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ONC GENERAL PRACTICE EXAM QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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ONC GENERAL PRACTICE EXAM QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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ONC GENERAL PRACTICE EXAMQUESTIONS AND ANSWERS WITH
SOLUTIONS 2024
To establish the diagnosis of osteoporosis, a patient's primary care provider orders a DEXA scan (dual energ
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y x-S
ray absorptiometry). The patient asks the nurse, "How will the test show if I have osteoporosis?" The nurse'
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s response should be based on knowledge that which of the following accurately describes this procedure?
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a. The patient will be given a radioactive isotope several hours before the scan, and its uptake into the patie
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nt's bones will be measured.
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b. The patient's bone density will be compared to the reference range of healthy young adults.
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c. The amount of calcium in the patient's bones will be compared to the patient's serum values of osteocalc
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in and alkaline phosphatase.
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d. The patient's peak bone mass will be measured by comparing the ratio of cortical to cancellous bone in h
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er distal forearm. -
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ANSWER b. The patient's bone density will be compared to the reference range of healthy young adults.
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Rationale: DEXA compares a patient's bone density in the hip and spine to that of a mean young adult norm
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al reference range (known as the T-
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score). DEXA is a noninvasive diagnostic that does not require the use of a radioisotope. There are also no a
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ssociated laboratory studies, and assessment of the distal forearm is not completed as part of DEXA scanni
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ng.
Reference: Core Curriculum for Orthopaedic Nursing (7th ed.), 2013, p. 96
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A patient is newly diagnosed with osteoporosis and risedronate sodium (Actonel®) is prescribed. The nurse
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should give which of these instructions about the drug to the patient?
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a. "Take the Actonel at night immediately before you got to bed."
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b. "Take a multivitamin that contains 400 IU of vitamin D every day to promote absorption of the Actonel."
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c. "After taking Actonel, remain in an upright position for at least 30 minutes."
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d. "Before taking Actonel, eat a small amount of food to prevent stomach irritation." -
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ANSWER c. "After taking Actonel, remain in an upright position for at least 30 minutes."
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,Rationale: Bisphosphonates such as Actonel need to be taken on an empty stomach at least 30 minutes bef
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ore breakfast, and the patient should remain in an upright position.
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Reference: Core Curriculum for Orthopaedic Nursing (7th ed.), 2013, p. 380, Table 14-1
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A patient is suspected of having osteomalacia and is undergoing diagnostic testing. The patient understand
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s this disease is caused by inadequate intake of vitamin D, but asks the nurse what other factors may have c
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ontributed to development of this condition. Based on the patient's history, the nurse should identify whic
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h of the following as a risk factor for decreased synthesis of vitamin D?
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a. Having renal disease
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b. Having light skin
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c. Living at low altitude
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d. Living on a farm - ANSWER a. Having renal disease
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Rationale: Adults affected by chronic diseases of the liver, kidney, and small intestine have decreased bone
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mineralization related to vitamin D deficiency. Dark skin does not synthesize vitamin D as easily as fair skin.
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Persons who live at high altitudes also do not synthesize vitamin D as readily as those living at lower altitud
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es. Living on a farm has no direct impact, but living in long-
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term care facilities with limited exposure to sunlight can affect vitamin D synthesis.
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Reference: Core Curriculum for Orthopaedic Nursing (7th ed.), 2013, p. 383
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The mother of a 50-year-
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old patient has been diagnosed with osteoporosis. The patient asks about her own risk for the disease. Bas
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ed on discussion with the patient about her history and lifestyle, the nurse should identify which of the foll
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owing as a risk factor for osteoporosis?
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a. She is 10 pounds overweight.
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b. She smokes one pack of cigarettes per day.
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c. She drinks two cups of coffee every morning.
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d. She never had children. - ANSWER b. She smokes one pack of cigarettes per day.
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Rationale: Smoking has been shown to increase the incidence of osteoporosis by influencing the onset of m
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enopause and the lowering of bone mineral density. Being overweight does not contribute to osteoporosis
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, ; two cups of coffee a day is moderate intake of caffeine and not considered a risk factor. Never having had c
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hildren is only a factor if it contributes to early menopause.
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Reference: Core Curriculum for Orthopaedic Nursing (7th ed.), 2013, p. 379
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A close friend of the nurse has experienced intermittent swelling and pain in the joints of the hands, feet, a
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nd knees over the past year. The nurse suspects the friend has rheumatoid arthritis (RA) and encourages ev
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aluation by a healthcare provider. What other, early symptom should lead the nurse to suspect RA?
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a. Hip pain
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b. Photosensitivity
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c. Weight gain
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d. Fatigue - ANSWER d. Fatigue
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Rationale: Fatigue, lethargy, and weight loss are common early symptoms of RA.
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Reference: Core Curriculum for Orthopaedic Nursing (7th ed.), 2013, p. 341
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After an acute episode of painful swelling of multiple joints accompanied by disabling morning stiffness, a p
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atient is diagnosed with psoriatic arthritis. The nurse should recognize that blood test results are likely to in
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clude which of the following?
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a. Erythrocyte sedimentation rate 20 mm/hr
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b. Rheumatoid factor 12 IU/ml
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c. Serum uric acid 7.6 mg/dL
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d. White blood cell count 7000 cells/microliter - ANSWER c. Serum uric acid 7.6 mg/dL
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Rationale: Hyperuricemia (greater than 7 mg/dL in men, 6 mg/dL in women) is possible in psoriasis becaus
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e of rapid cell turnover. While ESR may be elevated in psoriatic arthritis during acute inflammation, a value
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of 20 mm/hr is normal (0-22 for men, 0-
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29 for women). Less than 14 IU/ml is considered a normal RF value, as is 7000 white cells/microliter (norma
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l 4000-11,000).
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Reference: Core Curriculum for Orthopaedic Nursing (7th ed.), 2013, p. 363
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