Question 1

Which change in bone structure contributes to osteoporosis?

Accepted Answer

A)In osteoporosis, the diameter of the bone increases, thinning the outer supporting cortex. Trabeculae are lost from cancellous bone. Osteoporosis does not affect the length of the bone.
B)In osteoporosis, the diameter of the bone increases, thinning the outer supporting cortex. Trabeculae are lost from cancellous bone. Osteoporosis does not affect the length of the bone.
C)In osteoporosis, the diameter of the bone increases, thinning the outer supporting cortex. Trabeculae are lost from cancellous bone. Osteoporosis does not affect the length of the bone.
D)In osteoporosis, the diameter of the bone increases, thinning the outer supporting cortex. Trabeculae are lost from cancellous bone. Osteoporosis does not affect the length of the bone.

Question 2

The nurse is providing teaching to a young adult who is at risk for early-onset osteoporosis.Which intervention should the nurse suggest?

Accepted Answer

Increasing intake of calcium and vitamin D is the most appropriate intervention for someone at risk for early-onset osteoporosis. Physical activity is important for maintaining bone health, so the client should not stop all physical activity. Reduction of dairy intake may result in a calcium deficiency which can negatively affect bone health. Estrogen replacement therapy is not recommended for prevention of osteoporosis unless the client is experiencing menopause-related bone loss.

Question 3

A nurse is conducting a health history on an older adult client.Which assessment finding indicates the client is at risk for osteoporosis?

Accepted Answer

Long-term use of glucocorticoids, such as for a chronic lung disorder, is a known risk factor for osteoporosis. Choices A, C, and D do not necessarily indicate an increased risk for osteoporosis. Obesity can actually have a protective effect on bone density, while shrimp and liver are good sources of calcium and vitamin D, two nutrients important for bone health. Drinking milk can also benefit bone health, but it alone does not indicate an increased risk for osteoporosis.

Question 4

What is the primary cause of loss of height in individuals with osteoporosis?

Accepted Answer

The primary cause of loss of height in individuals with osteoporosis is the collapse of vertebral bodies. This occurs due to a decrease in bone mass and density, making the bones weak and prone to compression fractures. As a result, the height of the individual decreases as the collapsed bones can no longer support the weight of the upper body. Alternatively, choices B, C, and D do not typically cause a significant loss of height in individuals with osteoporosis.

Question 5

The nurse identifies the nursing diagnosis Imbalanced Nutrition: Less Than Body Requirements as appropriate for a client with osteoporosis.Which client statement indicated to the nurse that this nursing diagnosis was appropriate?

Accepted Answer

Osteoporosis often requires an increased intake of calcium and vitamin D, which are commonly found in dairy products. However, if a client is allergic to dairy products, they may not be getting the appropriate nutrients and could be at risk for imbalanced nutrition.

Question 6

An adult client who resides in a long-term care facility is diagnosed with osteoporosis.The client has a history of falls and dementia.Which nursing intervention will best aid in meeting an outcome goal of injury prevention for this client?

Accepted Answer

A)Keeping the bed in the lowest position will reduce the incidence of injury should the client attempt to get up. The use of restraints could increase the incidence of injury. Using the furniture as an obstacle could cause injury if the client is able to get up. In a long-term care facility, a nightlight should be provided in the room so the client can see to use the restroom.
B)Keeping the bed in the lowest position will reduce the incidence of injury should the client attempt to get up. The use of restraints could increase the incidence of injury. Using the furniture as an obstacle could cause injury if the client is able to get up. In a long-term care facility, a nightlight should be provided in the room so the client can see to use the restroom.
C)Keeping the bed in the lowest position will reduce the incidence of injury should the client attempt to get up. The use of restraints could increase the incidence of injury. Using the furniture as an obstacle could cause injury if the client is able to get up. In a long-term care facility, a nightlight should be provided in the room so the client can see to use the restroom.
D)Keeping the bed in the lowest position will reduce the incidence of injury should the client attempt to get up. The use of restraints could increase the incidence of injury. Using the furniture as an obstacle could cause injury if the client is able to get up. In a long-term care facility, a nightlight should be provided in the room so the client can see to use the restroom.

Question 7

Restricted blood flow through the liver results in which condition?

Accepted Answer

Portal hypertension occurs when there is increased pressure in the portal vein, which is responsible for carrying blood from the digestive organs through the liver. Restricted blood flow through the liver can cause this pressure to increase, leading to portal hypertension. This can result in complications such as varices, ascites, and hepatic encephalopathy. Cirrhosis and biliary atresia can also lead to portal hypertension, but restricted blood flow is not the only cause of these conditions. Jaundice is a symptom of liver dysfunction, but it is not directly related to restricted blood flow through the liver.

Question 8

When individuals engage in excessive alcohol consumption,which liver function is impacted,leading to subsequent liver damage?

Accepted Answer

Excessive alcohol consumption impacts the liver's detoxification function, leading to liver damage. The liver metabolizes alcohol into a toxic substance called acetaldehyde, which is then further broken down and eliminated. However, excessive drinking can overwhelm the liver's detoxification capacity, leading to inflammation, scarring, and ultimately liver damage.

Question 9

The nurse is caring for an older adult client who is taking calcium for the treatment of osteoporosis.Which statements will the nurse include when educating the client about this medication? Select all that apply.

Accepted Answer

A)Calcium gluconate and other calcium compounds are used to treat and prevent osteoporosis. Oral calcium supplements are best taken with meals or within 1 hour following meals. It is recommended that adults 50 years of age and over obtain at least 1000 to 1200 mg per day of elemental calcium. The most common adverse effect is hypercalcemia caused by taking too much of the supplement. Symptoms include lethargy, drowsiness, weakness, headache, anorexia, nausea and vomiting, increased urination, and thirst. Calcium supplementation is contraindicated in clients with ventricular fibrillation.
B)Calcium gluconate and other calcium compounds are used to treat and prevent osteoporosis. Oral calcium supplements are best taken with meals or within 1 hour following meals. It is recommended that adults 50 years of age and over obtain at least 1000 to 1200 mg per day of elemental calcium. The most common adverse effect is hypercalcemia caused by taking too much of the supplement. Symptoms include lethargy, drowsiness, weakness, headache, anorexia, nausea and vomiting, increased urination, and thirst. Calcium supplementation is contraindicated in clients with ventricular fibrillation.
C)Calcium gluconate and other calcium compounds are used to treat and prevent osteoporosis. Oral calcium supplements are best taken with meals or within 1 hour following meals. It is recommended that adults 50 years of age and over obtain at least 1000 to 1200 mg per day of elemental calcium. The most common adverse effect is hypercalcemia caused by taking too much of the supplement. Symptoms include lethargy, drowsiness, weakness, headache, anorexia, nausea and vomiting, increased urination, and thirst. Calcium supplementation is contraindicated in clients with ventricular fibrillation.
D)Calcium gluconate and other calcium compounds are used to treat and prevent osteoporosis. Oral calcium supplements are best taken with meals or within 1 hour following meals. It is recommended that adults 50 years of age and over obtain at least 1000 to 1200 mg per day of elemental calcium. The most common adverse effect is hypercalcemia caused by taking too much of the supplement. Symptoms include lethargy, drowsiness, weakness, headache, anorexia, nausea and vomiting, increased urination, and thirst. Calcium supplementation is contraindicated in clients with ventricular fibrillation.
E)Calcium gluconate and other calcium compounds are used to treat and prevent osteoporosis. Oral calcium supplements are best taken with meals or within 1 hour following meals. It is recommended that adults 50 years of age and over obtain at least 1000 to 1200 mg per day of elemental calcium. The most common adverse effect is hypercalcemia caused by taking too much of the supplement. Symptoms include lethargy, drowsiness, weakness, headache, anorexia, nausea and vomiting, increased urination, and thirst. Calcium supplementation is contraindicated in clients with ventricular fibrillation.

Question 10

A client who is at risk for developing osteoporosis asks what can be done to decrease the risk of actually developing the disease.Which intervention would be the most beneficial for this client?

Accepted Answer

Increasing regular weight-bearing activities is the most beneficial intervention to decrease the risk of developing osteoporosis. Weight-bearing activities such as walking, jogging, and dancing help to strengthen bones and decrease the risk of bone loss. Decreasing calcium intake or protecting bones with strict bedrest would actually increase the risk of developing osteoporosis. Assisted range of motion exercises may be beneficial for joint health, but do not directly impact bone density.

Question 11

A new mother brings her 2-week-old infant in for a checkup because he looks jaundiced and his stools are white.The provider suspects the infant might have biliary atresia.What findings does the nurse anticipate upon assessment of the infant?

Accepted Answer

Infants with biliary atresia often have abdominal distention, which is caused by a buildup of bile in the liver. They may also have pale stools due to a lack of bile flow and jaundice due to the buildup of bilirubin in the bloodstream. Weight gain and urine output are not directly related to biliary atresia. The rooting reflex is a normal developmental reflex and would not necessarily be affected by biliary atresia.

Question 12

A postmenopausal adult client is concerned about the development of osteoporosis and wants to begin preventative activities.Which statement by the nurse is appropriate?

Accepted Answer

Weight-bearing exercise and calcium supplements have been shown to be helpful in preventing osteoporosis. Option A is also correct, as it is important to determine if the client is at risk before beginning any preventative activities. Option B is incorrect, as it is never too late to begin preventative interventions. Option D is not recommended due to the potential side effects and risks associated with hormone replacement therapy.

Question 13

What nursing intervention should be used to decrease pruritus in clients with liver disease?

Accepted Answer

A)Clients with pruritus require nursing interventions aimed at reducing itching and promoting skin integrity. Emollients or lubricants should be applied as needed to keep the skin moist. The skin should not be rubbed, and soap or preparations with alcohol should be avoided. Warm water should be used rather than hot water when bathing, because hot water increases pruritus. Antihistamines should be used cautiously because decreased liver function could alter drug responses.
B)Clients with pruritus require nursing interventions aimed at reducing itching and promoting skin integrity. Emollients or lubricants should be applied as needed to keep the skin moist. The skin should not be rubbed, and soap or preparations with alcohol should be avoided. Warm water should be used rather than hot water when bathing, because hot water increases pruritus. Antihistamines should be used cautiously because decreased liver function could alter drug responses.
C)Clients with pruritus require nursing interventions aimed at reducing itching and promoting skin integrity. Emollients or lubricants should be applied as needed to keep the skin moist. The skin should not be rubbed, and soap or preparations with alcohol should be avoided. Warm water should be used rather than hot water when bathing, because hot water increases pruritus. Antihistamines should be used cautiously because decreased liver function could alter drug responses.
D)Clients with pruritus require nursing interventions aimed at reducing itching and promoting skin integrity. Emollients or lubricants should be applied as needed to keep the skin moist. The skin should not be rubbed, and soap or preparations with alcohol should be avoided. Warm water should be used rather than hot water when bathing, because hot water increases pruritus. Antihistamines should be used cautiously because decreased liver function could alter drug responses.

Question 14

A client with liver cirrhosis begins to drain bright red blood through the nasogastric tube.Which should the nurse prepare to administer to this client?

Accepted Answer

The client is bleeding from the gastrointestinal tract, which is a common complication of liver cirrhosis. Platelets would help control the bleeding by improving clotting function. Vitamin K, ferrous sulfate, and folic acid would not directly address the bleeding issue in this case.

Question 15

A nurse is caring for a client with end-stage liver disease.Which alterations should the nurse anticipate with this client? Select all that apply.

Accepted Answer

A)Impaired function of liver cells has multiple effects. Impaired protein metabolism with decreased production of albumin and clotting factors occurs. Low albumin levels contribute to edema in peripheral tissues and ascites (accumulation of fluid in the abdomen), as plasma oncotic pressure is reduced, not increased. Impaired clotting-factor production increases the risk for bleeding. Disrupted glucose metabolism and storage may result in hyperglycemia. Also, serum vitamin K is decreased due to impaired absorption of fat-soluble vitamins.
B)Impaired function of liver cells has multiple effects. Impaired protein metabolism with decreased production of albumin and clotting factors occurs. Low albumin levels contribute to edema in peripheral tissues and ascites (accumulation of fluid in the abdomen), as plasma oncotic pressure is reduced, not increased. Impaired clotting-factor production increases the risk for bleeding. Disrupted glucose metabolism and storage may result in hyperglycemia. Also, serum vitamin K is decreased due to impaired absorption of fat-soluble vitamins.
C)Impaired function of liver cells has multiple effects. Impaired protein metabolism with decreased production of albumin and clotting factors occurs. Low albumin levels contribute to edema in peripheral tissues and ascites (accumulation of fluid in the abdomen), as plasma oncotic pressure is reduced, not increased. Impaired clotting-factor production increases the risk for bleeding. Disrupted glucose metabolism and storage may result in hyperglycemia. Also, serum vitamin K is decreased due to impaired absorption of fat-soluble vitamins.
D)Impaired function of liver cells has multiple effects. Impaired protein metabolism with decreased production of albumin and clotting factors occurs. Low albumin levels contribute to edema in peripheral tissues and ascites (accumulation of fluid in the abdomen), as plasma oncotic pressure is reduced, not increased. Impaired clotting-factor production increases the risk for bleeding. Disrupted glucose metabolism and storage may result in hyperglycemia. Also, serum vitamin K is decreased due to impaired absorption of fat-soluble vitamins.
E)Impaired function of liver cells has multiple effects. Impaired protein metabolism with decreased production of albumin and clotting factors occurs. Low albumin levels contribute to edema in peripheral tissues and ascites (accumulation of fluid in the abdomen), as plasma oncotic pressure is reduced, not increased. Impaired clotting-factor production increases the risk for bleeding. Disrupted glucose metabolism and storage may result in hyperglycemia. Also, serum vitamin K is decreased due to impaired absorption of fat-soluble vitamins.

Question 16

The nurse is assessing a school-age child who complains of severe itching,bruising easily,restlessness,and involuntary jerking of the hands.When considering these manifestations collectively,which organ or system should the nurse anticipate needing to assess further?

Accepted Answer

A)Severe itching (pruritus)is common in children with liver cirrhosis. Bruising easily indicates a decreased clotting ability, which could be related to the inability of the liver to produce clotting factors. Restlessness and involuntary jerking of the hands (asterixis)are both signs of portal systemic encephalopathy. All of these symptoms relate to liver disease, particularly cirrhosis. Therefore, a history of infection or disease with liver involvement will be most important to obtain from this client. Infections or diseases with neural, gastrointestinal, or urinary involvement would not produce these symptoms.
B)Severe itching (pruritus)is common in children with liver cirrhosis. Bruising easily indicates a decreased clotting ability, which could be related to the inability of the liver to produce clotting factors. Restlessness and involuntary jerking of the hands (asterixis)are both signs of portal systemic encephalopathy. All of these symptoms relate to liver disease, particularly cirrhosis. Therefore, a history of infection or disease with liver involvement will be most important to obtain from this client. Infections or diseases with neural, gastrointestinal, or urinary involvement would not produce these symptoms.
C)Severe itching (pruritus)is common in children with liver cirrhosis. Bruising easily indicates a decreased clotting ability, which could be related to the inability of the liver to produce clotting factors. Restlessness and involuntary jerking of the hands (asterixis)are both signs of portal systemic encephalopathy. All of these symptoms relate to liver disease, particularly cirrhosis. Therefore, a history of infection or disease with liver involvement will be most important to obtain from this client. Infections or diseases with neural, gastrointestinal, or urinary involvement would not produce these symptoms.
D)Severe itching (pruritus)is common in children with liver cirrhosis. Bruising easily indicates a decreased clotting ability, which could be related to the inability of the liver to produce clotting factors. Restlessness and involuntary jerking of the hands (asterixis)are both signs of portal systemic encephalopathy. All of these symptoms relate to liver disease, particularly cirrhosis. Therefore, a history of infection or disease with liver involvement will be most important to obtain from this client. Infections or diseases with neural, gastrointestinal, or urinary involvement would not produce these symptoms.

Question 17

The nurse is assessing a postmenopausal client.Which question should the nurse ask to assess for signs of osteoporosis?

Accepted Answer

Low back pain is a common symptom of osteoporosis, which is a disease that causes bone density loss and increases the risk of fractures. Palpitations, swelling in the feet, and constipation are not necessarily associated with osteoporosis.

Question 18

The nurse is planning care for a female adult client who is high-risk for developing osteoporosis.Which interventions will decrease the client's risk of developing this health problem? Select all that apply.

Accepted Answer

A)Interventions that may decrease this client's risk of developing osteoporosis include regular weight-bearing exercise, such as walking, as this activity slows bone loss. Other intervention include encouraging clients to consume adequate amounts of calcium and vitamin D in their diets to prevent osteoporotic fracture. A DEXA test measures bone density, but it does not decrease the client's risk for developing osteoporosis. Measures to prevent or treat osteoporosis include limiting the intake of beverages containing alcohol, caffeine, and phosphorus. Isometric exercises are not effective against osteoporosis.
B)Interventions that may decrease this client's risk of developing osteoporosis include regular weight-bearing exercise, such as walking, as this activity slows bone loss. Other intervention include encouraging clients to consume adequate amounts of calcium and vitamin D in their diets to prevent osteoporotic fracture. A DEXA test measures bone density, but it does not decrease the client's risk for developing osteoporosis. Measures to prevent or treat osteoporosis include limiting the intake of beverages containing alcohol, caffeine, and phosphorus. Isometric exercises are not effective against osteoporosis.
C)Interventions that may decrease this client's risk of developing osteoporosis include regular weight-bearing exercise, such as walking, as this activity slows bone loss. Other intervention include encouraging clients to consume adequate amounts of calcium and vitamin D in their diets to prevent osteoporotic fracture. A DEXA test measures bone density, but it does not decrease the client's risk for developing osteoporosis. Measures to prevent or treat osteoporosis include limiting the intake of beverages containing alcohol, caffeine, and phosphorus. Isometric exercises are not effective against osteoporosis.
D)Interventions that may decrease this client's risk of developing osteoporosis include regular weight-bearing exercise, such as walking, as this activity slows bone loss. Other intervention include encouraging clients to consume adequate amounts of calcium and vitamin D in their diets to prevent osteoporotic fracture. A DEXA test measures bone density, but it does not decrease the client's risk for developing osteoporosis. Measures to prevent or treat osteoporosis include limiting the intake of beverages containing alcohol, caffeine, and phosphorus. Isometric exercises are not effective against osteoporosis.
E)Interventions that may decrease this client's risk of developing osteoporosis include regular weight-bearing exercise, such as walking, as this activity slows bone loss. Other intervention include encouraging clients to consume adequate amounts of calcium and vitamin D in their diets to prevent osteoporotic fracture. A DEXA test measures bone density, but it does not decrease the client's risk for developing osteoporosis. Measures to prevent or treat osteoporosis include limiting the intake of beverages containing alcohol, caffeine, and phosphorus. Isometric exercises are not effective against osteoporosis.

Question 19

A nurse is educating a group of adults about the risks for osteoporosis.Which statements will the nurse include when discussing the use of alcohol and cigarettes? Select all that apply.

Accepted Answer

A) Both cigarette smoking and excess alcohol intake are risk factors for osteoporosis. Smoking decreases the blood supply to bones, and nicotine slows the production of osteoblasts and impairs the absorption of calcium, contributing to decreased bone density. Alcohol has a direct toxic effect on osteoblast activity, suppressing bone formation during periods of alcohol intoxication. In addition, heavy alcohol use may be associated with nutritional deficiencies that contribute to osteoporosis. Interestingly, moderate alcohol consumption in postmenopausal women actually may increase bone mineral content, possibly by increasing levels of estrogen and calcitonin.
B) Both cigarette smoking and excess alcohol intake are risk factors for osteoporosis. Smoking decreases the blood supply to bones, and nicotine slows the production of osteoblasts and impairs the absorption of calcium, contributing to decreased bone density. Alcohol has a direct toxic effect on osteoblast activity, suppressing bone formation during periods of alcohol intoxication. In addition, heavy alcohol use may be associated with nutritional deficiencies that contribute to osteoporosis. Interestingly, moderate alcohol consumption in postmenopausal women actually may increase bone mineral content, possibly by increasing levels of estrogen and calcitonin.
C) Both cigarette smoking and excess alcohol intake are risk factors for osteoporosis. Smoking decreases the blood supply to bones, and nicotine slows the production of osteoblasts and impairs the absorption of calcium, contributing to decreased bone density. Alcohol has a direct toxic effect on osteoblast activity, suppressing bone formation during periods of alcohol intoxication. In addition, heavy alcohol use may be associated with nutritional deficiencies that contribute to osteoporosis. Interestingly, moderate alcohol consumption in postmenopausal women actually may increase bone mineral content, possibly by increasing levels of estrogen and calcitonin.
D) Both cigarette smoking and excess alcohol intake are risk factors for osteoporosis. Smoking decreases the blood supply to bones, and nicotine slows the production of osteoblasts and impairs the absorption of calcium, contributing to decreased bone density. Alcohol has a direct toxic effect on osteoblast activity, suppressing bone formation during periods of alcohol intoxication. In addition, heavy alcohol use may be associated with nutritional deficiencies that contribute to osteoporosis. Interestingly, moderate alcohol consumption in postmenopausal women actually may increase bone mineral content, possibly by increasing levels of estrogen and calcitonin.
E) Both cigarette smoking and excess alcohol intake are risk factors for osteoporosis. Smoking decreases the blood supply to bones, and nicotine slows the production of osteoblasts and impairs the absorption of calcium, contributing to decreased bone density. Alcohol has a direct toxic effect on osteoblast activity, suppressing bone formation during periods of alcohol intoxication. In addition, heavy alcohol use may be associated with nutritional deficiencies that contribute to osteoporosis. Interestingly, moderate alcohol consumption in postmenopausal women actually may increase bone mineral content, possibly by increasing levels of estrogen and calcitonin.

Question 20

A client with liver disease presents to the hospital with severe ascites.What pathophysiologic changes does the nurse recognize as contributing to the development of ascites? Select all that apply.

Accepted Answer

Ascites is the accumulation of fluid in the peritoneal cavity and can be caused by liver disease leading to portal hypertension and impaired sodium/water handling by the kidneys resulting in sodium and water retention. Hyperalbuminemia (B) and increased colloidal osmotic pressure (C) would actually decrease the likelihood of fluid accumulation. Hypoaldosteronism (E) is not a common contributing factor to ascites in liver disease.

Quiz 12: Metabolism