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N450 PrepU ch 41 Management of Patients with Musculoskeletal Disorders (1)
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N450 PrepU ch 41 Management of Patients with Musculoskeletal Disorders (1)
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N450 PrepU ch 41 Management of Patients withMusculoskeletal Disorders
A client with a musculoskeletal injury is instructed to alter the diet. The objective of altering the
diet is to facilitate the absorption of calcium from food and supplements. Considering the food
intake objective, which food item should the nurse encourage the client to include in the diet? -
ANS-Vitamin D-fortified milk
The nurse should advise the client to include dietary sources of vitamin D, such as fatty fish,
vitamin D-fortified milk, and cereals. These foods protect against bone loss and decrease the
risk of fracture by facilitating the absorption of calcium from food and supplements. Red meat,
bananas, and green vegetables do not facilitate calcium absorption from food and supplements.
Which is a strategy for lowering risk for osteoporosis? - ANS-Smoking cessation
Risk-lowering strategies include increased dietary calcium and vitamin D intake, smoking
cessation, alcohol and caffeine consumption in moderation, and outdoor activity. Individual risk
factors include low initial bone mass and increased age. A lifestyle risk factor is a diet low in
calcium and vitamin D.
Which of the following is the most common and most fatal primary malignant bone tumor? -
ANS-Osteogenic sarcoma (osteosarcoma)
Osteogenic sarcoma (osteosarcoma) is the most common and most often fatal primary
malignant bone tumor. Benign primary neoplasms of the musculoskeletal system include
osteochondroma, enchondroma, and rhabdomyoma.
On a visit to the family health care provider, a client is diagnosed with a bunion on the lateral
side of the great toe at the metatarsophalangeal joint. Which statement should the nurse include
in the teaching session? - ANS-"Some bunions are congenital; others are caused by wearing
shoes that are too short or narrow."
Bunions may be congenital or may be acquired by wearing shoes that are too short or narrow,
which increases pressure on the bursa at the metatarsophalangeal joint. Acquired bunions can
be prevented. Wearing shoes that are too big may cause other types of foot trauma but not
bunions. Gout doesn't cause bunions. Although a client with gout may have pain in the big toe,
such pain doesn't result from a bunion.
Morton neuroma is exhibited by which clinical manifestation? - ANS-Swelling of the third (lateral)
branch of the median plantar nerve
, Morton neuroma is swelling of the third branch of the median plantar nerve. Pes cavus refers to
a foot with an abnormally high arch and a fixed equinus deformity of the forefoot. Flatfoot is a
common disorder in which the longitudinal arch of the foot is diminished. Plantar fasciitis is an
inflammation of the foot-supporting fascia.
A nurse is caring for an elderly female client with osteoporosis. When teaching the client, the
nurse should include information about which major complication? - ANS-Bone fracture
Bone fracture is a major complication of osteoporosis; it results when loss of calcium and
phosphate increases the fragility of bones. Estrogen deficiencies result from menopause — not
osteoporosis. Calcium and vitamin D supplements may be used to support normal bone
metabolism, but a negative calcium balance isn't a complication of osteoporosis. Dowager's
hump results from bone fractures. It develops when repeated vertebral fractures increase spinal
curvature.
A client with chronic osteomyelitis has undergone 6 weeks of antibiotic therapy. The wound
appearance has not improved. What action would the nurse anticipate to promote healing? -
ANS-Surgical debridement
In chronic osteomyelitis, surgical debridement is used when the wound fails to respond to
antibiotic therapy. Wound packing, vitamin supplements, and wound irrigation are not the
standard of care when treating chronic osteomyelitis.
Which of the following inhibits bone resorption and promotes bone formation? - ANS-Calcitonin
Calcitonin, which inhibits bone resorption and promotes bone formation, is decreased in
osteoporosis. Estrogen, which inhibits bone breakdown, decreases with aging. On the other
hand, parathyroid hormone (PTH) increases with aging, increasing bone turnover and
resorption. The consequence of these changes is net loss of bone mass over time.
Corticosteroids place patients as risk for developing osteoporosis.
Assessment of a client reveals signs and symptoms of Paget's disease. Which of the following
would be most likely? - ANS-Long bone bowing
Some clients with Paget's disease are asymptomatic with only some mild skeletal deformity.
Other clients have marked skeletal deformities which may include enlargement of the skull,
bowing of the long bones, and kyphosis.
A client with osteoporosis is prescribed calcitonin 100 units subcutaneously. The medication is
available 200 units per ml. How many milliliters will the nurse administer to the client? - ANS-0.5
100 units x 1 ml/200 units = 0.5 ml.
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