Nokea
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.
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The nurse is planning an educational session related to foot problems at a local senior's club. Which of the following information should the nurse include in the session related to why the older adult is prone to developing foot problems? (Select all that apply.)
- A. Poor circulation
- B. Inactivity
- C. Decreased lower extremity sensation
- D. Poor foot hygiene
- E. Atherosclerosis
Correct Answer: A,C,E
Rationale: The older adult is prone to developing foot problems because of poor circulation, atherosclerosis, and decreased sensation in the lower extremities. Inactivity and foot hygiene are personal choices and are not age-related changes.
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 teaching a patient with persistent back pain, whose work involves lifting, about proper body mechanics. Which of the following patient statements indicates that the teaching has been effective?
- A. I plan to start doing exercises to strengthen the muscles of my back.
- B. I will try to sleep with my hips and knees extended to prevent back strain.
- C. I can tell my boss that I need to change to a job where I can work at a desk.
- D. I will keep my back straight when I need to lift anything higher than my waist.
Correct Answer: A
Rationale: Exercises can help to strengthen the muscles that support the back. Flexion of the hips and knees places less strain on the back. Modifications in the way the patient lifts boxes is needed as well as reminding that sitting for prolonged periods can aggravate back pain. The patient should not lift above the level of the elbows.
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.
The nurse is caring for a patient following a laminectomy with a spinal fusion who reports numbness and tingling of the right lower leg. Which of the following actions should the nurse do first?
- A. Report the patient's symptoms to the surgeon.
- B. Check the vital signs for indications of hemorrhage.
- C. Turn the patient to the side to relieve pressure on the right leg.
- D. Document the findings and reassess the patient in two hours.
Correct Answer: A
Rationale: Numbness and tingling should be immediately reported to the surgeon rather than documented and rechecked in two hours. Numbness and tingling are not symptoms associated with hemorrhage at the site. Turning the patient will not relieve the numbness.