Nokea
The client who is about to undergo arthroscopy of the knee begins to describe the procedure to the nurse. What statement(s) indicate to the nurse that the client understands the procedure?
- A. This procedure does not require an anesthetic.
- B. A needle will be inserted into the joint space.
- C. A special scan may be done to verify the placement of the needle.
- D. Fluid is taken from the joint for laboratory analysis.
- E. It is normal to hear crackling or clicking noises in the joint for about a week after the procedure.
Correct Answer: B,C,D
Rationale: If the client describes the procedure as one in which a needle is inserted into the joint space, with a special scan possibly being done to verify needle placement, to take fluid from the joint for laboratory analysis, the nurse can confirm that the client understands the arthroscopy procedure. Before the procedure, the provider first injects a local anesthetic. The client should expect the crackling or clicking noises to resolve after 2 days. Noises beyond this time are abnormal, the client should report them.
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A nurse is preparing a presentation for a health class about ways to ensure bone health, including the need for an adequate calcium intake. The participants are high school-aged girls. The nurse would encourage them to consume adequate calcium to maximize peak bone mass by which age?
- A. 20 years
- B. 30 years
- C. 40 years
- D. 50 years
Correct Answer: B
Rationale: Peak bone mass is attained sometime around 30 years of age. An adequate calcium intake before that time helps to maximize peak bone mass. This would result in denser bones that would be less susceptible to fracture. Bone mass begins to decrease after age 30.
The nurse is caring for a middle-aged female client who is experiencing premenopausal symptoms. Which client statement indicates the need for further teaching?
- A. I like to take a brisk walk in the morning.
- B. I only drink orange juice fortified with calcium and vitamin D.
- C. Bone resorption slows with aging due to a decrease in estrogen levels.
- D. I like to have a glass of red wine in the evening.
Correct Answer: C
Rationale: The nurse is correct to clarify that bone resorption occurs more rapidly with aging. In fact, it occurs more rapidly than bone formation. This leads to an increased risk of skeletal fractures. All of the other options are helpful in a client entering menopause.
A client is experiencing muscle weakness in the upper extremities. The client raises an arm above the head but then loses the ability to maintain the position. Muscular dystrophy is suspected. Which diagnostic test would evaluate muscle weakness or deterioration?
- A. A serum calcium test
- B. An electromyography
- C. An arthroscopy
- D. A magnetic resonance imaging (MRI)
Correct Answer: B
Rationale: An electromyography tests the electrical potential of muscles and nerves leading to the muscles. It is done to evaluate muscle weakness or deterioration. A serum calcium test evaluates the calcium in the blood. An arthroscopy assesses changes in the joint. An MRI identifies abnormalities in the targeted area.
A client is scheduled to have an x-ray examination of the shoulder in which the synovial fluid will be aspirated and sent to the laboratory for analysis. This will be followed by administration of a contrast medium and x-rays. The nurse understands that the client will be undergoing which test(s)?
- A. Arthroscopy
- B. Arthrocentesis
- C. Arthrogram
- D. Bone densit dissentery
- E. Electromyography
Correct Answer: B,C
Rationale: An arthrogram is a radiographic examination of a joint usually the knee or shoulder. The health care provider first injects a local anesthetic and then inserts a needle into the joint space. Fluoroscopy may be used to verify correct placement of the needle. The synovial fluid in the joint is aspirated and sent to the laboratory for analysis. A contrast medium is then injected, and x-ray films are taken. Arthroscopy is the internal inspection of a joint using an arthroscope. Arthrocentesis is the aspiration of synovial fluid. The client involves local anesthesia just before this procedure. The health care provider inserts a large needle into the joint and removes the fluid. This can be done during an arthrogram or arthroscopy. Bone densitometry estimates bone density using radiography or advanced radiographic techniques. Electromyography tests the electrical potential of the muscles and nerves leading to the muscles.
A nurse is caring for a client with an undiagnosed bone disease. When instructing on the normal process to maintain bone tissue, which process transforms osteoblasts into mature bone cells?
- A. Remodelling
- B. Resorption
- C. Ossification and calcification
- D. Epiphyses and diaphysis formation
Correct Answer: C
Rationale: Ossification and calcification transform osteoblasts into mature bone cells called osteocytes. Osteocytes are involved in maintaining bone tissue. Resorption and remodelling are involved in bone destruction. Epiphyses and diaphysis are bone tissues that provide strength and support to the human skeleton.