A client asks a nurse, “Why do I have to remove my nail polish in order for my pulse oximetry to be monitored?” Which is the best response by the nurse?

Choice A is wrong because women are more at risk for hip fractures than men.

This is partly because women lose bone density faster than men do, especially after menopause.

Choice C is wrong because an increase in estrogen will not weaken the bones. In fact, estrogen helps protect the bones from osteoporosis, which is a leading cause of hip fracture.

Some other risk factors for hip fracture include:

• Excessive alcohol and caffeine consumption
• Lack of physical activity
• Low body weight
• Tall stature
• Vision problems
• Dementia
• Medications that cause bone loss
• Cigarette smoking
• Institutional living, such as an assisted-care facility
• Increased risk for falls, related to conditions such as weakness, disability, or unsteady gait

Normal ranges for bone density vary by age and sex, but generally, a T-score of -1.0 or above is considered normal, while a T-score of -2.5 or below is considered osteoporotic. A T-score between -1.0 and -2.5 is considered osteopenic, which means low bone mass.

The client with a labored respiratory rate of 28 should be seen first because this indicates respiratory distress, which is a life-threatening condition that requires immediate intervention. Respiratory rate is one of the vital signs that are used to assess the severity of a patient’s condition and to triage them accordingly. A normal respiratory rate for an adult is 12 to 20 breaths per minute.

Choice A is wrong because a large laceration on the left scapula is not as urgent as respiratory distress.

A laceration is a wound that involves a cut or tear in the skin, which may cause bleeding, pain, and infection. However, it can be managed with wound care and suturing in the urgent care center.

Choice B is wrong because a compound fracture of the right tibia is not as urgent as respiratory distress.

A compound fracture is a fracture that breaks through the skin, which may cause bleeding, pain, infection, and nerve or blood vessel damage. However, it can be stabilized with splinting and dressing in the urgent care center before transferring to a hospital for further treatment.

Choice C is wrong because being unable to breastfeed a 4 week old is not as urgent as respiratory distress.

Breastfeeding difficulties may be caused by various factors, such as poor latch, low milk supply, sore nipples, or mastitis. However, they can be managed with education, support, and medication in the urgent care center.