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 B
Explanation
Choice A reason: Redness and heat are local inflammatory signs, occurring at the injury site due to vasodilation. Systemic manifestations, like fever and leukocytosis, affect the whole body, reflecting immune activation, so this is incorrect for systemic inflammation.
Choice B reason: Fever and leukocytosis are systemic manifestations of inflammation, involving the entire body. Fever results from cytokine release, and leukocytosis indicates increased white blood cells, both reflecting widespread immune response, making this the correct choice for systemic effects.
Choice C reason: Pain and edema are primarily local inflammatory responses, occurring at the site of injury or infection. Systemic effects, like fever and leukocytosis, involve broader physiological changes, so this is incorrect for systemic inflammation manifestations.
Choice D reason: Formation of exudates is a local inflammatory response, involving fluid leakage at the injury site. Systemic manifestations, such as fever and leukocytosis, affect the whole body, so this is incorrect for the systemic category of inflammation.
Correct Answer is ["A","B","D","E"]
Explanation
Choice A reason: Loss of short-term memory is a hallmark of Alzheimer’s disease, as seen in the patient’s difficulty recalling recent events. This reflects early hippocampal damage, impairing new memory formation, making it a correct clinical manifestation for this diagnosis.
Choice B reason: Alzheimer’s disease is the most likely diagnosis, given progressive memory loss, word-finding difficulties, and an MMSE score of 20/30 in a 65-year-old. These symptoms align with Alzheimer’s neurodegenerative pattern, making this the correct diagnosis.
Choice C reason: Vascular dementia typically presents with stepwise cognitive decline and focal neurological signs, often with vascular risk factors. The patient’s gradual memory loss without such history better fits Alzheimer’s, making vascular dementia incorrect.
Choice D reason: Word-finding difficulties, as exhibited, are a hallmark of Alzheimer’s, reflecting language cortex involvement. This progressive aphasia, common in early stages, impairs communication, making it a correct clinical manifestation for this patient.
Choice E reason: Disorientation to time and place, though not explicitly stated, is a hallmark of Alzheimer’s, often emerging as memory declines. Given the patient’s MMSE score and symptoms, this is likely, making it a correct manifestation.
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