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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.
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An older client with diabetes is admitted with a heavily draining leg wound. The client's white blood cell count is 38,000/mm³ but the client is afebrile. What action does the nurse take first?
- A. Administer acetaminophen (Tylenol)
- B. Place the client on contact isolation
- C. Refer the client to the wound care nurse
- D. Obtain wound cultures
Correct Answer: C
Rationale: A heavily draining wound suggests potential infection, and the elevated white blood cell count supports this. Placing the client on contact isolation is the priority to prevent the spread of infection. Acetaminophen is unnecessary without fever, wound cultures follow isolation, and referral to a wound care nurse is secondary.
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 nurse sees clients in an osteoporosis clinic. Which client should the nurse see first?
- A. Client taking calcium with vitamin D (Os-Cal) who reports flank pain 6 weeks ago
- B. Client taking ibandronate (Boniva) who cannot remember when the last dose was
- C. Client taking raloxifene who reports leg swelling 6 weeks ago
- D. Client taking risedronate (Actonel) who reports occasional dyspepsia
Correct Answer: C
Rationale: Leg swelling in a client taking raloxifene suggests possible deep vein thrombosis, a serious adverse effect requiring immediate attention. Flank pain from 6 weeks ago is less urgent, forgetting a dose of ibandronate is not immediately critical, and dyspepsia with risedronate is a common side effect that can be managed later.
A client is admitted with a bone tumor. The nurse finds the client weak and lethargic with decreased deep tendon reflexes. What actions by the nurse are best? (Select all that apply.)
- A. Assess the daily serum calcium level
- B. Consult the provider about a loop diuretic
- C. Institute seizure precautions for the client
- D. Raise the head of the bed
- E. Place the client on a 1500 mL fluid restriction
Correct Answer: A,B,D
Rationale: Weakness, lethargy, and decreased reflexes suggest hypercalcemia, common in bone tumors. Assessing serum calcium, consulting for loop diuretics, and raising the head of the bed to promote safety are appropriate. Seizure precautions and fluid restrictions are not indicated.
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.