Ms. Major, a 60-year-old female, presents to the emergency department after falling off a 25-foot ladder while cleaning the gutters. She complains of right-sided hip pain and is unable to bear weight. She has contusions on her right side and some scrapes and scratches but denies hitting her head or sustaining other injuries. She is diagnosed with a hip fracture. Ms. Major is a small-framed woman, very active, follows a healthy diet, and is well engaged in her community with many friends. What factor(s) make her more at risk for a hip fracture?
Active lifestyle and community engagement
Her active lifestyle and social engagement reduce her risk
Healthy diet and social support
Small frame and age-related bone density loss
The Correct Answer is D
Choice A reason: Active lifestyle and community engagement are protective, not risk factors, for hip fractures. Small frame and age-related bone loss increase fracture risk, so this misidentifies beneficial factors as risks and is incorrect.
Choice B reason: Active lifestyle and social engagement may reduce risk, but the question asks for risk factors. Small frame and age-related bone loss are primary risks for Ms. Major’s fracture, so this is incorrect.
Choice C reason: Healthy diet and social support are protective, not risk factors. Ms. Major’s small frame and age (60) increase bone density loss, elevating fracture risk, so this is incorrect.
Choice D reason: Small frame and age-related bone density loss (at 60) increase Ms. Major’s hip fracture risk, as lower bone mass and aging weaken bones. These are key risk factors, making this correct.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Retching is the involuntary attempt to vomit, involving abdominal muscle contractions without expelling stomach contents. The patient is actively expelling contents, which defines vomiting, not just the effort of retching, making this an incorrect term for documentation.
Choice B reason: Expectorate refers to coughing up and spitting out mucus or sputum from the respiratory tract. The patient is expelling stomach contents, not respiratory secretions, making expectorate an incorrect term for this gastrointestinal event.
Choice C reason: Regurgitation is the passive return of undigested food or liquid from the stomach or esophagus, often without force. The forceful expulsion of stomach contents described indicates vomiting, not regurgitation, making this an incorrect documentation term.
Choice D reason: Vomiting is the forceful expulsion of stomach contents through the mouth, driven by coordinated abdominal and diaphragmatic contractions. The patient’s active expulsion into a basin matches this definition, making vomiting the correct term for documentation.
Correct Answer is C
Explanation
Choice A reason: Gout tophi are urate crystal deposits, typically on joints like the big toe, not widespread on hands. Osteoarthritis nodes (Heberden’s/Bouchard’s) are more common in elderly hands, so this is incorrect.
Choice B reason: Rheumatoid nodules occur in rheumatoid arthritis, usually near elbows, not diffusely on hands. Osteoarthritis nodes are bony growths on finger joints, more likely in this patient, so this is incorrect.
Choice C reason: Osteoarthritis nodes (Heberden’s and Bouchard’s) are bony lumps on finger joints, common in elderly women with joint pain. This matches the hand findings, making it the correct diagnosis.
Choice D reason: Carpal tunnel syndrome causes wrist pain and numbness, not joint lumps. Osteoarthritis nodes explain the hand bumps in this elderly patient, so this is incorrect.
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