Nokea
The client is being evaluated for osteoporosis. Which diagnostic test is the most accurate when diagnosing osteoporosis?
- A. X-ray of the femur.
- B. Serum alkaline phosphatase.
- C. Dual-energy x-ray absorptiometry (DEXA).
- D. Serum bone Gla-protein test.
Correct Answer: C
Rationale: DEXA is the gold standard for osteoporosis diagnosis, measuring bone mineral density. X-rays detect fractures, alkaline phosphatase is nonspecific, and bone Gla-protein is not diagnostic.
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Which statement by the nurse provides the best explanation about the purpose of antiembolism stockings?
- A. Antiembolism stockings prevent blood from pooling in the legs.
- B. Antiembolism stockings reduce blood flow to the exercises.
- C. Antiembolism stockings keep the blood pressure lower in the legs.
- D. Antiembolism stockings keep the blood vessels constricted.
Correct Answer: A
Rationale: Antiembolism stockings apply graduated compression to promote venous return, preventing blood pooling and reducing the risk of deep vein thrombosis in immobile clients. The other options are inaccurate.
The client is ordered to be in a semi-reclining position following a myelogram. The nurse understands that the primary reason for this is which of the following?
- A. To prevent infection
- B. To prevent spinal headache
- C. To prevent seizures
- D. To promote excretion of dye
Correct Answer: B
Rationale: A semi-reclining position post-myelogram prevents spinal headache by reducing cerebrospinal fluid leakage.
Later the client says, 'I know my arm isn't there, but I feel it throbbing.' Which response by the nurse would be most accurate?
- A. You may be experiencing referred pain from an adjacent muscle.
- B. You may be experiencing phantom pain from the amputated site.
- C. You may be experiencing psychogenic pain from emotional distress.
- D. You may be experiencing intractable pain that can best be treated with opioids.
Correct Answer: B
Rationale: Phantom pain is a common sensation of pain in the amputated limb due to nerve endings firing, accurately describing the client's experience. The other options misattribute the cause.
The nurse gently elevates the client's newly casted arm on a pillow and explains that this is necessary for the first 24 to 48 hours after casting. What is the chief purpose of this action?
- A. It helps a damp cast to dry more evenly.
- B. It reduces the amount of pain medication needed.
- C. Venous return is enhanced, and edema is decreased.
- D. It is more comfortable than keeping the arm dependent.
Correct Answer: C
Rationale: Elevation enhances venous return and reduces edema, the primary reason for this action. It does not directly affect cast drying, pain medication needs, or comfort alone.
The nurse is discussing the importance of an exercise program for pain control to a client diagnosed with OA. Which intervention should the nurse include in the teaching?
- A. Wear supportive tennis shoes with white socks when walking.
- B. Carry a complex carbohydrate while exercising.
- C. Alternate walking briskly and jogging when exercising.
- D. Walk at least 30 minutes three (3) times a week.
Correct Answer: D
Rationale: Walking 30 minutes thrice weekly reduces OA pain and stiffness through low-impact exercise. Supportive shoes are helpful but secondary, carbohydrates are irrelevant, and jogging may worsen OA.