Question 1

A patient with osteoporosis is prescribed alendronate (Fosamax). What should the nurse include when instructing the patient about this medication?

Accepted Answer

Alendronate can cause esophageal irritation, so patients should report heartburn or swallowing issues (A) and remain upright for 30 minutes after taking it (C). The medication has a gradual response and continues to work after discontinuation (E).

Question 2

A 30-year-old female patient diagnosed with early onset of osteoporosis asks the nurse how she could be at risk for this disease, since she is so active. Which response by the nurse is most correct?

Accepted Answer

Dietary practices, such as insufficient calcium and vitamin D intake, can contribute to the development of osteoporosis, even in active individuals.

Question 3

The nurse is reviewing the health histories for a group of assigned patients. Which patients should the nurse identify as being at the greatest risk for the development of osteoporosis?

Accepted Answer

Osteoporosis risk is higher in individuals with certain demographic characteristics and medical treatments. Caucasian females and postmenopausal females have a higher risk due to hormonal changes and lower bone density. Patients taking corticosteroid therapy are also at increased risk because these medications can lead to bone loss.

Question 4

A patient diagnosed with systemic lupus erythematosus has laboratory values indicative of an exacerbation. Which values should the nurse report to the physician?

Accepted Answer

The answer of A patient diagnosed with systemic lupus erythematosus...

Question 5

A patient with osteoporosis taking calcitonin is experiencing nausea and vomiting. What should the nurse do about the patient's complaint?

Accepted Answer

The answer of A patient with osteoporosis taking calcitonin is...

Question 6

During an assessment the nurse notes that a patient has contracture deformities of the hand and complains of severe pain. What musculoskeletal disorder should the nurse suspect this patient is experiencing?

Accepted Answer

Contracture deformities and severe pain are commonly seen in rheumatoid arthritis, which is a chronic autoimmune disorder that involves inflammation of the joints. Osteomyelitis is a bone infection that can cause pain and deformity, but it is not typically associated with contracture deformities. Osteoporosis is a condition characterized by weakened bones, but it does not usually cause hand deformities or severe pain. Ankylosing spondylitis is a type of arthritis that mainly affects the spine, but it can also affect other joints in the body. Although it can cause stiffness and pain in the hands, it is not typically associated with contracture deformities.

Question 7

The patient diagnosed with osteoarthritis reports achieving pain relief when using an over-the-counter ointment on the affected areas. When reviewing safe administration practices, which principle should the nurse include in the teaching?

Accepted Answer

The nurse should instruct the patient to limit the use of the ointment to 3‒4 times per day to prevent overuse or potential adverse effects from excessive application. Applying heat or alternating heat and cold may provide additional pain relief, but this is not related to safe administration of the ointment. The nurse should also advise the patient that initial skin irritation is common, but if it persists or worsens, they should discontinue use and consult their healthcare provider.

Question 8

The nurse is providing discharge instructions to a patient recovering from a total hip replacement. What should the nurse include in these instructions?

Accepted Answer

These are all important discharge instructions for a patient recovering from a total hip replacement.

Question 9

The nurse is reviewing modifiable and nonmodifiable risk factors of osteoporosis with a patient. What should the nurse include as modifiable risk factors?

Accepted Answer

Modifiable risk factors for osteoporosis include calcium deficiency (A), as adequate calcium intake is crucial for bone health; high-protein diet (B), which can affect calcium absorption and bone density; and decrease in estrogen levels (D), which can be influenced by lifestyle choices and medical interventions. Choices C and E are considered nonmodifiable risk factors.

Question 10

A patient with gout is prescribed colchicine. For which laboratory value should the nurse question administering this medication to the patient?

Accepted Answer

Colchicine can be nephrotoxic, and a BUN of 68 indicates possible renal impairment. It's important to assess kidney function before administering colchicine, as it is excreted primarily by the kidneys.

Question 11

A patient diagnosed with gout is concerned that the small "lumps" on his ear and big toe will become lodged in his blood, resulting in a blood clot. What explanation by the nurse is the most accurate response to this patient?

Accepted Answer

The "lumps" or tophi that develop in gout are collections of uric acid crystals, but they do not cause clot development. The patient can be reassured that the tophi themselves do not pose a risk for clot formation. The other options do not provide accurate information or reassurance to the patient.

Question 12

The nurse is instructing a patient about foods high in calcium. The nurse knows the teaching was effective when the patient chooses which foods for a meal?

Accepted Answer

The answer of The nurse is instructing a patient about...

Question 13

The nurse assesses a butterfly rash on a newly admitted patient. What inflammatory connective tissue disease should the nurse associate with the assessment finding?

Accepted Answer

A butterfly rash is a hallmark symptom of systemic lupus erythematosus (SLE), an inflammatory connective tissue disease that affects multiple organs and tissues in the body. Rheumatoid arthritis primarily affects the joints, Paget disease affects the bones, and gout affects the joints due to urate crystal deposition.

Question 14

A patient is prescribed etidronate (Didronel). Which interventions would be appropriate when administering the medication to the patient?

Accepted Answer

A) Etidronate (Didronel) should be taken in the morning with water. 
E) Intake of any food or drink (except water) should be avoided for 30 minutes after taking the medication to ensure proper absorption. Milk or other dairy products should not be taken with etidronate as they can interfere with absorption. Fluoride levels do not need to be assessed annually unless specifically indicated for the patient. Administering the medication after meals is not necessary, as long as the patient waits 30 minutes before eating or drinking anything other than water.

Question 15

A patient with gout is experiencing foot pain. Which intervention will aid in promoting comfort in this patient?

Accepted Answer

Elevating the extremity and using a foot cradle will promote comfort in the patient with gout. This allows for decreased pressure on the affected joint and helps to reduce inflammation. Wrapping the extremity in an elastic bandage can further increase pressure and worsen symptoms. Encouraging fluid intake is important to prevent dehydration and aid in the excretion of uric acid, but it may not provide immediate relief of symptoms. Active range-of-motion exercises may be helpful in the long-term management of gout, but they may exacerbate pain and inflammation during an acute attack.

Question 16

A patient with a history of osteoarthritis reports discomfort unrelieved by the prescribed medications. Which nonpharmacological interventions might assist the patient in managing the discomfort?

Accepted Answer

The answer of A patient with a history of osteoarthritis...

Question 17

A patient diagnosed with systemic lupus erythematosis is experiencing a facial rash. What should the nurse instruct the patient regarding skin care?

Accepted Answer

Patients with systemic lupus erythematosus (SLE) often have photosensitivity, meaning they are more sensitive to the sun's rays. Therefore, they should avoid being out of doors during hours of greatest sun intensity, wear a wide-brimmed hat when outside and use sunscreen with an SPF of 15 or higher, and to reapply sunscreen after swimming, exercising, or bathing. Hydrocortisone cream 1% may help alleviate itching and redness associated with a rash, but it does not address the underlying cause of the rash. Therefore, it is not the best choice.

Question 18

An older patient with osteoporosis has a history of falls and dementia. What intervention will best aid in the prevention of injuries?

Accepted Answer

Keeping the bed in a low position can help prevent injuries from falls by reducing the distance to the floor, making it safer for patients who may try to get out of bed on their own.

Question 19

A patient is diagnosed with Paget disease. What should the nurse expect to assess in this patient?

Accepted Answer

The answer of A patient is diagnosed with Paget disease....

Question 20

Prior to signing informed consent for a total hip replacement, the patient asks the nurse if she should be concerned about complications. How should the nurse respond?

Accepted Answer

It is important for the nurse to discuss the potential complications with the patient and address any concerns or questions they may have. The nurse should encourage the patient to ask their surgeon about specific complications they may experience during or after the surgery.

Quiz 40: Nursing Care of Patients With Musculoskeletal Disorders

A patient with osteoporosis is prescribed alendronate (Fosamax) . What should the nurse include when instructing the patient about this medication?