Nokea
Which will the nurse stress to a patient who has had a knee replacement and is beginning strengthening exercises for the unaffected leg?
- A. Flex the knee and flex the foot.
- B. Lift the leg from the mattress and rotate the foot.
- C. Pull knee to chest and extend the foot.
- D. Push foot down against the footboard for a count of five.
Correct Answer: D
Rationale: The unaffected leg should be strengthened by pushing the foot down against the footboard for a count of five and repeating frequently during the day.
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Which foods should the home health nurse suggest for the patient with osteoporosis to help slow the disease?
- A. Leafy green vegetables
- B. Foods high in sodium
- C. Tea and coffee
- D. Vitamin A
Correct Answer: A
Rationale: To slow the bone loss, a patient with osteoporosis should eat green leafy vegetables, such as spinach and turnip greens, foods low in sodium, and avoid caffeine. Vitamin D helps with the absorption of calcium and stimulates bone formation.
A patient has undergone a bipolar hip repair (hemiarthroplasty). Which is the appropriate instruction?
- A. Sit in whatever position is most comfortable.
- B. Sit in a firm, straight-backed chair at a 90-degree angle.
- C. Avoid crossing the legs.
- D. Begin full weight-bearing as soon as tolerated.
Correct Answer: C
Rationale: Instructing the patient not to cross the legs is important because crossing the legs can adduct the affected extremity and dislocate the hip. The patient should have the head of the bed elevated to a maximum of 45 degrees to avoid acute flexion of the hip and strain on the fixation device. The patient will have limited weight bearing for the amount of time specified by the surgeon. This may be as long as 3 months post surgery.
When reinforcing teaching the patient about osteoarthritis, the nurse should include which characteristic about osteoarthritis?
- A. will cause the formation of Heberden nodes.
- B. can involve other organs.
- C. results from wear and tear.
- D. may affect only one side of the body.
- E. may cause constitutional symptoms of fatigue and fever.
- F. will cause marked erythema and edema of hands.
Correct Answer: A,C,D
Rationale: Osteoarthritis is a disease caused by wear and tear of the joints, causing the appearance of Heberden nodes on the fingers without marked edema or erythema. The disease may only affect one side of the body. Osteoarthritis does not involve other organs and does not cause constitutional symptoms. Marked erythema and hand edema are not associated with osteoarthritis.
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.
A patient's patellar-femoral cartilage has deteriorated due to arthritis. The medial and lateral cartilage is undamaged. This patient is likely to undergo partial or knee replacement surgery.
Correct Answer: unicompartmental
Rationale: Unicompartmental knee arthroplasty is also referred to as partial knee replacement and is performed on patients who have only one of the compartments of the knee affected by arthritis.