contamination from bone surgery, open fracture, or traumatic injury (e.g., gunshot wound); and osteomyelitis with vascular insufficiency, seen most commonly among patients with diabetes and peripheral vascular disease, most commonly affecting the feet. Osteomyelitis with muscular deterioration does not exist.
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 caring for an adult patient diagnosed with a back strain. What health education should the nurse provide to this patient?
- A. Avoid lifting more than one-third of body weight without assistance.
- B. Focus on using back muscles efficiently when lifting heavy objects.
- C. Lift objects while holding the object a safe distance from the body.
- D. Tighten the abdominal muscles and lock the knees when lifting of an object.
Correct Answer: A
Rationale: The nurse will instruct the patient on the safe and correct way to lift objects using the strong quadriceps muscles of the thighs, with minimal use of the weak back muscles. To prevent recurrence of acute low back pain, the nurse may instruct the patient to avoid lifting more than one-third of his weight without help. The patient should be informed to place the feet a hip-width apart to provide a wide base of support, the person should bend the knees, tighten the abdominal muscles, and lift the object close to the body with a smooth motion, avoiding twisting and jerking.
A nurse is caring for a patient who is being assessed following complaints of severe and persistent low back pain. The patient is scheduled for diagnostic testing in the morning. Which of the following are appropriate diagnostic tests for assessing low back pain?
- A. Computed tomography (CT)
- B. Angiography
- C. Magnetic resonance imaging (MRI)
- D. Ultrasound
- E. X-ray
Correct Answer: A,C,D,E
Rationale: A variety of diagnostic tests can be used to address lower back pain, including CT, MRI, ultrasound, and X-rays. Angiography is not related to the etiology of back pain.