Question 1

The nurse is planning care for a patient with osteosarcoma.What should be done before encouraging the patient to increase activity?

Accepted Answer

Before encouraging the patient to increase activity, the nurse should assess for pain as the patient may require pain management or modifications to their activity plan to prevent exacerbation of pain. Assessing heart rate and blood pressure may also be important, but assessing pain should take priority. Providing assistive devices may be helpful for the patient, but it is not necessary before assessing for pain.

Question 2

A patient is seeking medical treatment for chronic low back pain.Which approach will help speed this patient's recovery?

Accepted Answer

Regular exercise has been shown to be effective for chronic low back pain, as it helps strengthen muscles and improve flexibility, which can alleviate pain and prevent future injury. Spinal injections and NSAIDs may provide temporary relief, but they do not address the underlying issue and can have adverse side effects. TENS may provide some relief, but it is not as effective as regular exercise in promoting long-term recovery.

Question 3

A patient recovering from total knee replacement surgery develops osteomyelitis.What teaching should the nurse prepare as a priority for this patient?

Accepted Answer

D

Question 4

A patient is prescribed alendronate (Fosamax).What instruction should the nurse provide to the patient about this medication?

Accepted Answer

Alendronate should be taken on an empty stomach at least 30 minutes before the first food or drink of the day. This is important because food and other medications can decrease the absorption of alendronate. The patient should also remain upright (sitting or standing) for at least 30 minutes after taking the medication to prevent esophageal irritation.

Question 5

A patient is suspected of having osteoporosis.Which diagnostic test should the nurse expect to be prescribed for this patient?

Accepted Answer

A DEXA scan is the most appropriate test for diagnosing osteoporosis. MRI and CT scans are more useful for detecting injuries, tumors, or other abnormalities in the bones, while a bone scan is more helpful in identifying diseases that affect the bone metabolism such as cancer or infection, but not specifically osteoporosis.

Question 6

A patient is diagnosed with a primary bone tumor.Which treatment should the nurse expect to be prescribed first for this patient?

Accepted Answer

Radiotherapy is often the first line of treatment for a primary bone tumor as it can help shrink or destroy the tumor without the need for surgery or amputation. Chemotherapy may be used in combination with radiotherapy or after surgery in some cases. Surgery or amputation may be necessary if the tumor is too large or has not responded to other treatments. However, they are not typically the first choice of treatment.

Question 7

A patient with bone cancer is admitted for treatment.What finding should the nurse expect to observe when assessing this patient?

Accepted Answer

Patients with bone cancer often experience pain and may limp due to discomfort or weakness in the affected limb.

Question 8

A patient with osteoporosis asks why the health problem developed.What nursing response would be appropriate for this patient?

Accepted Answer

Osteoporosis occurs when osteoclastic activity (breakdown of bone) is greater than osteoblastic activity (formation of bone), resulting in a decrease in bone density and strength. This can be due to a variety of factors such as hormonal changes, aging, lack of physical activity, and poor diet.

Question 9

The nurse is evaluating dietary teaching provided to a patient recovering from osteomyelitis.Which meal choice indicates that additional teaching is required?

Accepted Answer

The meal in choice C includes creamed spinach, which is high in phosphorus. For a patient recovering from osteomyelitis, it's important to have a balanced intake of calcium and phosphorus. High phosphorus foods can affect bone health by potentially disrupting the balance of calcium, which is crucial for bone repair and health. The other meals do not contain items that are typically flagged for special consideration in the context of osteomyelitis recovery.

Question 10

A patient is diagnosed with Paget's disease.What finding should the nurse expect when assessing this patient?

Accepted Answer

Paget's disease is characterized by bone pain, deformities, and fractures. Edema, hypotension, and abdominal cramps are not typically associated with this condition.

Question 11

The nurse is reviewing orders written for a patient with muscular dystrophy.Which medication should the nurse expect to be prescribed for this patient?

Accepted Answer

Corticosteroids like cortisol are often prescribed to slow the progression of muscular dystrophy by reducing inflammation and improving muscle strength.

Question 12

The blood pressure of a patient recovering from total hip replacement surgery is dropping.What should the nurse suspect is occurring with this patient?

Accepted Answer

The dropping blood pressure may indicate blood loss. This is a possible complication after hip replacement surgery. Monitoring the patient's vital signs and the surgical site can help determine the cause of the blood pressure drop.

Question 13

The nurse is preparing material about back pain for a community health fair.What should be included as a reason why this pain occurs most frequently in the lumbar region of the spine?

Accepted Answer

The lumbar region of the spine is the most flexible area and is subject to a greater range of motion and stress than other areas. This increased mobility and stress makes it more susceptible to injury and pain.

Question 14

A patient with severe hip pain is diagnosed with osteoarthritis (OA).What information should the nurse provide to the patient about this disease process?

Accepted Answer

Osteoarthritis causes a decrease in joint fluid that affects the cartilage, leading to joint pain, stiffness, and limited mobility. It is a degenerative joint disease that results from the breakdown of cartilage in joints over time. There is no overgrowth of cartilage or fluid buildup in OA, and joint fluid does not change color.

Question 15

A middle-aged person with scoliosis asks why exercises are prescribed when the pain is already severe.How should the nurse respond to this patient?

Accepted Answer

Exercise can help to prevent the progression of spinal deformity and also improve the overall strength and flexibility of the spine. It may not stop the pain caused by the deformity but can help to manage it in the long term. Pain medication may still be needed for severe pain, but exercise is an important part of scoliosis management. Weight management may also be a factor contributing to scoliosis, but it may not be the primary reason for the condition.

Question 16

A patient is experiencing severe lower back pain that radiates down the leg causing weakness.Which diagnostic test should be considered after an MRI?

Accepted Answer

The patient's symptoms suggest a possible nerve involvement, which can be confirmed or localized with an electromyography (EMG) test. While a CT scan or bone scan may provide additional information, they are less specific for nerve-related issues. A spinal x-ray may show structural issues, but would not necessarily confirm nerve involvement.

Question 17

A patient recovering from total hip replacement surgery is having difficulty with position changes and ambulation.Which member of the interdisciplinary team should be consulted to address this patient's issues?

Accepted Answer

A physical therapist is best suited to address issues with position changes and ambulation following total hip replacement surgery. They can help the patient with exercises to improve strength and mobility, provide education on proper body mechanics, and assist with gait training to promote safe and effective walking. The orthopedic nurse and surgeon may also be involved in the patient's care, but they may not have the same level of expertise in physical therapy and rehabilitation techniques. The occupational therapist may be more focused on activities of daily living, such as dressing and grooming, which may not be the primary concern for this patient.

Question 18

A patient with Duchenne muscular dystrophy has significant muscle damage.What is the primary reason for this destruction?

Accepted Answer

Lack of dystrophin is the primary reason for muscle damage in Duchenne muscular dystrophy. Dystrophin is a protein that helps strengthen and protect muscles during contraction and relaxation. Without dystrophin, the muscles become weak and susceptible to damage.

Question 19

A patient with Paget's disease is prescribed a bisphosphonate medication.Which additional medication should the nurse expect to be prescribed for this patient?

Accepted Answer

Bisphosphonate medications are used to decrease bone loss and prevent fractures in patients with Paget's disease. However, these medications can also decrease the patient's blood calcium levels. Therefore, it is common to also prescribe a calcium and vitamin D supplement to help maintain proper calcium levels in the body. Anticholinergic medications are not typically used in the treatment of Paget's disease. Thiazide diuretics and antihypertensive medications may be used in the treatment of other conditions but are not necessarily indicated for treatment of Paget's disease.

Question 20

The manager notes that several nurses have been seen in employee health for low back pain over the last month.What type of education should the manager plan to help reduce the incidence of this health problem?

Accepted Answer

Based on the information provided, the nurses are experiencing low back pain, which is often related to poor body mechanics. Therefore, a program on proper body mechanics can help reduce the incidence of this problem. Safety education may be helpful but may not be directly related to low back pain. Coordinating care and stress management are not likely to directly reduce the incidence of low back pain.

Quiz 53: Coordinating Care for Patients With Musculoskeletal Disorders