Nokea
Which does prolonged bed rest put the older adult at risk for?
- A. Ankylosing spondylitis
- B. Pathologic fractures
- C. Osteomyelitis
- D. Gout
Correct Answer: B
Rationale: Immobilization results in bone resorption, and the bone tissue becomes less dense. Prolonged bed rest puts the patient at risk for pathologic fracture. This is a serious concern for an older adult in terms of regaining mobility.
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The patient has been diagnosed as having gouty arthritis. The patient asks the nurse to explain the cause of the inflammation of the great toe. Which is the appropriate nursing response?
- A. You have calcium oxalate deposits that are seen in gouty arthritis.'
- B. The inflammation is from small accumulations of uric acid crystals, which are called tophi.'
- C. The small nodules are not related to the arthritis condition.'
- D. You have fat deposits that are common with gouty arthritis.'
Correct Answer: B
Rationale: Gout is a metabolic disease resulting from an accumulation of uric acid in the blood. It is an acute inflammatory condition associated with ineffective metabolism of purines. Although some patients with gout also have kidney stones, and some kidney stones are caused by calcium oxalate deposits, gout is not caused from calcium oxalate deposits. A patient with gout usually has excruciating pain, edema and inflammation in the affected joint, not small nodules. Fat deposits are not associated with gouty arthritis.
Which patient is most likely to develop osteoporosis?
- A. 43-year-old African American woman
- B. 57-year-old white woman
- C. 48-year-old African American man
- D. 62-year-old Latino woman
Correct Answer: B
Rationale: White women have a higher incidence of osteoporosis than Asian women, followed by African American women and Hispanic women.
In order for a patient to flex the lower leg, which muscle must be contracted?
- A. Quadriceps
- B. Gastrocnemius
- C. Biceps femoris
- D. Rectus femoris
Correct Answer: C
Rationale: The contraction of the biceps femoris allows for the contraction of the lower leg.
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.
The nurse explains to a patient who has had a hip replacement that warfarin is prescribed for which reason?
- A. increase the red blood cells.
- B. reduce the threat of hemorrhage.
- C. prevent formation of emboli.
- D. help stabilize the prosthesis.
Correct Answer: C
Rationale: Warfarin is a standard postsurgical drug to prevent the formation of emboli. Warfarin does not increase red blood cells. The risk of hemorrhage is higher when an anticoagulant is taken. Warfarin does not help stabilize the prosthesis.