Nokea
The nurse is assessing a patient in the foot clinic who has severe heel pain. Which of the following foot disorders should the nurse assess for?
- A. Hallux rigidus
- B. Morton's neuroma
- C. Pes cavus
- D. Plantar fasciitis
Correct Answer: D
Rationale: Complaints of severe heel pain will alert the nurse to assess for plantar bursitis, plantar fasciitis, or bone spur in adult. Hallux rigidus, pes cavus, and Morton's neuroma do not have the symptom of severe heel pain.
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The nurse is caring for a patient who underwent a laminectomy and discectomy for a herniated intervertebral disc. Following the surgery, which of the following actions should the nurse implement when positioning the patient on their side?
- A. Instruct the patient to move their legs before turning the rest of the body.
- B. Have the patient turn by grasping the side rails and pulling the shoulders over.
- C. Place a pillow between the patient's legs and turn the entire body as a unit.
- D. Turn the patient's head and shoulders first, followed by the hips, legs, and feet.
Correct Answer: C
Rationale: The spine should be kept in correct alignment after laminectomy. The other positions will create misalignment of the spine.
Which of the following assessment findings should alert the nurse to the presence of osteoporosis in an older adult patient?
- A. Measurable loss of height
- B. Presence of bowed legs
- C. Aversion to dairy products
- D. Statements about frequent falls
Correct Answer: A
Rationale: Osteoporosis occurring in the vertebrae produces a gradual loss of height. Bowed legs are associated with osteomalacia. Low intake of dairy products is a risk factor for osteoporosis, but it does not indicate that osteoporosis is present. Frequent falls increase the risk for fractures but are not an indicator of osteoporosis.
Which of the following statements by a patient with osteosarcoma of the right tibia who is scheduled for an above-the-knee amputation indicates that patient teaching is needed?
- A. I did not have this bone cancer until my leg broke a week ago.
- B. I wish that I did not have to have chemotherapy after this surgery.
- C. I know that I will need to participate in physical therapy after surgery.
- D. I will use the patient-controlled analgesia (PCA)
Correct Answer: A
Rationale: The statement that the patient did not have bone cancer until the leg broke indicates a misunderstanding, as osteosarcoma is a primary bone cancer that may lead to fractures, not vice versa. The other statements reflect appropriate understanding of the need for chemotherapy, physical therapy, and pain management post-surgery.
The nurse is caring for a patient who has acute osteomyelitis and is receiving tobramycin 80 mg IV twice daily. Which of the following actions should the nurse take before administering the gentamicin?
- A. Ask the patient about any nausea.
- B. Obtain the patient's oral temperature.
- C. Change the prescribed wet-to-dry dressing.
- D. Review the patient's blood urea nitrogen (BUN) and creatinine levels.
Correct Answer: D
Rationale: Gentamicin is nephrotoxic and can cause renal failure. Monitoring the patient's temperature before gentamicin administration is not necessary. Nausea is not a common adverse effect of IV gentamicin. There is no need to change the dressing before gentamicin administration.
The nurse is caring for an older female adult patient who has a family history of osteoporosis and is diagnosed with osteopenia following densitometry testing. Which of the following explanations should the nurse provide when teaching the patient about osteoporosis?
- A. Estrogen replacement therapy must be started to prevent rapid progression to osteoporosis.
- B. Continuous, low-dose corticosteroid treatment is effective in stopping the course of osteoporosis.
- C. With a family history of osteoporosis, there is no way to prevent or slow gradual bone resorption.
- D. Calcium loss from bones can be slowed by increasing calcium intake and weight-bearing exercise.
Correct Answer: D
Rationale: Progression of osteoporosis can be slowed by increasing calcium intake and weight-bearing exercise. Estrogen replacement therapy does help prevent osteoporosis, but it is not the only treatment and is not appropriate for some patients. Corticosteroid therapy increases the risk for osteoporosis.