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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.
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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 is assessing a new patient in the clinic. Which of the following information about the patient's medications should be of most concern?
- A. The patient takes a daily multivitamin and calcium supplement.
- B. The patient has migraine headaches that are treated with nonsteroidal anti-inflammatory drugs (NSAIDs).
- C. The patient has severe asthma and requires frequent therapy with oral steroids.
- D. The patient takes hormone replacement therapy (HRT) to prevent 'hot flashes.'
Correct Answer: C
Rationale: Corticosteroid use may lead to skeletal problems such as avascular necrosis and osteoporosis. The use of HRT and calcium supplements will help prevent osteoporosis. NSAID use does not increase the risk for musculoskeletal problems.
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 preparing to assess a patient's musculoskeletal system. Which of the following actions should the nurse do first?
- A. Feel for the presence of crepitus during joint movement.
- B. Have the patient move the extremities against resistance.
- C. Observe the patient's body build and muscle configuration.
- D. Check active and passive range of motion for the extremities.
Correct Answer: C
Rationale: The usual technique in the physical assessment is to begin with inspection. Abnormalities in muscle mass or configuration will allow the nurse to perform a more focused assessment of abnormal areas. The other assessments also are included in the assessment but are usually done after inspection.
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.