Question 1

The nurse is caring for a client with osteoarthritis and a recently repaired hip fracture. Which nursing diagnoses are the nurse's priority?

Accepted Answer

The priority nursing diagnosis for a client with osteoarthritis and a recently repaired hip fracture is "Decreased mobility" because it directly impacts the client's recovery and ability to perform daily activities. Addressing mobility is crucial for preventing complications and promoting rehabilitation.

Question 2

The nurse has provided teaching for exercises that can be done during chronic symptomatic periods for a client with osteoarthritis. Which statement, made by the client, indicates further teaching is required?

Accepted Answer

Shuffling lightly on a treadmill is not an appropriate exercise for a client with osteoarthritis.

Question 3

The nurse is caring for a client who is postoperative from a hip replacement three days ago. Which assessment finding should be of concern to the nurse?

Accepted Answer

DC) Ambulating without compression stockings after hip replacement surgery can increase the risk of deep vein thrombosis (DVT), which is a concern postoperatively. D) Moderate amount of serous drainage on the dressing three days post-operation could indicate an infection or other complications, warranting further assessment and intervention.

Question 4

An older patient with osteoarthritis is prescribed acetaminophen (Tylenol) for pain. What should the nurse teach the patient about this medication?

Accepted Answer

The maximum recommended daily dose of acetaminophen for most adults is 4 grams (4000 mg) to avoid the risk of liver damage.

Question 5

The nurse is instructing the client on how to perform a balance exercise. Which information should the nurse include in the instruction?

Accepted Answer

The answer of The nurse is instructing the client on...

Question 6

The preceptor has reviewed with a new nurse the routine mobility tasks that should be observed to identify an older adult's risk for falling. Which observation made by the new nurse indicates the client is at risk for falling?

Accepted Answer

Shuffling feet while walking can indicate poor foot clearance and a higher risk of tripping and falling, which is a common issue among older adults.

Question 7

An older client is surprised to learn of a diagnosis of rheumatoid arthritis. What should the nurse explain to the patient about this health problem? Select all that apply.

Accepted Answer

Rheumatoid arthritis (RA) is a chronic inflammatory disorder that can lead to joint deformities, particularly in the hands, due to the progressive damage it causes to the joints. Additionally, RA is a systemic disease, meaning it can affect various organs and systems beyond the joints, including the heart, lungs, and kidneys, leading to a range of complications beyond the musculoskeletal system.

Question 8

After assessing an older patient, which musculoskeletal changes will the nurse attribute as being a normal part of the aging process? Select all that apply.

Accepted Answer

The answer of After assessing an older patient, which musculoskeletal...

Question 9

An older patient is concerned that many friends are having joint replacements and wants to know what can be done to prevent having to have one as well. Which modifiable risk factor should the nurse suggest the patient focus on at this time?

Accepted Answer

Maintaining a healthy body mass index (BMI) is crucial as excess weight puts additional stress on joints, increasing the risk of joint degeneration and the need for joint replacement.

Question 10

The nurse has provided medication teaching for an older client prescribed alendronate (Fosamax). Which statement made by the client indicates that further teaching is required?

Accepted Answer

Alendronate should not be taken with antacids as they can interfere with its absorption.

Question 11

The nurse is providing preventative education for an older patient at risk for osteoporosis. Which statement should the nurse include in the teaching?

Accepted Answer

Reducing caffeine intake can help prevent osteoporosis as caffeine can interfere with calcium absorption, which is crucial for bone health.

Question 12

The nurse is caring for an older client diagnosed with osteoarthritis. The client asks the nurse, "What is osteoarthritis?" Which statement should the nurse include in the teaching?

Accepted Answer

Osteoarthritis is characterized by the erosion or wearing away of joint cartilage, which leads to pain and stiffness in the affected joints. It is not primarily a metabolic bone disease, caused by synovial inflammation, or a disease of the muscles around the joints.

Question 13

The nurse has provided teaching for an older client prescribed a methotrexate disease modifying antirheumatic drug for rheumatoid arthritis. Which statement made, by the client, indicates further teaching is required?

Accepted Answer

Methotrexate is a disease-modifying antirheumatic drug (DMARD) that can slow the progression of rheumatoid arthritis but does not stop joints from wearing down completely. It manages symptoms and can slow damage, but it doesn't halt the disease entirely.

Question 14

The nurse reviewing the chart of an older client notes that kyphosis is present. Which assessment finding does the nurse anticipate?

Accepted Answer

Kyphosis is characterized by a thoracic rounding of the spine, which is a common finding in older clients due to factors such as osteoporosis and degenerative spine diseases.

Question 15

An older patient with multiple rib fractures is diagnosed with osteomalacia. What should the nurse teach the patient to help prevent further problems from this diagnosis? Select all that apply.

Accepted Answer

Osteomalacia is often due to vitamin D deficiency. Consuming vitamin D-fortified dairy products and getting sunlight exposure can help increase vitamin D levels, which is crucial for bone health.

Question 16

The nurse is designing a teaching plan for a middle-aged client experiencing arthritis of the hips and hands from constant computer work. What should the nurse include in this instruction? Select all that apply.

Accepted Answer

Alternating heat and cold therapies can help reduce pain and inflammation. Standing and walking frequently prevents stiffness from prolonged sitting. Alternating weight-bearing with non-weight-bearing exercises can help maintain joint function without overstraining. Taking frequent breaks from the keyboard can prevent exacerbation of symptoms. Avoiding hand exercises is not recommended as they can help maintain joint mobility.

Question 17

The nurse is assessing a client with pseudogout one week after the initiation of prescribed allopurinol (Zyloprim). Which finding indicates the treatment is effective?

Accepted Answer

Allopurinol is used to decrease uric acid levels in the blood, which is indicated by a serum urate level within the normal range, showing the treatment's effectiveness.

Question 18

The nurse screens an older adult woman for risk factors for osteoporosis. Which does the nurse identify as a contributing factor?

Accepted Answer

The answer of The nurse screens an older adult woman...

Question 19

An older patient with back pain is scheduled for computerized tomography (CT). What information should the nurse provide to the patient about this diagnostic test?

Accepted Answer

CT scans involve a machine that rotates around the patient to capture detailed images from various angles, which aids in the diagnostic process. This is a key characteristic of how CT scans work, providing comprehensive 180-degree imagery. Choices A, B, and C are not typically associated with CT scans. A refers to a preparation that might be more relevant for gastrointestinal procedures, B is incorrect because isotopes are used in nuclear medicine not typically in CT scans (though contrast might be used, it's not referred to as isotopes), and C describes an experience more common with MRI scans, which are known for loud clicking noises during the procedure.

Question 20

At the completion of an assessment the nurse determines that an older patient is at risk for the development of osteoporosis. What did the nurse assess in this patient?

Accepted Answer

Long-term use of corticosteroids is a known risk factor for the development of osteoporosis because they can decrease bone density, leading to an increased risk of fractures.

Quiz 18: The Musculoskeletal System