Falls Risk + Hip Fracture + Pulmonary Embolism

1. Susan visits her HCP. The nurse reviews Susan's electronic health record and notes history of hypertension, osteoporosis, and osteoarthiritis and her current regimen.

The nurse understands that which information is correct about osteoarthiritis?

• An autoimmune disorder that typically affects the small joints in the hands and feet.

• Involves reduced bone mineral density that weakens the bone and increases the risk for fractures.

• A primary benign bone tumour characterized by overgrowth of both cartilage and bone near the end of the bone plate.

• A noninflammatory condition involving formation of new joint tissue in response to cartilage destruction.

2.The nurse expects to see which manifestations of osteoarthritis in Mrs. Weil? (SATA)

• Fatigue

• Joint pain

• Fever

• Swollen nodes of the joints

• Asymmetrical involvement of the joints

3.Which symptom should Mrs. Weil report immediately while taking a non-steroidal anti-inflammatory drug (NSAID)?

• Black, tarry stools

• Swelling in the extremities

• Nausea

• Constipation

4.The nurse is teaching susan about medications for osteoporosis, which instruction is most important, knowing that Susan takes alendronate (Forsamax), a biphosphate?

• Take this medication at bedtime.

• Remain upright (sitting or standing) for at least 30 minutes after taking this medication.

• Take this medication at the same time everyday.

• Always take alendronate (Fosamax) with the mid-day meal to prevent stomach upset.

5.Which statement about the use of heat and cold for osteoarthiritis pain by the client is of most concern to the nurse?

• "I place an empty pillow between my skin and the cold pack."

• "I use moist heat packs on my knee for about 15 minutes before I have to walk for a long distance."

• "I leave the cold packs on for about 10 minutes at a time when I have very deep pain in my knee."

• "I wrap the heating pad around my knee and use an extension cord so I can walk around the house."

6.Which data places the client at highest risk for falls?

• BMI 21.9.

• Knee pain.

• Lives alone.

• Takes naproxen.

7.Which additional information is associated with an increased risk for falls? (SATA)

• BP remains at 130/72 between lying and sitting position.

• Throw rugs placed on hardwood floors in the home.

• Walks with short, shuffled steps.

• Uses furniture to steady self.

• Advanced age.

8.Susan falls and fractures her hip. Which clinical manifestations of hip fracture should a nurse practicing in the ED expect? (SATA)

• External rotation

• Shortening.

• Internal rotation.

• Muscle spasms.

• Hyper flexion.

9.Susan reports a pain scale of 10 out of 10. She is placed on bedrest and NPO status, and neurovascular checks q30 minutes is added to the care plan.

Which affected extremity should be assessed for which of the following when neurovascular checks are performed? (SATA)

• Color.

• Temperature.

• Full range of motion.

• Sensation.

• Gait.

10.You perform the neurovascular assessment and note pallor and absent pedal pulses to the right foot. You report to ED physician immediately. The physician suspects compartment syndrome and contacts the orthopaedic surgeon.

What is the correct description of compartment syndrome?

• The formation of a blood clot deep within a vein on the affected extremity.

• A blockage of the main artery of the lung.

• Full thickness tissue loss with exposed muscle, tendon or bone.

• Elevated pressure within a confined myofascial section compromises neurovasuclar function.