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Which will the nurse stress to a patient, who recently had a hip replacement, in quadriceps setting exercises?
- A. Push knee down to mattress and raise heel off the bed.
- B. Flex knee and extend foot.
- C. Adduct leg and flex foot.
- D. Lift leg and heel off the bed.
Correct Answer: A
Rationale: Pushing the knee down into the mattress and raising the heel will strengthen the quadriceps muscles. Flexing the knee and extending the foot will not strengthen the quadriceps muscles. Likewise, adducting the legs and flexing the knee will not strengthen the quadriceps muscles.
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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.
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.
Which action should the nurse take when a patient with osteomyelitis of the right forearm is admitted with an open wound that is draining?
- A. Enforce a low-calorie diet.
- B. Initiate drainage and secretion precautions.
- C. Frequently do passive ROM on the elbow.
- D. Ambulate several times daily.
Correct Answer: B
Rationale: The patient with osteomyelitis should be at least in drainage and secretion precaution. The limb should be positioned for maximum comfort and left at rest. These patients are usually on bed rest and require a high-calorie, high-protein diet.
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 56-year-old patient is being seen for osteoarthritis of the knee in the clinic. Which should the nurse recommend when discussing strengthening exercises?
- A. Jogging
- B. Walking rapidly on a treadmill
- C. Bicycling
- D. Aerobic exercises
Correct Answer: C
Rationale: Bicycling or swimming is recommended for osteoarthritis of the hip or knee. Jogging would put undue stress on knee joints. Climbing stairs should be avoided. Walking should be done on level ground, not up or down elevations.