Musculoskeletal nursing

Card Set Information

Author:
Anonymous
ID:
249896
Filename:
Musculoskeletal nursing
Updated:
2013-11-30 20:32:10
Tags:
Musculoskeletal nursing
Folders:
Med,surg
Description:
Musculoskeletal nursing
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user Anonymous on FreezingBlue Flashcards. What would you like to do?


  1. Osteomyelitis
    infection and inflammation of the bone or bone marrow
  2. Osteopenia is present when the T-score is ...
    < −1 but above −2.5
  3. Osteoporosisis diagnosed in a person who has a T-score at or lower than ...
    −2.5
  4. Medicare reimburses for BMD (Bone Mineral Density) testing every 2 years in people age 65 years and older who:
    • Are estrogen deficient
    • Receive long-term steroid therapy
    • Have hyperparathyroidism
    • Are being monitored while on osteoporosis drug therapy
  5. Although estrogen does not build bone, it ...
    helps prevent bone loss
  6. Primary osteoporosis is more common ando ccurs in ...
    postmenopausal women and in men in their seventh or eighth decade of life.
  7. Secondary osteoporosis may result from other medical conditions, such as ...
    • hyperparathyroidism
    • long-term drug therapy, such as with corticosteroids
    • prolonged immobility, such as that seen with spinal cord injury
  8. Regional osteoporosis, an example of secondary disease, occurs when ...
    a limb is immobilized related to a fracture, injury, or paralysis. Immobility for longer than 8 to 12 weeks can result inthis type of osteoporosis.
  9. The focus of osteoporosis prevention is to decrease modifiable risk factors ...
    • Ensure adequate calcium intake.
    • Avoid sedentary lifestyle.
    • Continue program of weight-bearing exercises.
  10. Tool for measuring bone mineral density (BMD) ...
    dual x-ray absorptiometry (DXA). The spine and hip are most often assessed.

    Quantitative computed tomography (QCT) can also measure bone density. This procedure analyzes trabecular and cortical bone separately and is especially sensitive to changes in the vertebral column. The test is more expensive than the DXA scan and exposes the patient to more radiation.

    Qualitative ultrasound (QUS) of the heel is an effective and low-cost screening tool that can detect osteoporosis and predict risk for hip fracture. The test requires no special preparation, is quick, and has no radiation exposure or specific follow-up care
  11. Nutrition needed for bone formation
    • Adequate amounts of protein
    • magnesium
    • vitamin K
    • trace minerals
    • Calcium
    • vitamin D
  12. Intake of calcium alone is not a AAA for osteoporosis, but calcium is an important part of a BBB program to promote bone health.
    • A) treatment
    • B) prevention
  13. Estrogen replacement therapy (ERT) and hormone replacement therapy (estrogen and progesterone) (HRT) have previously been used as ...
    primary prevention strategies for reducing bone loss in the postmenopausal woman.
  14. AAA slow bone resorption by binding with crystal elements in bone, especially spongy, trabecular bone tissue.
    Bisphosphonates (BPs)
  15. The selective estrogen receptor modulators (SERMs) are a class of drugs designed to mimic estrogen in some parts of the body while blocking its effect elsewhere. AAA is currently the only approved drug in this class and is used for prevention and treatment of osteoporosis in postmenopausal women.
    A) Raloxifene (Evista)
  16. Raloxifene (a AAA) increases BBB, reduces bone resorption, and reduces the incidence of osteoporotic vertebral fractures. The drug should not be given to women who have a history of CCC.
    • A) selective estrogen receptor modulators (SERMs)
    • B) bone mineral density (BMD)
    • C) thromboembolism
  17. Calcitonin is a thyroid hormone that inhibits osteoclastic activity, thus decreasing bone loss. It is used for the AAA of osteoporosis, Paget's disease, and hypercalcemia associated with cancer.
    A) treatment
  18. AAA is the injection of bone cement into the vertebral body to reduce a fracture or fill the space created by osteoporosis.
    Vertebroplasty
  19. AAA includes the use of a balloon in the vertebral body to contain the bone cement. These procedures greatly reduce pain and increase function in patients with back pain related to osteoporosis.
    Kyphoplasty
  20. AAA is loss of bone related to a BBB deficiency. It causes softening of the bone caused by inadequate deposits of calcium and phosphorus in the bone matrix. Normal remodeling of the bone is disrupted, and calcification does not occur. AAA is the adult equivalent of CCC, or BBB deficiency, in children.
    • A) Osteomalacia
    • B) vitamin D
    • C) rickets
  21. The minimum recommended daily allowance (RDA) of vitamin D is AAA international units. Because older adults are at risk for bone demineralization from aging, as well as for osteomalacia, they may need as much as BBB international units daily.
    • A) 400
    • B) 800
  22. The major treatment for osteomalacia is ...
    vitamin D
  23. Paget'sdisease, or AAA, is a chronic metabolic disorder inwhich bone is excessively broken down (osteoclastic activity) and re-formed (osteoblastic activity). The result is bone that is structurally disorganized, causing bones to be weak with increased risk forbowing of long bones and fractures.
    A) osteitis deformans
  24. When performing a musculoskeletal assessment in a patient with Paget's disease, pay particular attention to the ...
    size and shape of the skull, which is typically soft, thick, and enlarged.
  25. In Paget's pts pressure from an enlarged temporal bone may lead to ...
    deafness and vertigo (dizziness).
  26. Basilar (in the occipital area) complications in AAA can compress any of the cranial nerves and result in neurologic problems. Assess the patient for changes in BBB.
    • A) Paget's pts
    • B) vision, swallowing, and speech
  27. AAA, or basilar invagination, causes BBB that threatens life in CCC.
    • A) Platybasia
    • B) brainstem (vital sign center) damage
    • C) Paget's pts.
  28. Insome cases, Paget'sa causes bony enlargement of the skull which blocks AAA, resulting in BBB.
    • A) cerebrospinal fluid (CSF)
    • B) hydrocephalus
  29. Radionuclidebone scan may be most sensitive in detecting Paget's disease. A radiolabeled AAA is injected IV and shows pagetic bone in areas of high bone turnover activity.
    A) bisphosphonate
  30. When the calcium level is more than twice the normal value and the disease [Paget's] is widespread, the health care provider usually prescribes more potent drugs, such as selected ...
    bisphosphonates
  31. Administration of all biphosponates for AAA ot BBB is CCC.
    • A) osteoporosis
    • B) Paget's disease
    • C) Empty stomach, first thing in morning, full glass of water, 30 minutes before food, drink or other drugs, and remain upright (sitting/standing) for 30 minutes after taking.
  32. Six bisphosphonates are approved for use in the United States for treatment of Paget's disease. AAA and BBB are most commonly used. CCC and DDD are prescribed less often. These four drugs are oral preparations and require the same nursing considerations during administration as described in osteoporosis use.
    • A) Alendronate (Fosamax)
    • B) risedronate (Actonel)
    • C) Etidronate (Didronel)
    • D) tiludronate (Skelid)
  33. Two newer drugs have been approved for the treatment of Paget's disease when the oral agents are not effective. AAA and BBB are administered IV. Aredia is given once every 3 months, and Reclast is given once a year as a single IV dose.
    • A) Pamidronate (Aredia)
    • B) zoledronic acid (Reclast)
  34. AAA is a hormone that seems to reduce bone resorption and, subsequently, relieve pain. The drug often causes adramatic decrease in the alkaline phosphatase level in a few weeks.
    A) Calcitonin
  35. AAA is a potent chemotherapeutic agent with many side effects. It is reserved for patients with severe disease and neurologic compromise or marked hypercalcemia. Plicamycin is thought to block the effects of parathyroid hormone on osteoclasts.
    A) Plicamycin (Mithracin)
  36. Paget’s Disease: Surgical Management
    Tibial osteotomy

    Partial or total joint replacement

    Surgical decompression and stabilization of the spine
  37. Bone pain is described as AAA.
    a constant, localized, pulsating sensation that worsens with movement.
  38. Acute osteomyelitis often has a fever over 101F(38C) but older adults may not have an extreme temperature elevation because of ...
    lower core body temperature and compromised immune system that occur with normal aging.
  39. In addition to systemic drug therapy for osteomyelitis, the wound ...
    may be irrigated, either continuously or intermittently, with one or more antibiotic solutions.
  40. A treatment to increase tissue perfusion for patients with chronic, unremitting osteomyelitis is the use of a AAA therapy.
    A) hyperbaric chamberor portable device to administer hyperbaric oxygen (HBO)
  41. Because bone cannot heal in the presence of necrotic tissue caused by osteomyelitis, a AAA may be performed to débride the necrotic bone and allow revascularization of tissue.
    A) sequestrectomy
  42. With chronic osteomyelitis, fever may be AAA and BBB.
    • A) low grade
    • B) occur in the afternoon or evening
  43. Perform gentle ROM to joints ...
    above and below the affected part
  44. After a sequestrectomy performed to débride the necrotic bone resulting from osteomyelitis check for signs of neurovascular compromise, including AAA thru EEE. If any of these findings occur, report them immediately to the surgeon.
    • pain that cannot be controlled
    • paresis or paralysis (weakness or inability to move)
    • paresthesias (abnormal, tingling sensation)
    • pallor
    • pulselessness
  45. The major classifications of benign bone tumors include AAA, BBB and CCC.
    • A) chondrogenic tumors (from cartilage)
    • B) osteogenic tumors (from bone)
    • C) fibrogenic tumors (from fibrous tissue and found most often in children).
  46. The AAA, is a lesion of mature hyalinecartilage affecting primarily the hands and the feet. This giant cell tumor is aggressive and although classified as benign, it can BBB.
    • A) chondroma, or endochondroma
    • B) metastasize to the lung
  47. Benign bone tumor interventions:
    • Nondrug pain-relief measures
    • Drug therapy (analgesics, NSAIDs)
    • Surgical therapy (curettage, joint replacement, and less often arthrodesis - fused)
  48. AAA, is the most common type of primary malignant bone tumor.
    Osteosarcoma, or osteogenic sarcoma
  49. Primary tumors of the AAA thru EEE are called bone-seeking cancers because they spread to the bone more often than other primary tumors. The FFF thru III are the bone sites commonly affected.
    • A) prostate
    • B) breast
    • C) kidney
    • D) thyroid
    • E) lung

    • F) vertebrae
    • G) pelvis
    • H) femur
    • I ribs
  50. Pathologic fractures caused by metastatic bone are a major concern in patient care management. The most commonly affected areas for fracture are the AAA and BBB.
    • A) acetabulum
    • B) the proximal femur
  51. Chemotherapy seems to work best for AAA and may be administered BBB surgery.
    • A) small, metastatic tumors
    • B) before or after
  52. AAA is removal of the lesion surrounded by an intact cuff of normal tissue and leads to cure of BBB. A radical resection includes removal of the lesion, the entire muscle, bone, and other tissues directly involved. It is the procedure used for CCC.
    • A) Wide excision
    • B) low-grade (bone) tumors only
    • C) high-grade tumors
  53. AAA used when large bone defects from tumor removal result, can be taken from the iliac crest, rib, or fibula with adjacent tendons and ligaments. These are harvested from cadavers and can be frozen or freeze-dried for a prolonged period.
    Allografts
  54. With allografts weight bearing is prohibited until there is evidence that the graft is ...
    incorporated into the adjacent bone tissue
  55. AAA, or deformity, is a slowly progressive thickening of the palmar fascia, resulting in flexion contracture of the fourth (ring) and fifth (little) fingers of the hand. The third or middle finger is occasionally affected. Although AAA is a common problem, the cause is unknown. It usually occurs in older Euro-American men, tends to occur in families, and can be bilateral.
    Dupuytren's contracture
  56. A AAA is a round, benign cyst, often found on a wrist or foot joint or tendon.
    ganglion
  57. The AAA deformity is a common foot problem in which the great toe drifts laterally at the first metatarsophalangeal
    hallux valgus
  58. AAA, or plantar digital neuritis, a small tumor grows in a digital nerve of the foot.
    Morton's neuroma
  59. AAA is most common in the BBB lateral thoracic area. Curvature of greater than CCC degrees results in an CCC, and curvature of greater than DDD degrees in the thoracic spine results in DDD.
    • A) Scoliosis
    • B) right
    • C) 50 - unstable spine
    • D) 60 - compromise of cardiopulmonary function
  60. Exact cause of scoliosis is not well understood. The process may result from some problem in the AAA
    balance mechanism located in the central nervous system
  61. Methods of managing adult scoliosis differ from those used for children. The adult spinal column is less flexible and therefore less likely to respond to exercises, weight reduction, bracing, and casting for correction of the deformity. In the adult, the disorder is progressive and can result in an additional AAA.
    one degree of deviation each year
  62. The patient is diagnosed with possible osteoporosis. Which diagnostic tests do you anticipate will be ordered? (Select all that apply.)

    A. Sodium
    B. Phosphorus
    C. Serum calcium
    D. Electrocardiogram
    E. Thyroid function tests
    F. 24-hour urine collection
    G. Dual x-ray absorptiometry (DXA)
    B, C, E, F, G

    All tests listed, except for ECG and sodium, are tests used to gather information about the bones, or in the case of thyroid function tests, to check for hyperthyroidism.
  63. The patient is diagnosed with osteoporosis. Which intervention would be appropriate?

    A. Tell her to include high-impact activities, such as running, in her exercise regimen.
    B. Teach her to cut down on her cigarette-smoking.
    C. Suggest a diet that is high in protein and calcium but low in vitamin D.
    D. Recommend walking for 30 minutes 3 to 5 times a week.
    D. Recommend walking for 30 minutes 3 to 5 times a week.

    The single most effective exercise for osteoporosis iswalking 30 minutes 3 to 5 times a week. Patients should include increased vitamin D along with calcium in the diet. Smoking should be avoided as should high-impact exercises, which may cause vertebral compression fractures.
    (this multiple choice question has been scrambled)
  64. Which patient statement about self-care indicates a need for further teaching by the nurse?

    A. “I am going to swim at the YWCA.”
    B. “My husband is getting rid of our throw rugs.”
    C. “Low-fat yogurt is on my grocery list.”
    D. “Joining a bowling team will help me exercise.”
    D. “Joining a bowling team will help me exercise.”

    Bowling should be avoided for patients with osteoporosis because it can contribute to compression fractures. Swimming, eating yogurt, and eliminating throw rugs in the house are all appropriate things to consider for the patient with osteoporosis.
    (this multiple choice question has been scrambled)
  65. 1.The provider orders calcium 1.5 g orally twice a day (1 g in the morning and 500 mg at bedtime). The patient asks why she must drink extra fluids with this medication. What is your best response?

    2.The patient also asks why she can’t just take the calcium once a day. What is your best response?
    1.Increased fluid intake helps prevent the formation of calcium-based urinary stones.

    2.A third of the daily dose should be given at bedtime because calcium is most readily utilized by the body when the patient is fasting and immobile.
  66. What are the odds of a woman over the age of 50 breaking a bone because of osteoporosis?

    A. 1 out of 5
    B. 1 out of 10
    C. 1 out of 7
    D. 1 out of 2
    D. 1 out of 2

    One in two women over the age of 50 will break a bone because of osteoporosis. A woman’s risk of breaking a hip due to osteoporosis is equal to her risk of breast, ovarian, and uterine cancer combined. Women have lighter, thinner bones than men. Many women also lose bone quickly after menopause. Up to one in four men over the age of 50 will break a bone because of osteoporosis. A man older than age 50 is more likely to break a bone due to osteoporosis than he is to get prostate cancer.
    (this multiple choice question has been scrambled)
  67. The patient who is taking alendronate (Fosamax) is at high risk for developing which disorder?

    A. Breast cancer
    B. Stroke
    C. Cardiovascular disease
    D. Inflammation of the esophagus
    D. Inflammation of the esophagus

    Esophagitis and esophageal ulcers have beenreported with use of all of the bisphosphonates. The other answer selectionsapply to hormone replacement therapy.
    (this multiple choice question has been scrambled)
  68. A patient with Paget’s disease is at greatest risk for developing:

    A. Cardiac failure
    B. Chronic fatigue syndrome
    C. Kidney stones
    D. Pathologic bone fractures
    D. Pathologic bone fractures

    Pathologic fractures may be the presenting clinical manifestation of the disorder. The femur and the tibia are most often affected, and fracture of these bones can result from minimal trauma. Patients with Paget’s disease frequently are fatigued and, although less common, may develop renal stones, gout, and heart failure.
    (this multiple choice question has been scrambled)
  69. An expected outcome of an older patient with acuteosteomyelitis is:

    A. Elevated leukocyte count
    B. Low-grade fever
    C. Pain
    D. Fatigue
    B. Low-grade fever

    Common presenting symptoms of osteomyelitis are pain, fever, edema, elevated leukocyte count, fatigue, and general malaise. However, older adults may not have an extreme temperature elevation because of lower core body temperature and compromised immune system that occur with normal aging.
    (this multiple choice question has been scrambled)
  70. A client is placed on risedronate (Actonel) 35 mg for management of Paget’s disease of the bone. Which statement by the client indicates a need for further teaching?

    A. “I am taking this pill to prevent more bone loss.”
    B. “I have to take this pill faithfully every week.”
    C. “I am going to take this pill with food in the morning.”
    D. “I need to see my dentist before I start this drug.”
    B. “I have to take this pill faithfully every week.”

    For Paget’s disease, Actonel is usually prescribed daily (but at 30mg qday, not 35) for 2 months and then possibly repeated, depending on the results of laboratory values.

    B is incorrect. The medication does slow the rate of bone resorption and new bone formation.

    C is incorrect. The patient should have an oral assessment and preventive dentistry before beginning bisphosphonates therapy. In addition, the patient should alert the dentist regarding use of bisphosphonates before tooth extraction, implant, or other invasive procedures.

    D is incorrect. Medication should be taken in the morning with 6 to 8 ounces of water at least 30 minutes before eating. Warn against lying down after taking the medication to prevent severe heartburn or reflux.
    (this multiple choice question has been scrambled)
  71. What is the priority nursing diagnosis for the older adult diagnosed with bone cancer that has metastasized from the lungs?

    A. Risk for Injury related to weakness and drug therapy
    B. Impaired Physical Mobility related to weakness and fatigue
    C. Altered Self-Esteem related to fear of death and dying
    D. Chronic Pain related to tumor invasion and nerve involvement
    D. Chronic Pain related to tumor invasion and nerve involvement

    As with many forms of cancer, the priority diagnosis will focus on Acute Pain and Chronic Pain related to physical injury (direct tumor invasion into soft tissue and nerves). The patient, if possible, is expected to direct actions focused on pain management. The patient is instructed to identify onset of pain, recognize alleviating factors such as repositioning, use analgesics appropriately, and partake in alternatives to medication such as relaxation techniques, music therapy, meditation, and biofeedback. If the patient is unable to direct the care, family members need to be educated in methods to alleviate pain.
    (this multiple choice question has been scrambled)
  72. During the assessment of a 67 year-old female w/ osteoporosis, the nurse discovers that the patient does not take estrogen. What are contraindications or precautions if the physician decides to place her on estrogen replacement therapy?
    Thromboembolic disease, tumors, hypertension, or liver or gallbladder disease
  73. The 67 year-old female patient w/ osteoporosis says that she does not like milk and rarely drinks it. How could she increase her calcium intake?
    Encourage increased calcium intake through the following sources: natural calcium sources, such as oyster shells; over-the-counter calcium sources, such as TUMS; calcium citrate; foods rich in calcium, such as dairy products (cheese) and dark green leafy vegetables
  74. The health care provider suspects osteoporosis. What test is most likely to be ordered and what should the nurse tell the patient about the test?
    The most commonly used screening and diagnostic tool for measuring bone mineral density (BMD) is dual x-ray absorptiometry (DXA). The spine and hip are most often assessed. Many physicians recommend that women in their 40s have a baseline DXA scan so that later bone changes can be detected and compared. DXA is a painless scan that emits less radiation than a chest x-ray. It is the best tool currently available for a definite diagnosis of osteoporosis.
  75. The patient (67 year-old female patient w/ osteoporosis) is given a prescription for alendronate (Fosamax). What should the nurse tell her before she begins therapy with this drug?
    Contraindications include reduced renal function, hypocalcemia, and gastrointestinal reflux disease (GERD). This drug needs to be taken early in the morning with 8 ounces of water, but she should wait 30 minutes before eating. It is important to remain upright during this 30-minute period before eating to prevent esophageal irritation. If chest pain, a sign of esophageal irritation, occurs, the patient should discontinue the drug and notify her health care provider.
  76. Situation: Your patient is a 57-year-old man with metastatic bone cancer. It has been determined that the primary site of the cancer was his prostate. He is beginning chemotherapy. You are the nurse providing the education for him. He asks how chemotherapy works. Which of these statements will you include? Select all that apply.

    A. Chemotherapy is useful because its effects are systemic.
    B. The physician may prescribe chemotherapy alone or in combination with radiation or surgery.
    C. Chemotherapy has some selectivity for killing cancer cells over normal cells.
    D. Normal cells that divide rapidly are those most affected by chemotherapy.
    A, B, C and D

    Normal cells most affected are those that divide rapidly, including skin, hair, intestinal tissue, spermatocytes, and blood-forming cells.
  77. Situation: Your patient is a 57-year-old man with metastatic bone cancer. It has been determined that the primary site of the cancer was his prostate. He is beginning chemotherapy. You are the nurse providing the education for him. The chemotherapy drug is selected based on what criteria? Select all that apply.

    A. Based on universally accepted protocols
    B. Based on known tumor sensitivity
    C. Based on the primary source
    D. Based on the degree of side effects expected
    B, C and D

    At present, there are no universally accepted protocols. Drugs are selected, in part, based on primary source; for example, treatment for breast cancer metastasis may include estrogen. Selection is based on sensitivity and degree of side effects; for example, most chemotherapy drugs suppress bone marrow and immune function, with some agents having a greater effect than others.
  78. Situation: Your patient is a 57-year-old man with metastatic bone cancer. It has been determined that the primary site of the cancer was his prostate. He is beginning chemotherapy. You are the nurse providing the education for him. How is pain managed in the patient with metastatic bone disease? Select all that apply.

    A. Use of analgesics
    B. Recognition of pain onset
    C. Use of nonanalgesics
    D. Chemotherapy to cause tumor regression
    All

    In addition to analgesics used for pain, chemotherapy and radiation are often administered to cause tumor regression.
  79. Situation: Drugs such as Os-Cal are some of the most cost-effective supplement formulas. Calcium citrate, available OTC as Citracal, is often recommended for those who experience gastric upset when taking a calcium supplement. What patient teaching should you do to ensure that she is taking this supplement correctly? Select all that apply.

    A. Take the medication with food and 6 to 8 ounces of water.
    B. Citracal should be taken at bedtime.
    C. It is best to divide the daily dose, with one third of the daily dose taken at bedtime.
    D. The medication should not be taken with food because it blocks absorption.
    A, B and C

    Teach patients to take calcium supplements with food and 6 to 8 ounces of water, although Citracal can be taken anytime. It is best to divide the daily dose, with at least one third of the daily dose being taken in the evening.
  80. Situation: Your patient is a 56-year-old female diagnosed with osteoporosis. She has not experienced bone fractures but wants to get a "head start" on warding off bone problems. She has been taking the most cost-effective calcium supplement. After her bone density test, the physician has decided to place her on Boniva. What information should the patient receive to ensure that she takes this medication appropriately? Select all that apply.

    A. Take the medication on the same day each week.
    B. Take the medication on an empty stomach.
    C. Remain upright for 1 hour after administration.
    D. Take the medication with a full glass of water first thing in the morning.
    B, C and D

    Take on the same day each month. Take on an empty stomach, first thing in the morning with a full glass of water. Take 60 minutes before food, drink, or other medications. Remain upright for 1 hour after administration.
  81. Most types of MD are multi-system disorders with manifestations in body systems including the ...
    • heart
    • gastrointestinal system
    • nervous system
    • endocrine glands
    • eyes
    • brain
  82. Of these patients, which should the RN assess first?

    A. The patient who has had an endoscopic carpal tunnel release and is requesting pain medication
    B. The patient with osteosarcoma who is receiving morphine via patient-controlled analgesia and is nauseated
    C. The patient with osteoporosis and compression fractures of the lumbar spine who has not voided for 14 hours
    D. The patient who has osteomyelitis with an open ulcer and has a dressing change scheduled
    C. The patient with osteoporosis and compression fractures of the lumbar spine who has not voided for 14 hours

    This patient may be experiencing decreased neurologic function related to lumbar compression of the spinal cord and should be assessed immediately to avoid possible permanent spinal cord or urinary tract injury. The other patients should be assessed as soon as possible but are not the first priority.
    (this multiple choice question has been scrambled)
  83. Which members primarily make up the health care team caring for the client with musculoskeletal problems? (Select all that apply.)

    A. Speech therapist
    B. Nutritionist
    C. Occupational therapist
    D. Case manager
    E. Physical therapist
    F. Nurse
    G. Chaplain
    C, E, F and G
  84. Which community resource is the best for the client with osteoporosis?

    A. Client's place of worship
    B. Hospital support group
    C. American Bone Society
    D. American Heart Association
    B. Hospital support group

    Large hospitals often have osteoporosis specialty clinics and support groups for patients with osteoporosis.
    (this multiple choice question has been scrambled)
  85. Which are nonsurgical treatment options for cancerous bone tumors? (Select all that apply.)

    A. Chemotherapy
    B. Analgesics
    C. Total joint replacement
    D. Cordotomy
    E. Radiation therapy
    A and E

    nonsurgical treatment options

    Analgesics are used to treat pain related to cancerous bone tumors. They are administered together with nonsurgical procedures, i.e. these smart asses are saying that trating the pain caused by a thing is not treating the thing. So be it.
  86. Which method helps prevent the incidence of osteomyelitis?

    A. Brushing teeth after every meal
    B. Maintaining clean dressing change technique for long-term IV catheters
    C. Use of clean technique for clients undergoing hemodialysis
    D. Use of standard precautions for clients at risk for infection
    A. Brushing teeth after every meal

    Long-term IV catheters can be a primary source of infection, so dressing changes are done using sterile technique. Ditto with hemodialysis.
  87. Which is the best way to decrease the risk for osteoporosis?

    A. Engage in high-impact exercise, such as running.
    B. Increase nutritional intake of calcium.
    C. Walk for 30 minutes three times a week.
    D. Increase nutritional intake of phosphorus.
    C. Walk for 30 minutes three times a week.

    Calcium loss occurs at a more rapid rate when phosphorus intake is high. People who drink large amounts of carbonated beverages each day (over 40 ounces) are at high risk for calcium loss and subsequent osteoporosis, regardless of age or gender.
    (this multiple choice question has been scrambled)
  88. Which statement about Paget's disease is true?

    A. Several genetic and hematologic changes have been identified in families with Paget's disease.
    B. Paget's disease is seen in people younger than 50 years.
    C. Paget's disease is thought to have an autosomal recessive pattern.
    D. Paget's disease is the second to osteoporosis as the most commonly occurring bone disease.
    D. Paget's disease is the second to osteoporosis as the most commonly occurring bone disease.

    Several genetic and immunologic (not hematologic) changes have been identified in families with the disease.

    Paget's disease is seen more frequently in those aged 50 years and older.

    Paget's disease is thought to have an autosomal dominant pattern.
    (this multiple choice question has been scrambled)
  89. Which drugs are prescribed to clients for the prevention of bone loss and to increase bone density? (Select all that apply.)

    A. Carvedilol (Coreg)
    B. Raloxifene (Evista)
    C. Calcitonin (Calcimar)
    D. Tamsulosin hydrochloride Incorrect: Tamsulosin hydrochloride is an alpha-adrenergic blocker used for the treatment of benign prostatic hyperplasia.(Flomax)
    E. Medroxyprogesterone (Prempro)
    B, C and E

    These three prevent bone loss and increase bone density.
  90. High alcohol intake: risk factor for osteoporosis and/or osteomalacia?
    both
  91. History of smoking: risk factor for osteoporosis and/or osteomalacia?
    osteoporosis only.
  92. Inadequate exposure to sunlight: risk factor for osteoporosis and/or osteomalacia?
    osteomalacia only
  93. Homelessnes: risk factor for osteoporosis and/or osteomalacia?
    only osteomalacia
  94. Which is a key feature of Paget's disease?

    A. Low body weight, thin build
    B. Bone infection
    C. Progressive muscle weakness
    D. Enlarged thick skull
    D. Enlarged thick skull

    Progressive muscle weakness is a feature of muscular dystrophy.

    Low body weight and thin build is a feature of osteoporosis.

    Bone infection is a feature of osteomyelitis.
    (this multiple choice question has been scrambled)
  95. Which is a common feature of chronic osteomyelitis?

    A. Erythema of the affected area
    B. Fever; temperature usually above 101 degrees F (38 degrees C)
    C. Ulceration of the skin
    D. Bone pain that is constant, localized, and pulsating
    C. Ulceration of the skin

    The others are features of acute osteomyelitis.
  96. Which description best illustrates plantar fasciitis?

    A. Dorsiflexion of any metatarsophalangeal (MTP), with plantar flexion of the adjacent proximal interphalangeal (PIP) joint
    B. A small tumor in a digital nerve of the foot
    C. Lateral deviation of the great toe; first metatarsal head becomes enlarged
    D. Severe pain in the arch of the foot, especially when getting out of bed
    D. Severe pain in the arch of the foot, especially when getting out of bed.
    (this multiple choice question has been scrambled)
  97. Lateral deviation of the great toe; first metatarsal head becomes enlarged describes ...
    a bunion of the foot.
  98. Dorsiflexion of any metatarsophalangeal (MTP), with plantar flexion of the adjacent proximal interphalangeal (PIP) joint describes ...
    a hallux valgus and hammertoe of the foot.
  99. A small tumor in a digital nerve of the foot describes ...
    Morton's neuroma of the foot.

What would you like to do?

Home > Flashcards > Print Preview