Nokea
Which will the home health nurse include monitoring for in the plan of care for an 82-year-old female with severe kyphosis from ankylosis?
- A. Urinary output
- B. Respiratory effort
- C. Sleep cycle
- D. Nutritional status
Correct Answer: B
Rationale: Severe kyphosis may hinder the patient's ability to expand the rib cage and interfere with easy respiration. Severe kyphosis due to ankylosis will not affect the urinary output or the sleep cycle. Nutritional status is not necessarily impaired from severe kyphosis.
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The nurse reinforces instructions for the patient who is to have a unicompartmental knee replacement that which is a major advantage of this partial knee replacement?
- A. the patient will be up and walking 2 to 3 hours after the operation.
- B. the kneecap is completely removed.
- C. the procedure is especially helpful in the treatment of rheumatoid arthritis (RA).
- D. a small titanium disk replaces the worn cartilage.
Correct Answer: A
Rationale: Unicompartmental knee arthroplasty is also referred to as partial knee replacement in which the worn cartilage is replaced with a plastic disk. It is not as invasive as a full knee replacement and does not disturb the kneecap so that the patient can be up and walking in 2 to 3 hours after surgery. It is not recommended for patients with Rheumatoid Arthritis.
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.
How is rheumatoid arthritis (RA) distinguished from osteoarthritis?
- A. Rheumatoid arthritis is an autoimmune, systemic disease; osteoarthritis is a degenerative disease of the joints.
- B. Rheumatoid arthritis is an autoimmune, degenerative disease; osteoarthritis is a systemic inflammatory disease.
- C. People with osteoarthritis are considered to be genetically predisposed; there is no known genetic component to rheumatoid arthritis.
- D. Osteoarthritis is often caused by a virus; viruses play no part in the pathogenesis of rheumatoid arthritis.
Correct Answer: A
Rationale: RA is thought to be a systemic, autoimmune disorder. Degenerative joint disease is also known as osteoarthritis.
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.
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.