Osteopenia begins immediately after a spinal cord injury (SCI) occurs and plateaus 6-12 mo later. Pathologic fractures occur as a consequence of loss of bone mineral density. Of the following, the MOST common site of fracture is

Correct Answer: B

Rationale: The correct answer is B) supracondylar region of the femur. Osteopenia is a common complication following spinal cord injury (SCI) due to decreased weight-bearing activity and hormonal changes, leading to bone mineral density loss. The supracondylar region of the femur is the most common site for fractures in individuals with osteopenia due to its susceptibility to fractures under conditions of decreased bone density and increased stress. Option A) distal tibia is less likely as the most common site for fractures in osteopenia following SCI compared to the femur. Option C) lumbosacral spine is less likely as it is more commonly associated with vertebral compression fractures in conditions like osteoporosis. Option D) proximal humerus is less likely as it is not as commonly affected by osteopenia-related fractures in SCI patients compared to weight-bearing bones like the femur. Educationally, understanding the specific sites of fractures in osteopenia post-SCI is crucial for nurses caring for these patients. Recognizing the common sites of fractures can aid in preventive measures, early detection, and appropriate management to prevent further complications and promote optimal patient outcomes.

Correct Answer: C

Rationale: In the context of pediatric nursing and adoption, the least likely required investigation for the adoption of a 1-year-old girl is screening tests for sexually transmitted diseases (Option C). This is because sexually transmitted diseases are typically not a concern in children of this age group due to the mode of transmission and the child's developmental stage. Neonatal screening tests (Option A) are important to assess the child's health status and detect any congenital conditions that may require early intervention. Immunization history (Option B) is crucial to ensure that the child is up to date with vaccinations to prevent infectious diseases. Cognitive tests (Option D) may be needed to evaluate the child's developmental milestones and identify any delays that may require intervention. Educationally, understanding the rationale behind the least likely investigation helps pediatric nurses prioritize assessments based on the child's age, developmental stage, and specific needs. It underscores the importance of tailoring healthcare interventions to the individual needs of each child, promoting evidence-based and family-centered care in pediatric nursing practice.

Correct Answer: C

Rationale: Rationale: The hallmark symptom of Gout is severe pain, making option C the correct answer. Gout is a form of inflammatory arthritis caused by the buildup of uric acid crystals in joints. The pain experienced during a gout flare-up is intense and is often described as excruciating. This pain is typically sudden in onset and can be debilitating for the individual. Option A, joint swelling, is a common symptom of gout, but it is not the defining characteristic. While joint swelling may accompany gout attacks, it is not unique to gout and can be seen in other types of arthritis as well. Option B, tophi, are lumps of uric acid crystals that can form under the skin near joints affected by gout. While tophi are a characteristic feature of chronic gout, they are not the initial or hallmark symptom of the condition. Option D, redness, is another common symptom of gout during an acute flare-up. The affected joint may appear red, warm, and swollen. However, redness alone is not the primary defining feature of gout. In an educational context, understanding the hallmark symptoms of gout is crucial for nurses caring for pediatric patients with this condition. Recognizing the severe pain associated with gout can help healthcare providers provide appropriate pain management strategies and interventions to improve the quality of life for pediatric patients experiencing gout flare-ups.

Correct Answer: D

Rationale: The correct answer to the question is D) All of the above. Rheumatoid arthritis (RA) is a systemic autoimmune condition that not only affects the joints but can also involve extra-articular manifestations. Interstitial lung disease is a common extra-articular manifestation of RA, leading to complications like pulmonary fibrosis. Cardiovascular disease is also prevalent in individuals with RA due to chronic inflammation impacting the heart and blood vessels. Neuropathy, on the other hand, is not a common extra-articular manifestation of RA. In an educational context, understanding the extra-articular manifestations of rheumatoid arthritis is crucial for healthcare professionals, especially pediatric nurses. Recognizing these manifestations can aid in early detection, appropriate management, and preventing further complications in pediatric patients with RA. It is essential for nurses to have a comprehensive understanding of how RA can impact various body systems beyond the joints to provide holistic care to pediatric patients with this condition.

Correct Answer: D

Rationale: In pediatric nursing, understanding the different types of spondyloarthropathies is crucial for providing comprehensive care to children with these conditions. In this question, the correct answer is D) Rheumatoid arthritis, as it is NOT a seronegative spondyloarthropathy. Rheumatoid arthritis is a systemic autoimmune disorder characterized by the presence of rheumatoid factor in the blood, which is considered seropositive. On the other hand, seronegative spondyloarthropathies, such as ankylosing spondylitis, reactive arthritis, and psoriatic arthritis, do not typically present with rheumatoid factor in the blood. Ankylosing spondylitis is a type of seronegative spondyloarthropathy that primarily affects the spine and sacroiliac joints. Reactive arthritis is characterized by joint inflammation following an infection in another part of the body. Psoriatic arthritis is associated with psoriasis and can affect the joints, skin, and nails. Educationally, understanding the differences between these conditions is essential for accurate diagnosis and appropriate management in pediatric patients. Nurses need to be able to recognize the unique clinical presentations of each condition to provide effective care and support to pediatric patients with spondyloarthropathies.