A nurse is providing education to a female client that has a diagnosis of osteoporosis.
Which of the following statements by the client best indicates an understanding of the teaching?
I should place a throw rug over electrical cords so I don't trip over the cord.
I should use chairs without armrests so I can slide off the chair easier.
It is a good idea to use the handrails in the bathroom and non-skid socks.
I should get a longer cord for my telephone since it is difficult for me to stand from a sitting position.
The Correct Answer is C
Choice C rationale
Osteoporosis significantly increases the risk of fractures due to decreased bone mineral density, making fall prevention the highest priority for safety. Using handrails in the bathroom provides stability during transitions, while non-skid socks prevent slipping on smooth surfaces. These interventions directly address the physical environment to reduce the likelihood of a fall, which could lead to a devastating hip or spinal fracture in a client with compromised bone structural integrity.
Choice B rationale
Using chairs without armrests is unsafe for a client with osteoporosis because armrests provide necessary leverage and support when standing up or sitting down. Without them, the client is more likely to lose their balance or experience a fall. Safe furniture for those with bone density issues should be sturdy and provide ergonomic support to assist with mobility, rather than making it easier to slide off, which increases the risk of injury.
Choice C rationale
The use of handrails and non-skid socks represents an effective strategy for fall prevention by enhancing grip and stability. For women with osteoporosis, even a minor slip can result in a serious fracture. Bathroom safety is particularly critical due to wet surfaces. Implementing these environmental modifications demonstrates that the client understands how to mitigate their specific risk factors and maintain a safe living environment to protect their fragile skeletal system.
Choice D rationale
Using a longer telephone cord creates a significant tripping hazard, which is exactly what a client with osteoporosis must avoid. If the client finds it difficult to stand from a sitting position, the nurse should recommend a chair with a higher seat and armrests or a physical therapy consultation for strengthening. Suggesting a longer cord ignores the primary safety goal of keeping walkways clear of obstructions to prevent falls and subsequent bone fractures.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Gout is a form of inflammatory arthritis triggered by hyperuricemia, which is an excess of uric acid in the blood. When the concentration exceeds the solubility limit, monosodium urate crystals precipitate in the joints. This triggers an immune response where white blood cells engulf the crystals, releasing inflammatory mediators. This process causes the classic signs of heat, redness, and extreme pain. Normal serum uric acid levels are generally 3.5 to 7.2 mg/dL.
Choice B rationale
The development of gout is associated with high levels of uric acid, not low levels. Uric acid is a byproduct of purine metabolism. When levels drop significantly below the normal range, it does not cause crystal deposition or joint inflammation. The pathology of the disease relies entirely on the saturation of the blood and synovial fluid with urate, leading to crystallization. Therefore, a decrease in uric acid would actually reduce the risk of an attack.
Choice C rationale
Tophi are large, visible deposits of urate crystals that typically form in the skin, cartilage, or joints after years of uncontrolled hyperuricemia. While urate crystals can deposit in the kidneys and lead to renal stones or urate nephropathy, the tophi themselves are a result of the disease rather than the initial cause of it. The primary cause is the underlying metabolic imbalance or decreased renal excretion of uric acid that leads to the initial crystallization.
Choice D rationale
The thinning, splitting, and fragmentation of articular cartilage are the primary pathophysiological hallmarks of osteoarthritis, which is a degenerative joint disease. Gout is distinct from osteoarthritis because it is an inflammatory process caused by chemical crystals rather than mechanical wear and tear. While chronic gout can eventually lead to secondary joint damage and cartilage destruction, the initial development of the disorder is specifically defined by the presence and reaction to uric acid crystals.
Correct Answer is D
Explanation
Choice A rationale
While certain medications like anticholinergics or corticosteroids can affect vision or lead to cataracts and glaucoma, they are not the primary cause of age-related loss of near vision. The client's progressive trouble with close vision at age 45 is a classic physiological change. Attributing the change solely to medications ignores the natural aging process of the eye. A thorough history would be needed, but this statement does not show an understanding of presbyopia.
Choice B rationale
Eye trauma can cause various visual disturbances, including retinal detachment or traumatic cataracts, which might affect vision at any distance. However, trauma usually results in sudden or localized changes rather than a bilateral, progressive difficulty with near work. If the client had no history of injury, this explanation is incorrect. Understanding the problem involves recognizing that the lens loses elasticity over time, which is a developmental change rather than an accidental one.
Choice C rationale
Chronic hypertension can lead to hypertensive retinopathy, which may cause blurred vision or vision loss due to vascular damage in the retina. While maintaining blood pressure is vital for ocular health, it is not the typical reason a 45-year-old begins to struggle specifically with reading or close-up tasks. Presbyopia is a refractive error related to lens flexibility, whereas hypertension affects the vascular integrity of the eye. Therefore, this statement indicates a misunderstanding of the condition.
Choice D rationale
Presbyopia is the age-related loss of the eye's ability to focus actively on nearby objects. It typically becomes noticeable in the early to mid-40s as the crystalline lens loses elasticity and the ciliary muscles weaken. When the client identifies these symptoms as early signs of presbyopia, it demonstrates they understand the explanation of the natural aging process. This condition is easily corrected with reading glasses or bifocals and is considered a normal part of aging.
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