Nokea
The health care team is caring for a patient with osteomalacia. It has been determined that the osteomalacia is caused by malabsorption. What is the usual treatment for osteomalacia caused by malabsorption?
- A. Supplemental calcium and increased doses of vitamin D
- B. Exogenous parathyroid hormone and multivitamins
- C. Colony-stimulating factors and calcitonin
- D. Supplemental potassium and pancreatic enzymes
Correct Answer: A
Rationale: If osteomalacia is caused by malabsorption, increased doses of vitamin D, along with supplemental calcium, are usually prescribed.
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A nurse is reviewing the care of a patient who has a long history of lower back pain that has not responded to conservative treatment measures. The nurse should anticipate the administration of what drug?
- A. Calcitonin
- B. Prednisone
- C. Aspirin
- D. Cyclobenzaprine
Correct Answer: D
Rationale: Short-term prescription muscle relaxants (e.g., cyclobenzaprine [Flexeril]) are effective in relieving acute low back pain. ASA is not normally used for pain control, due to its antiplatelet action and associated risk for bleeding. Calcitonin and corticosteroids are not used in the treatment of lower back pain.
A nurse is providing a class on osteoporosis at the local seniors center. Which of the following statements related to osteoporosis is most accurate?
- A. Osteoporosis is categorized as a disease of the elderly.
- B. A nonmodifiable risk factor for osteoporosis is a person's level of activity.
- C. Secondary osteoporosis occurs in women after menopause.
- D. Slow discontinuation of corticosteroid therapy can halt the progression of the osteoporosis.
Correct Answer: D
Rationale: When corticosteroid therapy is discontinued, the progression of osteoporosis is halted, but restoration of lost bone mass does not occur. Osteoporosis is not a disease of the elderly because its onset occurs earlier in life, when bone mass peaks and then begins to decline. A person's level of physical activity is a modifiable factor that influences peak bone mass. Lack of activity increases the risk for the development of osteoporosis. Primary osteoporosis occurs in women after menopause.
A patient tells the nurse that he has pain and numbness to his thumb, first finger, and second finger of the right hand. The nurse discovers that the patient is employed as an auto mechanic, and that the pain is increased while working. This may indicate that the patient could possibly have what health problem?
- A. Carpel tunnel syndrome
- B. Tendonitis
- C. Impingement syndrome
- D. Dupuytren's contracture
Correct Answer: A
Rationale: Carpel tunnel syndrome may be manifested by numbness, pain, paresthesia, and weakness along the median nerve. Tendonitis is inflammation of muscle tendons. Impingement syndrome is a general term that describes all lesions that involve the rotator cuff of the shoulder. Dupuytren's contracture is a slowly progressive contracture of the palmar fascia.
A nurse is planning the care of an older adult patient with osteomalacia. What action should the nurse recommend in order to promote vitamin D synthesis?
- A. Ensuring adequate exposure to sunlight
- B. Eating a low-purine diet
- C. Performing cardiovascular exercise while avoiding weight-bearing exercises
- D. Taking thyroid supplements as ordered
Correct Answer: A
Rationale: Because sunlight is necessary for synthesizing vitamin D, patients should be encouraged to spend some time in the sun. A low-purine diet is not a relevant action and thyroid supplements do not directly affect bone function. Action must be taken to prevent fractures, but weight-bearing exercise within safe parameters is not necessarily contraindicated.
An orthopedic nurse is caring for a patient who is postoperative day one following foot surgery. What nursing intervention should be included in the patient's subsequent care?
- A. Dressing changes should not be performed unless there are clear signs of infection.
- B. The surgical site can be soaked in warm bath water for up to 5 minutes.
- C. The surgical site should be cleansed with hydrogen peroxide once daily.
- D. The foot should be elevated in order to prevent edema.
Correct Answer: D
Rationale: Pain experienced by patients who undergo foot surgery is related to inflammation and edema. To control the anticipated edema, the foot should be elevated on several pillows when the patient is sitting or lying. Regular dressing changes are performed and the wound should be kept dry. Hydrogen peroxide is not used to cleanse surgical wounds.