Question 1

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 2

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

A)Osteoporosis risk factors increase after menopause. Preventative activities include implementing weight-bearing exercise and beginning calcium supplements. It is not too late to begin prevention activities. Without additional information, it is not possible to determine if the client is a candidate for hormone replacement therapy. The client in the scenario has two risk factors presented. Although a full analysis would be beneficial, it does not answer the client's request for information.
B)Osteoporosis risk factors increase after menopause. Preventative activities include implementing weight-bearing exercise and beginning calcium supplements. It is not too late to begin prevention activities. Without additional information, it is not possible to determine if the client is a candidate for hormone replacement therapy. The client in the scenario has two risk factors presented. Although a full analysis would be beneficial, it does not answer the client's request for information.
C)Osteoporosis risk factors increase after menopause. Preventative activities include implementing weight-bearing exercise and beginning calcium supplements. It is not too late to begin prevention activities. Without additional information, it is not possible to determine if the client is a candidate for hormone replacement therapy. The client in the scenario has two risk factors presented. Although a full analysis would be beneficial, it does not answer the client's request for information.
D)Osteoporosis risk factors increase after menopause. Preventative activities include implementing weight-bearing exercise and beginning calcium supplements. It is not too late to begin prevention activities. Without additional information, it is not possible to determine if the client is a candidate for hormone replacement therapy. The client in the scenario has two risk factors presented. Although a full analysis would be beneficial, it does not answer the client's request for information.

Question 3

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

A)Symptoms of biliary atresia usually appear 2 to 3 weeks after birth. They include jaundice, abdominal distention, white or clay-colored stools with putty-like consistency, tea-colored urine, and failure to thrive. This would result in below average weight gain rather than above average weight gain. Urine should be assessed for color, not volume. Biliary atresia may cause malnutrition due to poor absorption of nutrients, not a reduced rooting reflex.
B)Symptoms of biliary atresia usually appear 2 to 3 weeks after birth. They include jaundice, abdominal distention, white or clay-colored stools with putty-like consistency, tea-colored urine, and failure to thrive. This would result in below average weight gain rather than above average weight gain. Urine should be assessed for color, not volume. Biliary atresia may cause malnutrition due to poor absorption of nutrients, not a reduced rooting reflex.
C)Symptoms of biliary atresia usually appear 2 to 3 weeks after birth. They include jaundice, abdominal distention, white or clay-colored stools with putty-like consistency, tea-colored urine, and failure to thrive. This would result in below average weight gain rather than above average weight gain. Urine should be assessed for color, not volume. Biliary atresia may cause malnutrition due to poor absorption of nutrients, not a reduced rooting reflex.
D)Symptoms of biliary atresia usually appear 2 to 3 weeks after birth. They include jaundice, abdominal distention, white or clay-colored stools with putty-like consistency, tea-colored urine, and failure to thrive. This would result in below average weight gain rather than above average weight gain. Urine should be assessed for color, not volume. Biliary atresia may cause malnutrition due to poor absorption of nutrients, not a reduced rooting reflex.

Question 4

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

A)A standard intervention for those attempting to prevent osteoporosis is beginning an exercise plan that includes weight-bearing activities. Strict bedrest, decreasing calcium intake, and assisted range of motion exercises may make the osteoporosis worse.
B)A standard intervention for those attempting to prevent osteoporosis is beginning an exercise plan that includes weight-bearing activities. Strict bedrest, decreasing calcium intake, and assisted range of motion exercises may make the osteoporosis worse.
C)A standard intervention for those attempting to prevent osteoporosis is beginning an exercise plan that includes weight-bearing activities. Strict bedrest, decreasing calcium intake, and assisted range of motion exercises may make the osteoporosis worse.
D)A standard intervention for those attempting to prevent osteoporosis is beginning an exercise plan that includes weight-bearing activities. Strict bedrest, decreasing calcium intake, and assisted range of motion exercises may make the osteoporosis worse.

Question 5

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

A)An appropriate goal for this client is a diet rich in calcium and vitamin D. Walking and weight-bearing exercise help prevent osteoporosis, so the client should not stop all physical activity. Dairy is rich in calcium, so reducing intake of dairy is not recommended. Due to the client's age, it is not likely that the client needs estrogen replacement therapy at this time.
B)An appropriate goal for this client is a diet rich in calcium and vitamin D. Walking and weight-bearing exercise help prevent osteoporosis, so the client should not stop all physical activity. Dairy is rich in calcium, so reducing intake of dairy is not recommended. Due to the client's age, it is not likely that the client needs estrogen replacement therapy at this time.
C)An appropriate goal for this client is a diet rich in calcium and vitamin D. Walking and weight-bearing exercise help prevent osteoporosis, so the client should not stop all physical activity. Dairy is rich in calcium, so reducing intake of dairy is not recommended. Due to the client's age, it is not likely that the client needs estrogen replacement therapy at this time.
D)An appropriate goal for this client is a diet rich in calcium and vitamin D. Walking and weight-bearing exercise help prevent osteoporosis, so the client should not stop all physical activity. Dairy is rich in calcium, so reducing intake of dairy is not recommended. Due to the client's age, it is not likely that the client needs estrogen replacement therapy at this time.

Question 6

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 7

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

Accepted Answer

A)The liver is responsible for detoxifying alcohol and other substances. If an individual participates in high-risk behaviors such as excessive alcohol consumption, the detoxification function of the liver can be overwhelmed, resulting in damage to the liver. Metabolism of proteins, carbohydrates, and fats; synthesis of albumin and clotting factors; and glycogen storage are normal functions of the liver that help maintain health.
B)The liver is responsible for detoxifying alcohol and other substances. If an individual participates in high-risk behaviors such as excessive alcohol consumption, the detoxification function of the liver can be overwhelmed, resulting in damage to the liver. Metabolism of proteins, carbohydrates, and fats; synthesis of albumin and clotting factors; and glycogen storage are normal functions of the liver that help maintain health.
C)The liver is responsible for detoxifying alcohol and other substances. If an individual participates in high-risk behaviors such as excessive alcohol consumption, the detoxification function of the liver can be overwhelmed, resulting in damage to the liver. Metabolism of proteins, carbohydrates, and fats; synthesis of albumin and clotting factors; and glycogen storage are normal functions of the liver that help maintain health.
D)The liver is responsible for detoxifying alcohol and other substances. If an individual participates in high-risk behaviors such as excessive alcohol consumption, the detoxification function of the liver can be overwhelmed, resulting in damage to the liver. Metabolism of proteins, carbohydrates, and fats; synthesis of albumin and clotting factors; and glycogen storage are normal functions of the liver that help maintain health.

Question 8

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 9

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 10

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

A)Ferrous sulfate and folic acid are given as indicated to treat anemia. Vitamin K may be ordered to reduce the risk of bleeding. When bleeding is acute, packed RBCs, fresh frozen plasma, or platelets may be administered to restore blood components and promote hemostasis.
B)Ferrous sulfate and folic acid are given as indicated to treat anemia. Vitamin K may be ordered to reduce the risk of bleeding. When bleeding is acute, packed RBCs, fresh frozen plasma, or platelets may be administered to restore blood components and promote hemostasis.
C)Ferrous sulfate and folic acid are given as indicated to treat anemia. Vitamin K may be ordered to reduce the risk of bleeding. When bleeding is acute, packed RBCs, fresh frozen plasma, or platelets may be administered to restore blood components and promote hemostasis.
D)Ferrous sulfate and folic acid are given as indicated to treat anemia. Vitamin K may be ordered to reduce the risk of bleeding. When bleeding is acute, packed RBCs, fresh frozen plasma, or platelets may be administered to restore blood components and promote hemostasis.

Question 11

Restricted blood flow through the liver results in which condition?

Accepted Answer

A)Restricted blood flow through the liver results in portal hypertension, or increased pressure in the portal venous system. Jaundice results from impaired bilirubin conversion and excretion. Cirrhosis results when functional liver tissue is destroyed and replaced by fibrous scar tissue. Biliary atresia is a disorder of the bile ducts that causes backup of bile into the liver, resulting in tissue damage.
B)Restricted blood flow through the liver results in portal hypertension, or increased pressure in the portal venous system. Jaundice results from impaired bilirubin conversion and excretion. Cirrhosis results when functional liver tissue is destroyed and replaced by fibrous scar tissue. Biliary atresia is a disorder of the bile ducts that causes backup of bile into the liver, resulting in tissue damage.
C)Restricted blood flow through the liver results in portal hypertension, or increased pressure in the portal venous system. Jaundice results from impaired bilirubin conversion and excretion. Cirrhosis results when functional liver tissue is destroyed and replaced by fibrous scar tissue. Biliary atresia is a disorder of the bile ducts that causes backup of bile into the liver, resulting in tissue damage.
D)Restricted blood flow through the liver results in portal hypertension, or increased pressure in the portal venous system. Jaundice results from impaired bilirubin conversion and excretion. Cirrhosis results when functional liver tissue is destroyed and replaced by fibrous scar tissue. Biliary atresia is a disorder of the bile ducts that causes backup of bile into the liver, resulting in tissue damage.

Question 12

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

Accepted Answer

A)A client with osteoporosis will often present with low back pain as well as a decrease in height. Palpitations, constipation, and swelling are not early signs of osteoporosis.
B)A client with osteoporosis will often present with low back pain as well as a decrease in height. Palpitations, constipation, and swelling are not early signs of osteoporosis.
C)A client with osteoporosis will often present with low back pain as well as a decrease in height. Palpitations, constipation, and swelling are not early signs of osteoporosis.
D)A client with osteoporosis will often present with low back pain as well as a decrease in height. Palpitations, constipation, and swelling are not early signs of osteoporosis.

Question 13

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

A)Long-time use of corticosteroids is a risk factor for developing osteoporosis. Obesity is not a risk factor for osteoporosis. Skim milk is a good source of calcium and vitamin D, which prevents or slows osteoporosis. A diet rich in shellfish and organ meats is high in purine, which may predispose the client to gout.
B)Long-time use of corticosteroids is a risk factor for developing osteoporosis. Obesity is not a risk factor for osteoporosis. Skim milk is a good source of calcium and vitamin D, which prevents or slows osteoporosis. A diet rich in shellfish and organ meats is high in purine, which may predispose the client to gout.
C)Long-time use of corticosteroids is a risk factor for developing osteoporosis. Obesity is not a risk factor for osteoporosis. Skim milk is a good source of calcium and vitamin D, which prevents or slows osteoporosis. A diet rich in shellfish and organ meats is high in purine, which may predispose the client to gout.
D)Long-time use of corticosteroids is a risk factor for developing osteoporosis. Obesity is not a risk factor for osteoporosis. Skim milk is a good source of calcium and vitamin D, which prevents or slows osteoporosis. A diet rich in shellfish and organ meats is high in purine, which may predispose the client to gout.

Question 14

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

A)Ascites is the accumulation of plasma-rich fluid in the abdominal cavity. Although portal hypertension is the primary cause of ascites, decreased serum proteins and increased aldosterone also contribute to the fluid accumulation. Hypoalbuminemia (low serum albumin)decreases the colloidal osmotic pressure of plasma. This pressure normally holds fluid in the intravascular compartment, but when the plasma colloidal osmotic pressure decreases, fluid escapes into extravascular compartments. Hyperaldosteronism (an increase in aldosterone)causes sodium and water retention, contributing to ascites and generalized edema.
B)Ascites is the accumulation of plasma-rich fluid in the abdominal cavity. Although portal hypertension is the primary cause of ascites, decreased serum proteins and increased aldosterone also contribute to the fluid accumulation. Hypoalbuminemia (low serum albumin)decreases the colloidal osmotic pressure of plasma. This pressure normally holds fluid in the intravascular compartment, but when the plasma colloidal osmotic pressure decreases, fluid escapes into extravascular compartments. Hyperaldosteronism (an increase in aldosterone)causes sodium and water retention, contributing to ascites and generalized edema.
C)Ascites is the accumulation of plasma-rich fluid in the abdominal cavity. Although portal hypertension is the primary cause of ascites, decreased serum proteins and increased aldosterone also contribute to the fluid accumulation. Hypoalbuminemia (low serum albumin)decreases the colloidal osmotic pressure of plasma. This pressure normally holds fluid in the intravascular compartment, but when the plasma colloidal osmotic pressure decreases, fluid escapes into extravascular compartments. Hyperaldosteronism (an increase in aldosterone)causes sodium and water retention, contributing to ascites and generalized edema.
D)Ascites is the accumulation of plasma-rich fluid in the abdominal cavity. Although portal hypertension is the primary cause of ascites, decreased serum proteins and increased aldosterone also contribute to the fluid accumulation. Hypoalbuminemia (low serum albumin)decreases the colloidal osmotic pressure of plasma. This pressure normally holds fluid in the intravascular compartment, but when the plasma colloidal osmotic pressure decreases, fluid escapes into extravascular compartments. Hyperaldosteronism (an increase in aldosterone)causes sodium and water retention, contributing to ascites and generalized edema.
E)Ascites is the accumulation of plasma-rich fluid in the abdominal cavity. Although portal hypertension is the primary cause of ascites, decreased serum proteins and increased aldosterone also contribute to the fluid accumulation. Hypoalbuminemia (low serum albumin)decreases the colloidal osmotic pressure of plasma. This pressure normally holds fluid in the intravascular compartment, but when the plasma colloidal osmotic pressure decreases, fluid escapes into extravascular compartments. Hyperaldosteronism (an increase in aldosterone)causes sodium and water retention, contributing to ascites and generalized edema.

Question 15

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 16

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

Accepted Answer

A)The loss of height in individuals with osteoporosis occurs primarily as a result of vertebral body collapse. Osteoporosis also contributes to cervical lordosis, and the knees and hips flex to help maintain the center of gravity; however, these do not contribute to overall loss of height. Osteoporosis does not cause a decrease in the length of long bones.
B)The loss of height in individuals with osteoporosis occurs primarily as a result of vertebral body collapse. Osteoporosis also contributes to cervical lordosis, and the knees and hips flex to help maintain the center of gravity; however, these do not contribute to overall loss of height. Osteoporosis does not cause a decrease in the length of long bones.
C)The loss of height in individuals with osteoporosis occurs primarily as a result of vertebral body collapse. Osteoporosis also contributes to cervical lordosis, and the knees and hips flex to help maintain the center of gravity; however, these do not contribute to overall loss of height. Osteoporosis does not cause a decrease in the length of long bones.
D)The loss of height in individuals with osteoporosis occurs primarily as a result of vertebral body collapse. Osteoporosis also contributes to cervical lordosis, and the knees and hips flex to help maintain the center of gravity; however, these do not contribute to overall loss of height. Osteoporosis does not cause a decrease in the length of long bones.

Question 17

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 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

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 20

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

A)The client who is allergic to dairy products may not take in much calcium, which increases the risk of osteoporosis, so focusing on diet would be a priority for this client. The statements about removing fat, eating a low-carb diet, and eating out less are healthy changes for many individuals that help reduce calorie intake, but they would not address one of the root causes of osteoporosis, deficient calcium intake.
B)The client who is allergic to dairy products may not take in much calcium, which increases the risk of osteoporosis, so focusing on diet would be a priority for this client. The statements about removing fat, eating a low-carb diet, and eating out less are healthy changes for many individuals that help reduce calorie intake, but they would not address one of the root causes of osteoporosis, deficient calcium intake.
C)The client who is allergic to dairy products may not take in much calcium, which increases the risk of osteoporosis, so focusing on diet would be a priority for this client. The statements about removing fat, eating a low-carb diet, and eating out less are healthy changes for many individuals that help reduce calorie intake, but they would not address one of the root causes of osteoporosis, deficient calcium intake.
D)The client who is allergic to dairy products may not take in much calcium, which increases the risk of osteoporosis, so focusing on diet would be a priority for this client. The statements about removing fat, eating a low-carb diet, and eating out less are healthy changes for many individuals that help reduce calorie intake, but they would not address one of the root causes of osteoporosis, deficient calcium intake.

Quiz 12: Metabolism