Nokea
The patient, age 58, is diagnosed with osteoporosis after densitometry testing. She has been menopausal for 5 years and has been concerned about her risk for osteoporosis because her mother has osteoporosis. When reinforcing instructions about her osteoporosis, which information does the nurse include?
- A. Even with a family history of osteoporosis, the calcium loss from bones can be slowed by increased calcium intake and exercise.
- B. Estrogen replacement therapy must be started to prevent rapid progression of her osteoporosis.
- C. With a family history of osteoporosis, there is no way to prevent or slow bone reabsorption.
- D. Continuous, low-dose corticosteroid treatment is effective in stopping the course of osteoporosis.
Correct Answer: A
Rationale: To prevent osteoporosis, women are advised to have an adequate daily intake of calcium and vitamin D; exercise regularly; avoid smoking; decrease caffeine intake; decrease excess protein in the diet; and engage in regular moderate activity such as walking, bike riding, or swimming at least 3 days a week. Estrogen does not increase bone formation. Prevention of osteoporosis should begin before bone loss has occurred. A contributing factor may be use of steroids.
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The patient that has a bipolar hip replacement following an intracapsular fracture has an order to be turned every 2 hours. The nurse understands that the correct nursing intervention is to keep the legs in which position?
- A. together so they do not separate while turning.
- B. flexed to stabilize the prosthesis.
- C. abducted so the prosthesis does not become dislocated.
- D. adducted to prevent additional pain for the patient with turning.
Correct Answer: C
Rationale: Nursing interventions also involve postoperative maintenance of leg abduction by using an abduction splint for 7 to 10 days to prevent dislocation of the prosthesis. Leg abduction does not involve keeping the legs together, flexion to stabilize the prosthesis or to keep the legs adducted to prevent additional pain with turning.
Which is the main purpose of traction?
- A. Align and stabilize a fracture.
- B. Prevent deformities.
- C. Relieve muscle spasms.
- D. Promote bed rest.
- E. Increase circulation to the rest of the body.
Correct Answer: A,B,C
Rationale: Skin and skeletal traction provide alignment and stabilize a fracture. This prevents deformities. Traction may also be used to relieve muscle spasms. Traction is not used to promote bed rest or to increase circulation to the rest of the body.
The nurse takes into consideration that a healing fracture progresses through several healing stages. Which is the third healing stage?
- A. Development of fibrin meshwork
- B. Collagen fibers collect calcium
- C. Osteoblasts home fracture site form
- D. Callus
Correct Answer: A
Rationale: The healing stages of a fracture start with a clot formation, which leads to a hematoma. The development of a fibrin meshwork, which traps osteoblasts to keep the fracture site firm, vascularization, collagen fibers collect calcium to make the callus.
The nurse explains that the use of the brace allows a person with a cervical fracture to be mobile.
Correct Answer: halo
Rationale: Halo braces attach to the skull with pins, which stabilize a cervical vertebral fracture, allowing the patient to be mobile.
When reinforcing teaching the patient about osteoarthritis, the nurse should include which characteristic about osteoarthritis?
- A. will cause the formation of Heberden nodes.
- B. can involve other organs.
- C. results from wear and tear.
- D. may affect only one side of the body.
- E. may cause constitutional symptoms of fatigue and fever.
- F. will cause marked erythema and edema of hands.
Correct Answer: A,C,D
Rationale: Osteoarthritis is a disease caused by wear and tear of the joints, causing the appearance of Heberden nodes on the fingers without marked edema or erythema. The disease may only affect one side of the body. Osteoarthritis does not involve other organs and does not cause constitutional symptoms. Marked erythema and hand edema are not associated with osteoarthritis.