Question 1 of 6
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Which priority concern would the nurse monitor for potential development during the immediate postoperative period for a patient with insulin-dependent diabetes who has received a left below-the-knee amputation secondary to peripheral vascular complications?
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- InfectionSigns and symptoms of infection and contracture do not appear for 24 to 48 hours postoperatively; standard nursing measures (e.g., deep breathing, incentive spirometer, correct positioning) would address these issues.
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- HemorrhageHemorrhage is the immediate concern after an amputation.
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- Respiratory statusAlthough respiratory status is always the general priority, the question asks for the priority specifically related to the patient’s musculoskeletal diagnosis.
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- Contracture formationSigns and symptoms of infection and contracture do not appear for 24 to 48 hours postoperatively; standard nursing measures (e.g., deep breathing, incentive spirometer, correct positioning) would address these issues.
Question 2 of 6
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Which response would the nurse use when the patient states, “I feel my leg” when changing a patient’s surgical site dressing on a lower-left limb amputation?
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- “You have lost your leg.”This response is not therapeutic for the patient with a limb amputation and would not be used by the nurse.
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- “You feel your leg? It is healing well.”This response does not directly reply to the patient’s statement. The nurse would provide an explanation for the patient “feeling” the leg that is now absent.
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- “You are having phantom limb sensation.”Phantom limb sensations are common responses for patients who have amputations. Intravenous infusion of calcitonin during the week after amputation has been known to reduce phantom pain in many patients.
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- “You had better discuss this feeling with your health care provider soon.”This response is not therapeutic for the patient with a limb amputation and would not be used by the nurse. This sensation is common.
Question 3 of 6
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Which patient is at highest risk for developing osteoporosis?
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- 75-year-old patient who walks dailyAdvancing age puts patients at risk for osteoporosis, but this patient has only one risk factor. This does not place them at highest risk for developing osteoporosis.
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- 70-year-old patient who smokes cigarettesAdvanced age and smoking are both risk factors for developing osteoporosis. As all other options have only one risk factor, this patient is at highest risk.
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- 45-year-old patient who works in an officeSedentary lifestyle is a risk factor for osteoporosis, but this patient has only one risk factor. This does not place them at highest risk for developing osteoporosis.
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- 50-year-old patient who has chronic kidney diseaseChronic kidney disease may lead to osteoporosis, but this patient has only one risk factor. This does not place them at highest risk for developing osteoporosis.
Question 4 of 6
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Which potential complication is a patient taking alendronate and presenting with facial twitching and tingling in the extremities likely experiencing?
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- NeuropathyNeuropathy is not a likely complication of taking alendronate.
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- Cranial nerve deficitsAlendronate does not cause cranial nerve deficits.
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- HypernatremiaAlendronate does not lead to sodium imbalances.
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- HypercalcemiaFacial twitching and tingling in the extremities are signs of hypercalcemia, which is a potential side effect of alendronate.
Question 5 of 6
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Which response would the nurse provide to a patient on long-term steroid therapy who asks about exercise that may help bone health?
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- Exercise should be avoided because it can lead to fractures.Exercise should not be avoided; bone health is improved by weight bearing activities.
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- Swimming is excellent exercise to maintain bone health.Swimming is not typically a weight bearing activity that will enhance bone health.
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- Walking down stairs may be especially beneficial.Weight bearing activities are helpful for bone health, and walking down stairs has been proven to be especially beneficial.
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- Yoga may promote the health of bones.Evidence does not support yoga as a way to maintain bone health.
Question 6 of 6
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Which goal would be suggested for a patient hospitalized after a recent amputation of an upper extremity?
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- Brush hair without assistance.Goals should be small and related to self-care immediately after an amputation.
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- Use prosthesis appropriately.Using the prosthesis appropriately will require more time. Helping the patient find short-range goals is more appropriate.
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- Adapt to body changes.Significant time will be required to adapt to body changes. Helping the patient find short-range goals is more appropriate.
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- Complete all activities of living independently.Completing all goals independently may be too much after recent amputation. Helping the patient find short-range goals is more appropriate.