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Which instruction will the nurse reinforce for a patient who is taking alendronate?
- A. Take drug with any meal.
- B. Take drug first thing in the morning.
- C. Drink at least $5 \mathrm{oz}$ of milk before taking drug.
- D. Take drug with an antacid to avoid heartburn.
Correct Answer: B
Rationale: Alendronate should be taken on an empty stomach first thing in the morning with $6 \mathrm{oz}$ of water, accompanied by no other medication. The patient should remain upright for 30 minutes after a dose to minimize risk of esophageal irritation.
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A patient has been casted to stabilize a fracture of the right radius and ulna. The nurse assesses a capillary refill of 5 seconds and cold fingers of the right hand. Which initial intervention should the nurse deploy?
- A. Notify the charge nurse of a probable compartment syndrome.
- B. Apply a warm compress to the fingers to relieve swelling.
- C. Elevate the right hand to heart level to maintain arterial pressure.
- D. Cut the cast off to release constriction.
Correct Answer: C
Rationale: The nurse should first elevate the right hand to heart level and notify the charge nurse. Permanent damage can occur in as little time as 6 hours. While the charge nurse does need to be notified it is most crucial to elevate the hand to heart level first. A warm compress would likely cause blood vessels to dilate, worsening the edema. The nurse cannot independently cut the cast off.
The 14-year-old boy who is scheduled for left leg amputation says to the nurse, 'What in the world am I going to do with only one leg?' Which is the nurse's therapeutic response?
- A. This is a tough thing to go through'
- B. With a prosthesis, you will be as good as new.'
- C. It is way too early to be concerned about that now.'
- D. When my brother had his leg removed, he did great!'
Correct Answer: A
Rationale: The patient's concern should be acknowledged and the patient encouraged to express feelings. Telling the patient he will be as good as new is false reassurance and does not further encourage the patient to express feelings. The patient IS concerned about having to deal with one leg; telling the patient it is way too early to be concerned is inappropriate and nontherapeutic. The nurse is changing the subject when talking about the brother who also had his leg removed.
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 division of the skeletal system that comprises the skull, hyoid, vertebral column, and thorax is the division.
Correct Answer: axial
Rationale: The axial division of the skeletal system is comprised of the skull, hyoid, vertebral column, and the thorax.
Which instructions should the nurse reinforce in a teaching plan for a person with gouty arthritis?
- A. Avoid excessive alcohol.
- B. Maintain rest and immobility while disease is symptomatic.
- C. Check urine and urine output for possible kidney stones.
- D. Include food high in purine in the diet.
- E. Use bed cradle to support linens.
Correct Answer: A,B,C,E
Rationale: The person with gout should avoid alcohol and food with high purine content, maintain rest and immobility while symptomatic, and check urine and urine output for possible kidney stones. A bed cradle keeps the linens off the patient's feet to promote comfort.