Nokea
Which of the following menu choices by a patient with osteoporosis indicates that the nurse's teaching about appropriate diet has been effective?
- A. Pancakes with syrup and bacon
- B. Whole wheat toast and fruit jelly
- C. Two-egg omelet and a half grapefruit
- D. Oatmeal with skim milk and fruit yogurt
Correct Answer: D
Rationale: Skim milk and yogurt are high in calcium. The other choices do not contain any high calcium foods.
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The nurse is caring for a patient following a laminectomy with a spinal fusion who reports numbness and tingling of the right lower leg. Which of the following actions should the nurse do first?
- A. Report the patient's symptoms to the surgeon.
- B. Check the vital signs for indications of hemorrhage.
- C. Turn the patient to the side to relieve pressure on the right leg.
- D. Document the findings and reassess the patient in two hours.
Correct Answer: A
Rationale: Numbness and tingling should be immediately reported to the surgeon rather than documented and rechecked in two hours. Numbness and tingling are not symptoms associated with hemorrhage at the site. Turning the patient will not relieve the numbness.
The nurse is caring for an older female adult patient who has a family history of osteoporosis and is diagnosed with osteopenia following densitometry testing. Which of the following explanations should the nurse provide when teaching the patient about osteoporosis?
- A. Estrogen replacement therapy must be started to prevent rapid progression to osteoporosis.
- B. Continuous, low-dose corticosteroid treatment is effective in stopping the course of osteoporosis.
- C. With a family history of osteoporosis, there is no way to prevent or slow gradual bone resorption.
- D. Calcium loss from bones can be slowed by increasing calcium intake and weight-bearing exercise.
Correct Answer: D
Rationale: Progression of osteoporosis can be slowed by increasing calcium intake and weight-bearing exercise. Estrogen replacement therapy does help prevent osteoporosis, but it is not the only treatment and is not appropriate for some patients. Corticosteroid therapy increases the risk for osteoporosis.
Which of the following assessment findings should alert the nurse to the presence of osteoporosis in an older adult patient?
- A. Measurable loss of height
- B. Presence of bowed legs
- C. Aversion to dairy products
- D. Statements about frequent falls
Correct Answer: A
Rationale: Osteoporosis occurring in the vertebrae produces a gradual loss of height. Bowed legs are associated with osteomalacia. Low intake of dairy products is a risk factor for osteoporosis, but it does not indicate that osteoporosis is present. Frequent falls increase the risk for fractures but are not an indicator of osteoporosis.
The nurse is preparing to administer alendronate to a patient with osteoporosis. Which of the following actions will the nurse implement initially?
- A. Ensure the patient has recently eaten.
- B. Ask about any leg cramps or hot flashes.
- C. Assist the patient to sit up at the bedside.
- D. Administer the prescribed calcium carbonate.
Correct Answer: C
Rationale: To avoid esophageal erosions, the patient taking bisphosphonates should be upright for at least 30 minutes after taking the medication. Fosamax should be taken on an empty stomach, not after taking other medications or eating. Leg cramps and hot flashes are not adverse effects of bisphosphonates.
Which of the following statements by a patient with osteosarcoma of the right tibia who is scheduled for an above-the-knee amputation indicates that patient teaching is needed?
- A. I did not have this bone cancer until my leg broke a week ago.
- B. I wish that I did not have to have chemotherapy after this surgery.
- C. I know that I will need to participate in physical therapy after surgery.
- D. I will use the patient-controlled analgesia (PCA)
Correct Answer: A
Rationale: The statement that the patient did not have bone cancer until the leg broke indicates a misunderstanding, as osteosarcoma is a primary bone cancer that may lead to fractures, not vice versa. The other statements reflect appropriate understanding of the need for chemotherapy, physical therapy, and pain management post-surgery.