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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.
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The nurse is caring for a patient who has Paget's disease and is prescribed salmon calcitonin and acetaminophen. Which of the following assessment information will the nurse obtain to evaluate the effectiveness of these medications?
- A. Pain level
- B. Oral intake
- C. Daily weight
- D. Grip strength
Correct Answer: A
Rationale: Bone pain is one of the common early manifestations of Paget's disease, and the nurse should assess the pain level to determine whether the treatment is effective. The other information will also be collected by the nurse, but will not be used in evaluating the effectiveness of the therapy.
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.
The nurse is preparing to administer alendronate to a patient with osteoporosis. Which of the following actions will the nurse implement initially?
- A. Ensure the patient has recently eaten.
- B. Ask about any leg cramps or hot flashes.
- C. Assist the patient to sit up at the bedside.
- D. Administer the prescribed calcium carbonate.
Correct Answer: C
Rationale: To avoid esophageal erosions, the patient taking bisphosphonates should be upright for at least 30 minutes after taking the medication. Fosamax should be taken on an empty stomach, not after taking other medications or eating. Leg cramps and hot flashes are not adverse effects of bisphosphonates.
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 teaching a patient with a bunion how to prevent further deformity. Which of the following patient statements indicates that more teaching is required?
- A. I will throw away my high heel shoes.
- B. I will use the bunion pad to relieve the pain.
- C. I will need to wear open sandals at all times.
- D. I will take ibuprofen when I need it.
Correct Answer: C
Rationale: The patient can wear shoes that have a wide forefoot. The other patient statements indicate that the teaching has been effective.