Ortho NCLEX Questions with accurate answers, Graded A+

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Ortho NCLEX Questions with accurate answers, Graded A+ A retired 66- year- old female patient is being evaluated for osteoporosis as part of a yearly physical exam. The patient states that she ... is a smoker, watches television for most of the day, and has been hospitalized twice with fractures within the last year. Based on this information, the nurse suspects which condition? A.Low bone mass leading to increased bone fragility B.Degeneration of the articular cartilage C.Recurrent attacks of acute arthritis D.Personality changes caused by chronic nature of illness - ✔✔A. Low bone mass leading to increased bone fragility ' Low bone mass, structural deterioration of bone tissue leading to bone fragility, and increased susceptibility to fractures are seen with osteoporosis. The patient also has risk factors associated with osteoporosis: smoking, sedentary lifestyle, and being female and menopausal. Degenerative changes are associated with frequent exacerbations of arthritis. There is no indication of personality change in this patient. The nurse determines that a 55- year-old female patient is experiencing menopause and is also at risk for osteoporosis. What foods other than milk can the nurse suggest to this patient to increase calcium intake? A. Seafood, wheat, corn, green vegetables B. Chicken vegetables, green vegetables, pasta, broccoli C. Green vegetables, sardines, salmon with bone, molasses D. Fresh fruits, English muffins, black beans, asparagus - ✔✔Answer C is correct. Women of menopausal age are at risk for osteoporosis, and foods high in calcium should be encouraged. A diet with green vegetables, sardines, salmon with bone, and molasses provides high- quality calcium and is recommended for a patient experiencing menopause in order to decrease the risk of osteoporosis. A diet with seafood, wheat, corn, and green vegetables is more concentrated in carbohydrates than proteins containing more calcium. A diet with chicken, green vegetables, sardines, and broccoli contains some calcium but is lower than the other option. Foods such as fresh fruits, English muffins, black beans, and asparagus are inadequate in calcium. A patient with osteoporosis has been advised to increase the amount of calcium in her diet. Which food provides the most calcium? An 8- oz glass of milk An ounce of cheddar cheese A half cup of raw broccoli A 4- ounce salmon croquette - ✔✔Answer A is correct. An 8-ounce glass of milk contains 290mg of calcium. Answers B, C, and D contain lesser amounts; therefore, they are incorrect. (Note: An ounce of cheddar cheese contains 205 mg of calcium; half a cup of raw broccoli contains 175mg of calcium; and 4 ounces of salmon croquette contains 165 mg of calcium). Which of the following instructions should be included for the patient taking calcium supplements? A.The patient should take her calcium with meals B.The patient should take all her daily calcium supplements at one time C.The patient should take her calcium supplement after meals to prevent stomach upset D.The patient can use calcium- based antacids for supplement. - ✔✔Rationale: Answer D is correct. Many people prefer to supplement their calcium intake with calcium- based antacids. If calcium supplements are used, they should be administered 30 minutes before meals to maximize absorption, so answer A is wrong. Calcium absorption is better if it is administered throughout the day rather than in a single dose, making answer B wrong. Calcium supplements do not cause stomach upset, so answer C is wrong. Alendronate (Fosamax) is ordered for a patient with osteoporosis. Which information should the nurse teach the patient about the medication? A. Acts as a selective estrogen receptor modulator B. Reduces risk of invasive breast cancer C. May be obtained as a nasal spray D. Inhibits bone resorption - ✔✔Alendronate (Fosamax), a bisphosphonate, is a potent inhibitor of bone resorption that preserves bone mass and increases bone density. Raloxifene (Evista) is an example of a selective estrogen receptor modulator that is used to treat osteoporosis, and which also reduces the risk of invasive breast cancer. Calcitonin (Miacalcin) is dispensed as a nasal spray. The nurse is caring for a patient with osteoporosis who is being discharged on alendronate (Fosamax). Which statement would indicate effective teaching? A. "I should take the medication immediately before bed" B. "I should remain in an upright position for 30 minutes after taking the medication" C. "The medication is more effective if I take it with milk or dairy products" D. If I skip a dose, I can take two tablets the next time" - ✔✔Answer: B- Rationale should remain upright for 30 mins. How long does a patient taking bisphosphonates need to stay upright after administration? A. 10 minutes B. 20 minutes C. 30 minutes D. 120 minutes - ✔✔30 minutes Bisphosphonates are administered on arising in the morning with a full glass of water on an empty stomach, and the patient must stay upright for 30 to 60 minutes. When caring for a client with hypocalcemia, the nurse should assess for: A. A decreased level of consciousness B. Tetany C. Bradycardia D. Respiratory Depression - ✔✔Answer B is correct. The most common complication of hypocalcemia is overstimulation of the nerves and muscles. Tetany, which can progress to convulsions, indicated that the patient's condition is worsening. Answer A is incorrect because a decreased level of consciousness is not associated with hypocalcemia. Tachycardia, not bradycardia, is associated with hypocalcemia, making answer C incorrect. Answer D is incorrect because respiratory depression is not directly related to hypocalcemia. A patient has been diagnosised with osteomalacia. What symptoms does the nurse recognize that correlate with the diagnosis? A. Bone fractures and kyphosis B. Bone pain and tenderness C. Muscle Weakness and spasms D. Softened and compressed vertebrae - ✔✔Rationale: Answer B is correct. The patient who is taking alendronate (Fosamax) is at high risk for developing which disorder? A. Cardiovascular disease B. Breast cancer C. Inflammation of the esophagus D. Stroke - ✔✔Answer: C Rationale: Esophagitis and esophageal ulcers have been reported with use of all of the bisphosphonates. The other answer selections apply to hormone replacement therapy. The patient who has completed radiation therapy treatments for a form of cancer is at high risk for developing: A. Osteomalacia B. Osteosarcoma C. Paget's disease of the bone D. Osteochondroma - ✔✔Answer: B Rationale: Patients who have received radiation for other forms of cancer are at high risk for developing osteosarcoma. Osteomalacia is caused by a vitamin D deficiency. Paget's disease is a metabolic disorder of bone remodeling. Osteochondroma is a benign bone tumor that has its onset in childhood An expected outcome of an older patient with acute osteomyelitis is: A. Pain B. Fatigue C. Low-grade fever D. Elevated leukocyte count - ✔✔Answer: C Rationale: Common presenting symptoms of osteomyelitis are pain, fever, edema, elevated leukocyte count, fatigue, and general malaise. However, older adults may not have an extreme temperature elevation because of lower core body temperature and compromised immune system that occur with normal aging. Certain transdermal patches must be removed before an MRI is performed because they can cause burns. True False - ✔✔True. Rationale: Transdermal patches (eg, NicoDerm, Transderm Nitro, Transderm Scopolamine, and Catapres-TTS) that have a thin layer of aluminized backing must be removed before an MRI because they can cause burns A patient is admitted for an MRI, a CT scan, and a myelogram. Which of the following medication orders should be questioned for the patient who is to have a myelogram? A. Ampicillin 250mg PO q6H B. Motrin 400mg PO q4h PRN for headache C. Seconal 50mg HS PRN sleep D. Darvon 65mg PO q4h for pain - ✔✔Rationale: Answer C is correct. Seconal is a barbiturate, and CNS depressants and stimulants, as well as phenothiazines, should not be given for 48 hours prior to a mylegram because they decrease the sizure threshold. Ampicillin is an antibiotic, Motrin is an NSAID, and Darvon is an analgesic, so they can all be given, making answers A,B, and D wrong. Which findings indicates a need for further assessment of the patient scheduled for a magnetic resonance imaging (MRI)? A. The patient is an insulin- dependent diabetic B. The patient refuses a corner bed C. The patient is allergic to shellfish D. The patient has a history of asthma - ✔✔An MRI requires the patient to be confined in a small enclosure for a period of time. The patient's refusal to accept the corner bed could indicate claustrophobia, so the patient needs further assessment. An MRI is not contraindicated for patients with diabetes or asthma; therefore, answers A and D are incorrect. Answer C is incorrect because no contrast medium is used. The prevalence of osteoporosis in women aged more than 80 years is 50%. True False - ✔✔True. Rationale: The prevalence of osteoporosis in women aged more than 80 years is 50%. The primary defect in osteomalacia is a deficiency in which vitamin [Show More]

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