Nokea
The nurse is teaching a client with osteomalacia regarding ways to strengthen their bones. Which statement by the client would necessitate further teaching by the nurse?
- A. I've started to walk more frequently under the sun.'
- B. I don't like dairy products so I've stopped eating them.'
- C. I've enrolled myself in an exercise program for seniors at the community center.'
- D. I've been taking Vitamin D supplements lately.'
Correct Answer: B
Rationale: Avoiding dairy removes a key calcium source, critical for bone strength in osteomalacia. Sun exposure, exercise, and vitamin D supplements all support bone health.
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The nurse is assessing a client who reports left knee pain after playing baseball. The nurse should initially
- A. Feel the knee for warmth.
- B. Inspect the knee for any swelling.
- C. Palpate for crepitus in the knee.
- D. Have the client perform active range of motion in the knee.
Correct Answer: B
Rationale: Initial assessment starts with inspection for swelling, a visible sign of injury or inflammation post-activity. Warmth, crepitus, and range of motion are assessed next but are not the first step.
Which of the following best describes an appropriate outcome for a 75-yr-old patient with a history of Huntington's disease, which has developed contractures?
- A. The patient will monitor for signs of skin breakdown as a result of the contractures.
- B. The patient will learn to reposition himself in bed and in his chair without assistance.
- C. The patient will participate in range of motion exercises to reduce the effects of contractures.
- D. The patient will verbalize the effects of contractures on activities of daily living.
Correct Answer: C
Rationale: For a patient with Huntington's disease and contractures, participating in range of motion exercises is an appropriate outcome to help maintain joint mobility and reduce the severity of contractures. Monitoring for skin breakdown is important but not the primary outcome. Independent repositioning may not be feasible due to the progressive nature of Huntington's, and verbalizing effects is less actionable than active intervention.
The nurse is caring for a client diagnosed with chronic gout. The nurse anticipates a prescription for which medication to lower uric acid levels?
- A. colchicine
- B. allopurinol
- C. naproxen
- D. prednisone
Correct Answer: B
Rationale: Allopurinol inhibits xanthine oxidase, reducing uric acid production and preventing gout flares in chronic gout. Colchicine and naproxen manage acute inflammation, and prednisone reduces inflammation but does not lower uric acid levels long-term.
The nurse is preparing to give alendronate to the client with osteoporosis. The nurse should explain to the client that the expected outcome of this medication is primarily to
- A. decrease bone inflammation
- B. increase synovial fluid in the joint space
- C. inhibit bone resorption
- D. increase serum calcium levels
Correct Answer: C
Rationale: Alendronate, a bisphosphonate, inhibits osteoclast activity, thereby reducing bone resorption and increasing bone density in osteoporosis. It does not primarily reduce inflammation, increase synovial fluid, or directly increase serum calcium levels, which may actually decrease due to reduced bone breakdown.
The nurse is developing a self-management teaching plan for a client with low back pain. Which of the following should the nurse include?
- A. Avoid bending at the waist and lifting heavy objects.'
- B. Weight-bearing exercises are recommended.'
- C. Wear shoes with a higher heel.'
- D. Lay on your stomach four times daily and flex your legs.'
Correct Answer: A
Rationale: Avoiding bending at the waist and heavy lifting prevents back strain. Weight-bearing exercises help bones but not always back pain, high heels strain the back, and stomach lying with leg flexion can worsen pain.