Chapter 49 Medical Surgical Nursing Preparation For Practice 2nd Edition By Osborn

Chapter 49 Medical Surgical Nursing Preparation For Practice 2nd Edition By Osborn

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

Question 1

Type: MCSA

A 65-year-old female admitted with a fractured hip tells the nurse that she was unaware that she has osteoporosis. What is the nurse’s best response?

1. “Sometimes the first sign of the disorder is a fracture.”
2. “It is rare for someone your age to have osteoporosis.”
3. “There is no way to prevent the disorder.”
4. “Everyone has it now.”

Correct Answer: 1

Rationale 1: The manifestations of osteoporosis may go undetected because many patients are asymptomatic. The first sign of the disorder may be a fracture.

Rationale 2: There are different types of osteoporosis that occur in postmenopausal women as a natural result of aging. It is not rare for a 65-year-old female to be diagnosed with the disorder.

Rationale 3: Osteoporosis can be prevented by sufficient intake of calcium and vitamin D, weight management, and exercise.

Rationale 4: Not everyone has osteoporosis.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 49-1

Question 2

Type: MCSA

A patient recovering from a total hip replacement develops a fever and redness at the surgical site. The nurse’s priority is to conduct additional assessment for which disorder?

1. Pathologic fracture
2. Osteomyelitis
3. Undiagnosed osteitis deformans
4. Subacute osteoporosis

Correct Answer: 2

Rationale 1: Pathologic fracture occurs in the absence of trauma. Fever and redness are not manifestations of pathologic fracture.

Rationale 2: Acute osteomyelitis results from direct trauma or surgery. It is the direct contact of bacteria or the implanting of bacteria from the outside environment during a surgical procedure. Symptoms of acute osteomyelitis include fever, edema at the surgical site, warmth, redness, tenderness, and limited mobility.

Rationale 3: Osteitis deformans is a chronic disorder that causes irregular bone breakdown and bone weakness.

Rationale 4: Subacute osteoporosis is not a clinical disorder.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 49-1

Question 3

Type: MCSA

A 55-year-old female patient with rheumatoid arthritis is diagnosed with osteoporosis. The nurse anticipates that the patient may be prescribed which medication to help with the treatment of this bone disorder?

1. Antihypertensive
2. Cardiac glycoside
3. Parathyroid hormone
4. Vitamins A and E

Correct Answer: 3

Rationale 1: An antihypertensive medication would not have a direct effect on the progression of osteoporosis.

Rationale 2: A cardiac glycoside would not have a direct effect on the progression of osteoporosis.

Rationale 3: Parathyroid hormone is used to reverse the inhibitory effects of bone formation in secondary osteoporosis resulting from the use of steroids.

Rationale 4: Vitamins A and E would not have a direct effect on the progression of osteoporosis.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 49-1

Question 4

Type: MCMA

The nurse is planning a community education program on osteoporosis prevention. Which topics should be included in this program?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Lack of hereditary link
2. Limiting alcohol intake
3. Higher incidence in both men and women who are obese
4. Lifetime adequate intake of calcium and vitamin D
5. Avoidance of cigarette smoking

Correct Answer: 2,4,5

Rationale 1: There is a higher incidence in those with a family history of fractures and osteoporosis. It is thought that the disorder is 70% dependent on genetic factors.

Rationale 2: The excessive use of alcohol increases the risk for developing osteoporosis.

Rationale 3: There is a higher incidence in small, thin-boned men and women.

Rationale 4: One way to prevent the onset of osteoporosis is to have an adequate intake of calcium and vitamin D throughout the lifetime.

Rationale 5: Cigarette smoking increases the risk for developing osteoporosis.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 49-1