Nokea
A patient's patellar-femoral cartilage has deteriorated due to arthritis. The medial and lateral cartilage is undamaged. This patient is likely to undergo partial or knee replacement surgery.
Correct Answer: unicompartmental
Rationale: Unicompartmental knee arthroplasty is also referred to as partial knee replacement and is performed on patients who have only one of the compartments of the knee affected by arthritis.
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Which instructions should the nurse reinforce in a teaching plan for a person with gouty arthritis?
- A. Avoid excessive alcohol.
- B. Maintain rest and immobility while disease is symptomatic.
- C. Check urine and urine output for possible kidney stones.
- D. Include food high in purine in the diet.
- E. Use bed cradle to support linens.
Correct Answer: A,B,C,E
Rationale: The person with gout should avoid alcohol and food with high purine content, maintain rest and immobility while symptomatic, and check urine and urine output for possible kidney stones. A bed cradle keeps the linens off the patient's feet to promote comfort.
Which instruction will the nurse reinforce for a patient who is taking alendronate?
- A. Take drug with any meal.
- B. Take drug first thing in the morning.
- C. Drink at least $5 \mathrm{oz}$ of milk before taking drug.
- D. Take drug with an antacid to avoid heartburn.
Correct Answer: B
Rationale: Alendronate should be taken on an empty stomach first thing in the morning with $6 \mathrm{oz}$ of water, accompanied by no other medication. The patient should remain upright for 30 minutes after a dose to minimize risk of esophageal irritation.
The patient that has a bipolar hip replacement following an intracapsular fracture has an order to be turned every 2 hours. The nurse understands that the correct nursing intervention is to keep the legs in which position?
- A. together so they do not separate while turning.
- B. flexed to stabilize the prosthesis.
- C. abducted so the prosthesis does not become dislocated.
- D. adducted to prevent additional pain for the patient with turning.
Correct Answer: C
Rationale: Nursing interventions also involve postoperative maintenance of leg abduction by using an abduction splint for 7 to 10 days to prevent dislocation of the prosthesis. Leg abduction does not involve keeping the legs together, flexion to stabilize the prosthesis or to keep the legs adducted to prevent additional pain with turning.
The nurse explains that the use of the brace allows a person with a cervical fracture to be mobile.
Correct Answer: halo
Rationale: Halo braces attach to the skull with pins, which stabilize a cervical vertebral fracture, allowing the patient to be mobile.
The patient has been diagnosed as having gouty arthritis. The patient asks the nurse to explain the cause of the inflammation of the great toe. Which is the appropriate nursing response?
- A. You have calcium oxalate deposits that are seen in gouty arthritis.'
- B. The inflammation is from small accumulations of uric acid crystals, which are called tophi.'
- C. The small nodules are not related to the arthritis condition.'
- D. You have fat deposits that are common with gouty arthritis.'
Correct Answer: B
Rationale: Gout is a metabolic disease resulting from an accumulation of uric acid in the blood. It is an acute inflammatory condition associated with ineffective metabolism of purines. Although some patients with gout also have kidney stones, and some kidney stones are caused by calcium oxalate deposits, gout is not caused from calcium oxalate deposits. A patient with gout usually has excruciating pain, edema and inflammation in the affected joint, not small nodules. Fat deposits are not associated with gouty arthritis.