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A patient presents at the clinic with complaints of morning numbness, cramping, and stiffness in his fourth and fifth fingers. What disease process should the nurse suspect?
- A. Tendonitis
- B. A ganglion
- C. Carpal tunnel syndrome
- D. Dupuytren's disease
Correct Answer: D
Rationale: In cases of Dupuytren's disease, the patient may experience dull, aching discomfort, morning numbness, cramping, and stiffness in the affected fingers. This condition starts in one hand, but eventually both hands are affected. This clinical scenario does not describe tendonitis, a ganglion, or carpal tunnel syndrome.
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A nurse is caring for a patient with Paget's disease and is reviewing the patient's most recent laboratory values. Which of the following values is most characteristic of Paget's disease?
- A. An elevated level of parathyroid hormone and low calcitonin levels
- B. A low serum alkaline phosphatase level and a low serum calcium level
- C. An elevated serum alkaline phosphatase level and a normal serum calcium level
- D. An elevated calcitonin level and low levels of parathyroid hormone
Correct Answer: C
Rationale: Patients with Paget's disease have normal blood calcium levels. Elevated serum alkaline phosphatase concentration and urinary hydroxyproline excretion reflect the increased osteoblastic activity associated with this condition.
A patient has been admitted to the medical unit for the treatment of Paget's disease. When reviewing the medication administration record, the nurse should anticipate what medications?
- A. Calcitonin
- B. Bisphosphonates
- C. Alkaline phosphatase
- D. Calcium gluconate
- E. Estrogen
Correct Answer: A,B
Rationale: Bisphosphonates are the cornerstone of Paget therapy in that they stabilize the rapid bone turnover. Calcitonin is also used because it retards bone resorption by decreasing the number and availability of osteoclasts. Alkaline phosphatase is a naturally occurring enzyme, not a drug. Calcium gluconate and estrogen are not used in the treatment of Paget's disease.
A nurse is providing an educational class to a group of older adults at a community senior center. In an effort to prevent osteoporosis, the nurse should encourage participants to ensure that they consume the recommended adequate intake of what nutrients?
- A. Vitamin B12
- B. Potassium
- C. Calcitonin
- D. Calcium
- E. Vitamin D
Correct Answer: D,E
Rationale: A diet rich in calcium and vitamin D protects against skeletal demineralization. Intake of vitamin B12 and potassium does not directly influence the risk for osteoporosis. Calcitonin is not considered to be a dietary nutrient.
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.
A patient with diabetes is attending a class on the prevention of associated diseases. What action should the patient perform to reduce the risk of osteomyelitis?
- A. Increase calcium and vitamin intake.
- B. Perform meticulous foot care.
- C. Exercise 3 to 4 times weekly for at least 30 minutes.
- D. Take corticosteroids as ordered.
Correct Answer: B
Rationale: Diabetic foot ulcers have a high potential for progressing to osteomyelitis. Meticulous foot care can help mitigate this risk. Corticosteroids can exacerbate the risk of osteomyelitis. Increased intake of calcium and vitamins as well as regular exercise are beneficial health promotion exercises, but they do not directly reduce the risk of osteomyelitis.