NURS 317 Unit 6 Path Chapter 49 Flashcards
When performing a musculoskeletal assessment on a young boy, the nurse notices that the boy has decreased space between the knees so that the medial malleoli cannot be brought together. The nurse documents this as:
A) Bowleg
B) Internal femoral torsion
C) Genu varum
D) Genu valgum
D) Genu valgum
Rationale:Genu valgum or knock-knees is the deformity described. It can be differentiated between genu varum, or bowlegs, in that the medial malleoli of the ankles can touch. Femoral torsion is a rotation (turning) of the thigh bone at the hip.
When assessing a client diagnosed with Paget disease focused in the skull, the nurse should anticipate which findings? Select all that apply.
A) Vertigo
B) Headaches
C) Intermittent tinnitus
D) Visual disturbances
E) Hearing loss
A) Vertigo
B) Headaches
C) Intermittent tinnitus
E) Hearing loss
Rationale:Involvement of the skull can cause headaches, intermittent tinnitus, vertigo, and eventual hearing loss. Visual impairment is not associated with Paget disease of the skull.
While getting up out of bed for the first time after surgery, a client reports feeling dizzy and faint. Which condition is the client most likely experiencing?
A) Increase in blood volume
B) Anemia
C) Virchow triad
D) Orthostatic intolerance
D) Orthostatic intolerance
Rationale:Orthostatic intolerance may occur in clients that have been on prolonged bed rest and results in symptoms of tachycardia, nausea, diaphoresis, and sometimes syncope or fainting. When there is a change in position a decrease (not an increase) in central blood volume occurs as blood is displaced to the lower extremities. Virchow triad refers to the three factors that predispose a client to venous thrombosis. There is no reason to believe this client is anemic, which generally presents with shortness of breath.
The diagnosis of chronic fatigue syndrome (CFS) is made using both a holistic approach as well as:
A) focused physical and occupational therapies.
B) mental health screenings for depression and anxiety.
C) aggressive diagnostic testing.
D) elimination of possible physical causes.
D) elimination of possible physical causes.
Rationale:Diagnosis of CFS is often made by a process of elimination, and treatment requires a holistic approach. The other options are examples of very narrowly focused interventions.
The nurse is providing teaching for parents of a 2-week-old infant just diagnosed with clubfoot. The nurse includes that the first treatment option is:
A) surgical relaxation of foot ligaments and tendons.
B) full-time wearing of Denis Brown splint.
C) percutaneous tendoachilles lengthening.
D) serial manipulations and casting.
D) serial manipulations and casting.
Rationale:Serial manipulations and casting will be the first treatment. Each of the other options is more involved and would be attempted after manipulation and casting.
Regarding embryonic development, in what week do the paddle-shaped limb buds of the lower extremities begin to appear?
A) 10th week
B) 26th week
C) 4th week
D) 1st week
C) 4th week
Rationale:The limb buds begin to develop late in the 4th week, with hands and fingers being developed by 41 to 43 days.
A client diagnosed with Paget disease asks the health care provider how the disease developed. The best response would be:
A) “It is a result of a sedentary lifestyle.”
B) “It can result from a deficiency in calcium.”
C) “It results from a chromosomal disorder.”
D) “It is thought to have a probable association with a viral infection: paramyxovirus.”
D) “It is thought to have a probable association with a viral infection: paramyxovirus.”
Rationale:Paget disease may be linked to both genetic and environmental influences: a positive family history; mutations in genes encoding proteins in the RANK signaling pathway; and/or a probable association with a virus, possibly a paramyxovirus, suggesting that a viral infection may serve as a trigger for development of Paget disease in genetically predisposed individuals. A more sedentary lifestyle will reduce the mechanical loading of the skeleton and may decrease the incidence and severity of Paget disease
The nurse is caring for a child who presented to the emergency department with multiple fractures in various stages of healing all over the body. The nurse collaborates with the physician on care for a client with which potential condition?
A) Rheumatoid arthritis
B) Developmental dysplasia of the hip
C) Osteogenesis imperfecta
D) Recessive trait disorder
C) Osteogenesis imperfecta
Rationale:Osteogenesis imperfecta needs to be considered after ruling out abuse related to the various stages of healing fractures. The condition can be inherited as a recessive trait, but infants are usually stillborn related to injury. The other options are not associated with the symptoms described.
A client with confirmed low bone density asks the nurse if there is anything she can to decrease the risk of trauma. The best response would be:
A) Lawn bowling for 1 hour per week
B) Running 1 mile per day with good athletic shoes
C) Brisk walking three times per week on a flat surface
D) High-impact aerobic exercise for 1 hour three times per week
C) Brisk walking three times per week on a flat surface
Rationale:Weight-bearing exercises such as walking, jogging, rowing, and weight lifting are important in the maintenance of bone mass. The other options place the person at risk for injury if the bones are weakened.
Which statement is true concerning acute fatigue?
A) It is not relieved by cessation of activity.
B) It lasts longer than 1 month.
C) It serves a protective function for the body.
D) It has an insidious onset.
C) It serves a protective function for the body.
Rationale:Acute fatigue serves a protective function to people who are out of condition. All of the other options are symptoms of chronic fatigue.
The nurse is performing an admission assessment to a rehabilitation unit. Which assessment tools should she utilize to determine an alert client’s normal activities, perceived level of activity tolerance, or level of fatigue?
A) Human Activity Profile
B) Fatigue Severity Scale
C) Mini-Mental Examination
D) Ergometry
A) Human Activity Profile
Rationale:The Human Activity Profile (HAP) is a paper and pencil test in which participants describe their normal activities, their perceived level of activity tolerance, or their level of fatigue. The Fatigue Severity Scale only assesses the fatigue and not the normal activities or tolerance. The ergometry and the Mini-Mental Examination are not directly related to assessing fatigue.
The nurse concludes that the participants of a community education class on prevention of osteoporosis are understanding the information when they identify which cause as a potential risk factor? Select all that apply.
A) Excessive caffeine intake
B) Large bone structure
C) High-protein diet
D) Smoking
E) Alcoholism
A) Excessive caffeine intake
C) High-protein diet
D) Smoking
E) Alcoholism
Rationale:Smoking, excessive alcohol and caffeine intake, and a high-protein diet are all risk factors for the development of osteoporosis. A small bone structure is a risk factor.
Which chronic disorders have been associated with chronic fatigue? Select all that apply.
A) Multiple sclerosis
B) Cardiac disease
C) Asthma
D) Arthritis
E)Anemia
A) Multiple sclerosis
B) Cardiac disease
D) Arthritis
E)Anemia
Rationale:Chronic fatigue occurs across a broad spectrum of disease states. It is a common complaint of persons with cancer, cardiac disease, end-stage renal disease, chronic lung disease, hepatitis C, arthritis, human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS), and neurologic disorders such as multiple sclerosis. There are several types of cancer-related factors, the most prominent being anemia.
The nurse suspects idiopathic scoliosis in a client based on which assessment finding?
A) Late onset of first menarche
B) Reports of back pain in the teen years
C) Uneven shoulders or iliac crest
D) Loss of bone density confirmed with x-ray
C) Uneven shoulders or iliac crest
Rationale:The cardinal signs of scoliosis are uneven shoulders or iliac crest, prominent scapula on the convex side of the curve, asymmetry of the thoracic cage, and rib hump. Curves that are detected before menarche are more likely to progress than those detected after. This is not the only cause of pain in teens.
The nurse is caring for several clients who have chronic fatigue. Which intervention is the appropriate match for the cause of the clients’ fatigue?
A) Clients with insomnia who are served hot chocolate at bedtime
B) Clients with end-stage renal disease receiving erythropoietin
C) Clients with depression who are given a sedative
D) Clients with loss of muscle mass who are given analgesic
B) Clients with end-stage renal disease receiving erythropoietin
Rationale:Chronic fatigue may arise from different causes. If a client has anemia caused by renal failure, the hormone erythropoietin will help stimulate production of more red blood cells. Insomnia can be treated with a quiet environment, caffeine-free hot beverages, and short-term use of hypnotic agents. Antidepressants will be more effective for fatigue caused by depression. Loss of muscle mass creates a loss of endurance, but it is not usually painful.
