A patient is admitted with an open fracture of the tibia after a bicycle accident. What information would the nurse obtain when assessing the patient?

The status of tetanus immunization.

Whether the injury was exposed to dirt or gravel.

Any previous injuries to the leg.

The use of antibiotics in the last month.

Answer and Explanation

The Correct Answer is A

Choice A reason: Assessing tetanus immunization status is critical for an open fracture, as wounds exposed to soil or debris risk Clostridium tetani infection. Tetanus prophylaxis (vaccine or immunoglobulin) prevents lockjaw and neuromuscular complications. This ensures timely immunization, reducing life-threatening infection risks in contaminated wounds like those from bicycle accidents.

Choice B reason: Determining exposure to dirt or gravel is essential, as open fractures are prone to bacterial contamination (e.g., Staphylococcus aureus or Pseudomonas). Contaminated wounds require urgent irrigation, debridement, and antibiotics. This assessment guides infection prevention, ensuring prompt surgical and antimicrobial interventions to minimize osteomyelitis or sepsis risks in open tibial fractures.

Choice C reason: Previous leg injuries are relevant for overall musculoskeletal history but not immediate for open fracture management. Current wound contamination and infection risk take precedence. Focusing on past injuries delays critical interventions like tetanus prophylaxis or debridement, potentially worsening outcomes in acute open fractures from bicycle accidents.

Choice D reason: Recent antibiotic use is less urgent than contamination or tetanus status in open fractures. While it may inform antibiotic resistance, it’s not a primary assessment focus. Prioritizing this risks delaying wound cleaning and prophylaxis, increasing infection risks like cellulitis or osteomyelitis in contaminated open tibial fractures.

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Correct Answer is B

Explanation

Choice A reason: Ankylosis, fusion of spinal joints, is associated with ankylosing spondylitis, not osteoporosis. Osteoporosis causes bone density loss, leading to fractures and deformities like kyphosis, not joint fusion. Expecting ankylosis misaligns assessment, potentially overlooking osteoporosis-related vertebral compression fractures critical for managing mobility and pain in older adults.

Choice B reason: Kyphosis, an exaggerated thoracic spine curvature, is common in osteoporosis due to vertebral compression fractures from weakened bones. These fractures collapse anteriorly, causing a hunchback appearance, affecting posture and balance. Recognizing kyphosis guides interventions like bracing or bisphosphonates to prevent further fractures and improve quality of life.

Choice C reason: Scoliosis, lateral spine curvature, is typically congenital or idiopathic, not directly caused by osteoporosis. While osteoporosis may exacerbate existing scoliosis through fractures, it’s not a primary deformity. Expecting scoliosis risks misdiagnosis, diverting focus from osteoporosis-related kyphosis and its management, like calcium supplementation or physical therapy.

Choice D reason: Lordosis, exaggerated lumbar curvature, is not typical in osteoporosis. Osteoporosis primarily affects thoracic vertebrae, causing kyphosis from compression fractures. Lordosis may occur in other conditions like muscular imbalances, but expecting it in osteoporosis misguides assessment, delaying interventions for fracture prevention and spinal stability in older adults.

A. I should increase my caffeine intake. B. I will take my duloxetine in the morning, so I have more energy to accomplish tasks. C. A course of chemotherapy treatment should provide a cure. D. Low-impact aerobics can help reduce episodes of pain.

Correct Answer is D

Explanation

Choice A reason: Increasing caffeine intake is not recommended for fibromyalgia, as it can exacerbate sleep disturbances and anxiety, common in the condition. Fibromyalgia management focuses on improving sleep, reducing pain, and enhancing function through exercise and medications. This statement reflects misunderstanding, potentially worsening symptoms and hindering effective self-management strategies.

Choice B reason: Taking duloxetine in the morning is reasonable but not the best indicator of fibromyalgia teaching comprehension. Duloxetine, a serotonin-norepinephrine reuptake inhibitor, helps pain and mood but isn’t primarily for energy. This statement shows partial understanding, missing broader management strategies like exercise, which are central to fibromyalgia care.

Choice C reason: Chemotherapy is irrelevant for fibromyalgia, a non-inflammatory pain syndrome, not a malignancy. This statement indicates a significant misunderstanding of fibromyalgia’s nature and treatment, which involves exercise, medications like duloxetine, and cognitive therapies. Expecting a cure via chemotherapy misaligns expectations, delaying effective symptom management and patient education.

Choice D reason: Low-impact aerobics reduce fibromyalgia pain by improving muscle conditioning, circulation, and endorphin release, supported by evidence-based guidelines. This statement reflects understanding of nonpharmacological management, a cornerstone of fibromyalgia treatment, promoting physical function and pain relief, and aligning with comprehensive care to enhance quality of life.

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A patient is admitted with an open fracture of the tibia after a bicycle accident. What information would the nurse obtain when assessing the patient?

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Naxlex Comprehensive Predictor Exams

A nurse is assessing an older adult client who has osteoporosis. Which of the following spinal deformities should the nurse expect to find in the client?

Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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