When reviewing the chart of a 25-year-old male, the nurse reads that the client was diagnosed with an osteosarcoma of the distal femur. Which statement indicates the nurse's correct interpretation of the client's diagnosis?
- A. The tumor originated elsewhere in the client's body and metastasized to the bone.
- B. Osteosarcoma is the most common and most often fatal primary malignant bone tumor.
- C. The only treatment for osteosarcoma is a leg amputation well above the tumor growth.
- D. The tumor is nonmalignant;it can be excised and the bone replaced with a bone graft.
Correct Answer: B
Rationale: B. Osteosarcoma is a malignant primary tumor of the bone, appearing most frequently in males between 10 and 25 years (when bones grow rapidly). Prognosis depends on whether the tumor has metastasized to the lungs, but it is often fatal.
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When planning the client's discharge, the nurse must help the client obtain which essential piece of equipment for home care?
- A. A wheelchair
- B. A hospital bed
- C. A raised toilet seat
- D. A mechanical lift
Correct Answer: C
Rationale: A raised toilet seat maintains hip angles below 90 degrees, preventing dislocation during toileting, which is essential for safe home care post-hip replacement.
What is the expected Glasgow Coma Scale score for a child with a mild head injury?
- A. A score of 0 is not possible on the Glasgow Coma Scale. The lowest possible score is 3.
- B. A score of 3 on the Glasgow Coma Scale indicates that the child has an absent eye opening, verbal, and motor response. This score is not expected with a mild head injury.
- C. A score of 10 on the Glasgow Coma Scale indicates an altered eye opening, verbal, or motor response and would not be expected with a mild head injury.
- D. Glasgow Coma Scale scores range from 3 (no response) to 15 (normal response). A score of 15 indicates that brain function is intact. A child with a mild head injury should have intact neurological function.
Correct Answer: D
Rationale: A score of 15 on the Glasgow Coma Scale indicates intact neurological function, expected in a mild head injury.
During a physical exam on the 18-month-old, the nurse observes genu varum. What should the nurse do?
- A. Document the finding as normal
- B. Report this finding to the HCP
- C. Teach the parents about rickets
- D. Prepare the parent about using braces
Correct Answer: A
Rationale: Genu varum (bowlegs) is a normal finding in children up to 2 years old and should be documented as normal.
The nurse knows that elderly women have a high incidence of hip fracture for which reason?
- A. Decreased progesterone secretion
- B. Decreased mobility due to arthritic conditions
- C. Increased calcium absorption
- D. Osteoporosis in the skeletal structure
Correct Answer: D
Rationale: Osteoporosis, common in elderly women, weakens bones, increasing hip fracture risk.
Which intervention(s) should the nurse include in the child's plan of care immediately following insertion of a ventriculoperitoneal (VP) shunt for treatment of hydrocephalus?
- A. Maintain the head of the bed in an elevated position.
- B. Ensure that the child minimizes movement of the extremities.
- C. Provide a pressure dressing over the cephalic insertion site.
- D. Maintain a flat position and reposition the child every 2 hours.
Correct Answer: D
Rationale: Maintaining a flat position and repositioning every 2 hours helps prevent complications and ensures shunt function post-VP shunt insertion.
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