Nokea
When a patient recovering from a fractured tibia asks what callus formation is, the nurse provides which explanation?
- A. when blood vessels of the bone are compressed.
- B. a part of the bone healing process after a fracture when new bone is being formed over the fracture site.
- C. the formation of a clot over the fracture site.
- D. when the hematoma becomes organized and a fibrin meshwork is formed.
Correct Answer: B
Rationale: Callus formation occurs when the osteoblasts continue to lay the network for bone buildup and osteoclasts destroy dead bone. In compartment syndrome, blood vessels are compressed. Clot formation and hematoma organization occur in different phases of the bone healing process.
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Forty-eight hours after a patient sustained a fractured femur in a car accident, the nurse notes the patient has a pulse of 110, respirations at 25, labored respirations and crackles in both lung fields. The nurse immediately reports to the charge nurse the probability of which disorder?
- A. impending pneumonia.
- B. atelectasis.
- C. fat embolism.
- D. anxiety attack.
Correct Answer: C
Rationale: A pulmonary fat embolism involves the embolization of fat tissue with platelets and circulation of free fatty acids within the pulmonary circulation. Dyspnea, tachypnea, and chest pain are symptomatic of a fat embolus. These signs are not associated with impending pneumonia or atelectasis. The patient is undergoing a major complication; this is not an anxiety attack.
A patient who has had a right below the knee amputation continues to complain of unpleasant sensation in the right foot. Which explanation will the nurse provide about this 'phantom pain'?
- A. It only exists in the mind.
- B. It is a complication following an amputation and can be clarified by the surgeon.
- C. It is related to the severed nerves that are still sending messages to the brain.
- D. It occurs when the person becomes focused on the loss of the limb.
Correct Answer: C
Rationale: Phantom pain (pain felt in the missing extremity as if it were still present) may occur and be frightening to the patient. Phantom pain occurs because the nerve tracts that register pain in the amputated area continue to send a message to the brain (this is normal). It is an actual problem and does not 'exist only in the mind'. The nurse can answer this question about phantom pain. Phantom pain does not occur when the patient becomes focused on limb loss.
A 16-year-old male patient presents in the emergency room with a pathologic fracture of the left femur and complains of pain on weight-bearing. These are common indicators of which disorder?
- A. osteogenic sarcoma.
- B. osteoporosis.
- C. rheumatoid arthritis.
- D. osteochondroma.
Correct Answer: A
Rationale: Osteogenic sarcoma occurs in young men aged 10 to 25. They are malignant bone tumors that can cause a pathologic fracture and they are accompanied by pain on weight-bearing. Osteoporosis is a disorder that results in loss of bone density. Rheumatoid arthritis is a systemic inflammatory autoimmune disease. Osteochondromas are benign and usually do not cause fractures.
Calcium is a mineral found in many foods that can slow bone loss during the aging process. Which food is high in calcium?
- A. Oranges
- B. Bananas
- C. Spinach
- D. Eggs
Correct Answer: C
Rationale: Spinach and green vegetables, as well as yogurt, are considered calcium-rich foods. Fresh oranges, bananas, and eggs are not good calcium choices.
The nurse administering the drug colchicine for gout will give $0.5 \mathrm{mg}$ hourly for hours.
Correct Answer: 12
Rationale: Colchicine is given orally in a dose of $0.5 \mathrm{mg}$ for a period of 12 hours or until relief from pain is achieved or diarrhea occurs.