Nokea
Several months after antibiotic therapy, a child is readmitted to the hospital with an exacerbation of osteomyelitis, which is now in the chronic stage. The mother appears anxious and asks what she could have done to prevent the exacerbation. The nurse's response is based on the knowledge that chronic osteomyelitis:
- A. Is caused by poor physical conditions or poor nutrition
- B. Often results from unhygienic conditions or an unclean environment
- C. Is directly related to sluggish circulation in the affected limb
- D. May develop from sinuses in the involved bone that retain infectious material
Correct Answer: D
Rationale: Areas of sequestrum may be surrounded by dense bone, become honeycombed with sinuses, and retain infectious organisms for a long time, leading to chronic osteomyelitis exacerbation.
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Which of the following risk factors associated with breast cancer would a nurse consider most significant in a client's history?
- A. Menarche after age 13
- B. Nulliparity
- C. Maternal family history of breast cancer
- D. Early menopause
Correct Answer: C
Rationale: Women who begin menarche late (after 13 years old) have a lower risk of developing breast cancer than women who have begun earlier. Average age for menarche is 12.5 years. Women who have never been pregnant have an increased risk for breast cancer, but a positive family history poses an even greater risk. A positive family history puts a woman at an increased risk of developing breast cancer. It is recommended that mammography screening begin 5 years before the age at which an immediate female relative was diagnosed with breast cancer. Early menopause decreases the risk of developing breast cancer.
The nurse is caring for a client with a history of heart failure. Which discharge instruction is most important?
- A. Weigh yourself daily.'
- B. Limit exercise to 10 minutes daily.'
- C. Increase sodium intake.'
- D. Take over-the-counter pain relievers as needed.'
Correct Answer: A
Rationale: Daily weight monitoring detects fluid retention early in heart failure, allowing timely intervention. Exercise should be moderate, sodium restricted, and pain relievers used cautiously.
The nurse is caring for a client with a history of a tracheostomy. Which intervention is most important when suctioning the tracheostomy?
- A. Using sterile technique
- B. Applying suction for 20 seconds
- C. Instilling saline before suctioning
- D. Using a large-diameter catheter
Correct Answer: A
Rationale: Sterile technique during tracheostomy suctioning prevents infection, a critical concern. Suctioning should last 10-15 seconds, saline is optional, and catheter size should be appropriate.
A client is admitted with sickle cell crises and sequestration. Upon assessing the client, the nurse would expect to find:
- A. Decreased blood pressure
- B. Moist mucus membranes
- C. Decreased respirations
- D. Increased blood pressure
Correct Answer: A
Rationale: Sickle cell crisis with sequestration can lead to hypovolemia due to blood pooling in organs, resulting in decreased blood pressure.
Which diet would the nurse expect to see ordered for a patient with nephrotic syndrome?
- A. Low carbohydrate potassium
- B. Moderate protein
- C. Low calcium
- D. Increased potassium
Correct Answer: B
Rationale: Nephrotic syndrome causes proteinuria, leading to hypoalbuminemia. A moderate protein diet (0.8–1 g/kg/day) helps replace lost protein without overloading the kidneys. Low carbohydrate, low calcium, or increased potassium diets are not specific to nephrotic syndrome.