Nokea
The nurse sees several clients with osteoporosis. For which client would bisphosphonates not be a good option?
- A. Client with diabetes who has a serum creatinine of 0.8 mg/dL
- B. Client who recently fell and has vertebral compression fractures
- C. Hypertensive client who takes calcium channel blockers
- D. Client with a spinal cord injury who cannot tolerate sitting up
Correct Answer: D
Rationale: Bisphosphonates require the client to sit upright for 30"?60 minutes after administration to prevent esophageal irritation. A client with a spinal cord injury who cannot tolerate sitting up is not a good candidate. A serum creatinine of 0.8 mg/dL is normal, and neither vertebral fractures nor calcium channel blockers contraindicate bisphosphonates.
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A client is admitted with a large draining wound on the leg. What action does the nurse take first?
- A. Administer ordered antibiotics
- B. Insert an intravenous line
- C. Give pain medications if needed
- D. Obtain cultures of the leg wound
Correct Answer: D
Rationale: Obtaining wound cultures is the priority to identify the causative organism before administering antibiotics, which could alter culture results. IV insertion and pain management follow, as they are secondary to accurate diagnosis.
A client with chronic osteomyelitis is being discharged from the hospital. What information is important for the nurse to teach this client and family? (Select all that apply.)
- A. Administering the antibiotic regimen
- B. Correct intramuscular injection technique
- C. Eating high-protein and high-carbohydrate foods
- D. Keeping daily follow-up appointments
- E. Proper use of the intravenous equipment
Correct Answer: A,C,E
Rationale: Chronic osteomyelitis requires long-term IV or oral antibiotics, proper IV equipment use, and a high-protein, high-carbohydrate diet to promote healing. IM injections are not typically used, and daily follow-up is unnecessary.
A client with osteoporosis is going home, where the client lives alone. What action by the nurse is best?
- A. Arrange a home safety evaluation
- B. Ensure the client has a walker at home
- C. Schedule daily nursing visits
- D. Refer the client to a support group
Correct Answer: A
Rationale: A home safety evaluation is critical for a client with osteoporosis living alone to reduce fall risks, which can lead to fractures. A walker may not be necessary without assessment, daily visits are excessive, and a support group is secondary to safety.
What information does the nurse teach a women's group about osteoporosis?
- A. After menopause, women lose about 2% of bone mass yearly
- B. Men actually have higher rates of the disease but are underdiagnosed
- C. There is no way to prevent or slow osteoporosis after menopause
- D. Bone loss stops 5 years after menopause
Correct Answer: A
Rationale: Women lose approximately 2% of bone mass annually after menopause due to decreased estrogen levels. Men have lower rates of osteoporosis, and treatments like calcium, vitamin D, and medications can slow bone loss post-menopause.
The nurse is assessing a client for chronic osteomyelitis. Which features distinguish this from the acute form of the disease? (Select all that apply.)
- A. Draining sinus tracts
- B. Presence of sequestra
- C. High fever
- D. Presence of foot ulcers
- E. Swelling and redness
Correct Answer: A,B,D
Rationale: Chronic osteomyelitis is characterized by draining sinus tracts, sequestra (dead bone), and foot ulcers. High fever and swelling/redness are more typical of acute osteomyelitis.