Nokea
The nurse is caring for a patient who has a new prescription for magnetic resonance imaging (MRI) to evaluate for right femur osteomyelitis. Which of the following patient information indicates that the nurse should consult with the health care provider before scheduling the MRI?
- A. The patient has a pacemaker.
- B. The patient is claustrophobic.
- C. The patient wears a hearing aid.
- D. The patient is allergic to shellfish.
Correct Answer: A
Rationale: Patients with permanent pacemakers cannot have MRI because of the force exerted by the magnetic field on metal objects. An open MRI will not cause claustrophobia. The patient will need to be instructed to remove the hearing aid before the MRI, but this does not require consultation with the health care provider. Since contrast medium will not be used, shellfish allergy is not a contraindication to MRI.
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The nurse is caring for a patient who has pain during circumduction of the shoulder when the nurse moves the arm behind the patient. Which of the following questions should the nurse ask?
- A. Do you have difficulty in putting on a jacket?
- B. Are you able to feed yourself without difficulty?
- C. Are you able to sleep through the night without waking?
- D. Do you ever have trouble lowering yourself to the toilet?
Correct Answer: A
Rationale: The patient's pain will make it more difficult to accomplish tasks like putting on a shirt or jacket. This pain should not affect the patient's ability to feed himself or herself or use the toilet because these tasks do not involve moving the arm behind the patient. The arm will not usually be positioned behind the patient during sleeping.
The nurse obtains this information when assessing an older-adult patient in the outpatient clinic. Which of the following findings is of highest priority when the nurse is planning care for the patient?
- A. Symmetrical joint swelling of fingers
- B. Decreased right knee range of motion
- C. History of recent loss of balance and fall
- D. Complaint of left hip aching when jogging
Correct Answer: C
Rationale: A history of falls requires further assessment and development of fall prevention strategies. The other changes are more typical of bone and joint changes associated with normal aging.
The nurse is assessing an older female patient and notes that the patient has lost 2 cm in height since the previous visit 2 years ago. Which of the following diagnostic tests should the nurse include in the teaching plan?
- A. Discography studies
- B. Myelographic testing
- C. Magnetic resonance imaging (MRI)
- D. Dual-energy x-ray absorptiometry (DEXA)
Correct Answer: D
Rationale: The decreased height and the patient's age suggest that the patient may have osteoporosis and that bone density testing is needed. Discography, MRI, and myelography are typically done for patients with current symptoms caused by musculoskeletal dysfunction and are not the initial diagnostic tests for osteoporosis.
Which of the following information obtained during the nurse's assessment of the patient's nutritional-metabolic pattern may indicate the risk for musculoskeletal condition?
- A. The patient takes a multivitamin daily.
- B. The patient dislikes fruits and vegetables.
- C. The patient is 158 cm and weighs 81 kg.
- D. The patient prefers whole milk to nonfat milk.
Correct Answer: C
Rationale: The patient's height and weight indicate obesity, which places stress on weight-bearing joints. The use of whole milk, avoiding fruits and vegetables, and use of a daily multivitamin are not risk factors for musculoskeletal condition.
The nurse is caring for a patient with kyphosis who is scheduled for dual-energy x-ray absorptiometry (DEXA) testing. Which of the following actions should the nurse plan to implement?
- A. Give an oral sedative.
- B. Start an intravenous line
- C. Teach the patient about DEXA.
- D. Screen the patient for shellfish allergies.
Correct Answer: C
Rationale: DEXA testing is painless and noninvasive. No IV access is necessary. Contrast medium is not used. Because the procedure is painless, no antianxiety medications are required.