When obtaining a nursing history, which of the following represents a major complaint of a patient with osteoarthritis?

Correct Answer: B

Rationale: In assessing a patient with osteoarthritis, the major complaint often includes joint-related symptoms. Grating during hip motion (option B) is a common complaint in osteoarthritis due to the degeneration of joint cartilage, resulting in friction during movement. This symptom aligns with the pathophysiology of osteoarthritis and is a hallmark sign for this condition. Numbness of the lower extremities (option A) is more indicative of neurological issues such as nerve compression or neuropathy, not typically associated with osteoarthritis. Cramping of calf muscles at night (option C) is more suggestive of vascular issues like peripheral artery disease. Cold feet when sitting (option D) could be related to poor circulation or nerve-related problems but is not a typical complaint specifically linked to osteoarthritis. Educationally, understanding the distinguishing symptoms of various conditions is crucial for accurate assessment and diagnosis in nursing practice. Connecting symptoms to their underlying pathophysiology aids in providing appropriate interventions and improving patient outcomes. Students need to grasp the significance of specific complaints in differentiating between musculoskeletal, neurological, and vascular disorders to deliver effective patient care.

Correct Answer: B

Rationale: The correct answer is B) First thing in the morning on an empty stomach with a full glass of water, 30 to 60 minutes before eating, without lying down. This is the proper way to take bisphosphonate medications for the treatment of osteoporosis because these medications are best absorbed on an empty stomach. Taking them with a full glass of water helps ensure proper absorption and reduces the risk of irritation to the esophagus. It is important to remain upright for 30 to 60 minutes after taking bisphosphonates to prevent reflux and potential irritation of the esophagus. Option A) On a full stomach is incorrect because bisphosphonates should be taken on an empty stomach to maximize absorption. Option C) Just before getting into bed is incorrect because lying down too soon after taking bisphosphonates can increase the risk of esophageal irritation. Option D) With an acidic liquid, like orange juice, is incorrect because acidic beverages can reduce the absorption of bisphosphonates. In an educational context, teaching patients the correct way to take their medications is crucial for ensuring treatment efficacy and minimizing side effects. Proper medication administration can significantly impact the outcomes of therapy, especially in conditions like osteoporosis where adherence to medication regimens is essential for preventing fractures and maintaining bone health. Providing clear instructions on medication administration empowers patients to take an active role in their treatment and promotes better health outcomes.

Correct Answer: B

Rationale: The correct answer is B) Canned salmon with bones. This option is the best choice because it contains both calcium and vitamin D, which are essential for optimal calcium absorption in the body. The bones in canned salmon are a rich source of easily absorbable calcium, making it an ideal non-dairy source for meeting daily calcium requirements. Option A) Green leafy vegetables are good sources of calcium, but the calcium in them is not as easily absorbed by the body compared to the calcium in salmon with bones. Option C) Broccoli contains some calcium, but the amount is relatively low compared to what the client may need to meet daily requirements. Option D) Calcium-fortified orange juice is a good source of calcium, but it may not provide as much calcium per serving as canned salmon with bones. In an educational context, it is important for healthcare professionals to be knowledgeable about alternative sources of nutrients, especially for clients with specific dietary restrictions or preferences. Understanding the bioavailability of nutrients from different food sources can help in providing appropriate dietary recommendations for clients to support their recovery and overall health.

Correct Answer: A

Rationale: The correct answer is A) Severe pain at the site of the fracture. When assessing a client with a femoral neck fracture, monitoring for severe pain is crucial because it is a typical symptom associated with this type of injury. Femoral neck fractures can cause intense pain in the hip or groin area, which can be exacerbated by movement or weight-bearing. This symptom is indicative of the severity of the injury and can also help in determining the need for immediate medical intervention to manage pain and prevent complications like immobility or further damage. Option B) Bleeding from joint capsules is not typically a common symptom associated with a femoral neck fracture. While there may be internal bleeding associated with the fracture, it is not usually visible externally as bleeding from joint capsules. Option C) Muscle spasms are not specific to femoral neck fractures and can occur due to various reasons such as muscle strain or nerve irritation. While muscle spasms can be a response to pain, they are not unique to this type of fracture. Option D) Crepitus at the site of the fracture, which refers to a grating or grinding sensation or sound with movement, is more commonly associated with conditions like osteoarthritis or joint injuries involving cartilage damage. It is not a typical finding in femoral neck fractures. Educationally, understanding the specific symptoms associated with different types of fractures is crucial for nurses to accurately assess and provide appropriate care to clients. Recognizing the key signs of a femoral neck fracture, such as severe pain, enables prompt intervention and can help prevent complications and promote better outcomes for the patient.

Correct Answer: C

Rationale: In the case of a patient diagnosed with advanced ALS, the priority intervention is to develop a method of communication, which is option C. This is the correct answer because communication is essential for maintaining the patient's dignity, autonomy, and quality of life. ALS progressively impairs the patient's ability to speak and move, making effective communication challenging. By developing a method of communication, such as using communication boards, eye-tracking devices, or other assistive technologies, the healthcare team can ensure the patient's needs, preferences, and concerns are heard and addressed. Option A is incorrect because focusing solely on providing meals without addressing communication neglects the patient's holistic needs and preferences. Option B is inappropriate as it disregards the patient's right to participate in decisions about their care, regardless of their mental status. Option D is incorrect as it prioritizes meal provision over addressing the crucial issue of communication in a patient with ALS. Educationally, this question highlights the importance of recognizing the holistic needs of patients with neurological conditions, such as ALS, and the significance of effective communication in providing patient-centered care. It emphasizes the role of healthcare professionals in ensuring that patients with communication challenges are supported in expressing their needs and maintaining their agency and dignity.