Nokea
The nurse is assessing a client for chronic osteomyelitis. Which features distinguish this from the acute form of the disease? (Select all that apply.)
- A. Draining sinus tracts
- B. Presence of sequestra
- C. High fever
- D. Presence of foot ulcers
- E. Swelling and redness
Correct Answer: A,B,D
Rationale: Chronic osteomyelitis is characterized by draining sinus tracts, sequestra (dead bone), and foot ulcers. High fever and swelling/redness are more typical of acute osteomyelitis.
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A nurse is assessing a community group for dietary factors that contribute to osteoporosis. In addition to inquiring about calcium, the nurse also assesses for which other dietary components? (Select all that apply.)
- A. Alcohol
- B. Caffeine
- C. Fat
- D. Carbonated beverages
- E. Vitamin D
Correct Answer: A,B,D,E
Rationale: Alcohol, caffeine, carbonated beverages (high in phosphorus), and low vitamin D intake contribute to osteoporosis risk. Fat intake does not directly affect bone density.
A client is admitted with a bone tumor. The nurse finds the client weak and lethargic with decreased deep tendon reflexes. What actions by the nurse are best? (Select all that apply.)
- A. Assess the daily serum calcium level
- B. Consult the provider about a loop diuretic
- C. Institute seizure precautions for the client
- D. Raise the head of the bed
- E. Place the client on a 1500 mL fluid restriction
Correct Answer: A,B,D
Rationale: Weakness, lethargy, and decreased reflexes suggest hypercalcemia, common in bone tumors. Assessing serum calcium, consulting for loop diuretics, and raising the head of the bed to promote safety are appropriate. Seizure precautions and fluid restrictions are not indicated.
A client has an ingrown toenail. About what self-management measure does the nurse teach the client?
- A. Long-term antibiotic use
- B. Shoe padding
- C. Toenail trimming by the client
- D. Warm moist soaks and proper nail trimming by a podiatrist
Correct Answer: D
Rationale: Proper treatment for an ingrown toenail includes warm moist soaks and professional nail trimming by a podiatrist to prevent recurrence. Long-term antibiotics are unnecessary, shoe padding does not treat the condition, and self-trimming can worsen it.
A client has scoliosis with a 65-degree curve to the spine. What action by the nurse takes priority?
- A. Allow the client to rest in a position of comfort
- B. Assess the client's cardiac and respiratory systems
- C. Assist the client with ambulating and position changes
- D. Position the client on one side propped with pillows
Correct Answer: B
Rationale: A 65-degree spinal curve in scoliosis can impair cardiac and respiratory function due to chest deformity. Assessing these systems is the priority to ensure the client's safety. Comfort, ambulation, and positioning are important but secondary.
A nurse is assessing an older client and discovers back pain with tenderness along L2 and L3. What action by the nurse is best?
- A. Consult the provider about an X-ray
- B. Encourage the client to use ibuprofen (Motrin)
- C. Have the client perform hip range of motion
- D. Apply a cervical collar
Correct Answer: A
Rationale: Back pain with tenderness at L2 and L3 suggests a spinal compression fracture, common in osteoporosis. Consulting the provider for an X-ray is the priority to confirm the diagnosis. Ibuprofen may be considered post-diagnosis, and hip range of motion is unrelated. A cervical collar is inappropriate for lumbar issues.