Nokea
The client is prescribed Fosamax, a bisphosphonate. Which information should the nurse teach?
- A. Take this medication with a full glass of water.
- B. Take with breakfast to prevent gastrointestinal upset.
- C. Use sunscreen to prevent sensitivity to sunlight.
- D. This medication increases calcium reabsorption.
Correct Answer: A
Rationale: Fosamax is taken with water to prevent esophageal irritation. Food reduces absorption, photosensitivity is not a side effect, and it inhibits bone resorption, not calcium reabsorption.
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The client with a long arm cast is complaining of unrelenting severe pain and feeling as if the fingers are asleep. Which complication should the nurse suspect the client is experiencing?
- A. Fat embolism.
- B. Compartment syndrome.
- C. Pressure ulcer under the cast.
- D. Surgical incision infection.
Correct Answer: B
Rationale: Severe pain and numbness in a casted arm suggest compartment syndrome, a medical emergency. Fat embolism, pressure ulcers, and infections present differently.
Which laboratory test value, if elevated, is the best diagnostic indicator of rheumatoid arthritis?
- A. Erythrocyte sedimentation rate (ESR)
- B. Partial thromboplastin time (PTT)
- C. Partial thromboplastin time (PTT)
- D. Blood urea nitrogen (BUN)
Correct Answer: A
Rationale: An elevated ESR indicates inflammation, a hallmark of rheumatoid arthritis, making it a key diagnostic marker. PTT and BUN are unrelated to rheumatoid arthritis diagnosis.
When the client asks the nurse what is meant by the term manipulation, which explanation is most accurate?
- A. Manipulation involves making an incision to realign the bones.
- B. Manipulation involves the insertion of a pin or wire into the joint.
- C. Manipulation repositions the bone ends manually.
- D. Manipulation strengthens the joint with exercise.
Correct Answer: C
Rationale: Manipulation for a dislocated shoulder involves manually repositioning the bone ends into their normal alignment without surgical intervention. Incisions or pins are used in surgical procedures, and exercise is for rehabilitation, not repositioning.
The client diagnosed with OA is a resident in a long-term care facility. The resident is refusing to bathe because she is hurting. Which instruction should the nurse give the unlicensed assistive personnel (UAP)?
- A. Allow the client to stay in bed until the pain becomes bearable.
- B. Tell the UAP to give the client a bed bath this morning.
- C. Try to encourage the client to get up and go to the shower.
- D. Notify the family the client is refusing to be bathed.
Correct Answer: C
Rationale: Encouraging the client to shower promotes mobility, which reduces OA stiffness, while addressing pain. Bed rest worsens stiffness, bed baths enable immobility, and family notification is unnecessary.
Which evidence is the best indication that the client who had a knee arthroplasty is recovering according to expected outcomes and no longer needs the continuous passive motion (CPM) machine?
- A. The client has minimal pain when ambulating.
- B. The client can flex the operative knee 90 degrees.
- C. The client can tolerate full weight bearing.
- D. The edges of the client's surgical wound are approximated.
Correct Answer: B
Rationale: 90-degree knee flexion indicates restored joint function, a key recovery milestone.