The nurse is assessing a client with Paget's disease. Which finding would the nurse identify as being characteristic of this disease?

Elevated serum calcium levels

Elongated trunk

Warm, swollen areas over femur

Mosaic pattern of bone

Answer and Explanation

The Correct Answer is D

A. Elevated serum calcium levels: This is not typical for Paget's disease. While hypercalcemia can occur in advanced stages, the primary issue in Paget's disease is abnormal bone remodeling.

B. Elongated trunk: This is not characteristic of Paget's disease. Paget's disease affects bone remodeling and can lead to deformities such as bowing of the legs or enlarged bones, but not an elongated trunk.

C. Warm, swollen areas over femur: This can occur in Paget's disease due to increased blood flow to the affected bones, but it is not the most distinctive feature.

D. Mosaic pattern of bone: This pattern, which appears on X-ray, is a hallmark of Paget’s disease, indicating disorganized bone remodeling and a disruption of normal bone architecture.

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Correct Answer is D

Explanation

A. Apply warm compresses to site of the client's pacemaker insertion: Heat application is contraindicated as it may increase swelling or risk infection.

B. Teach the client to avoid being near any type of household microwave oven: Modern pacemakers are shielded, so microwaves do not interfere with their function.

C. Ambulate the client as soon as possible to evaluate pacemaker function: While early ambulation is encouraged, pacemaker function is not evaluated through ambulation.

D. Instruct client to limit movement of the arm on side where pacemaker was inserted: Limiting arm movement prevents dislodging the pacemaker leads during the healing phase.

A. The client's head should be turned to the side with the head of the bed elevated 60 degrees. B. The client's head should be placed on a flat pillow with the foot of the bed higher than the head. C. The client should be placed in dorsal recumbent with the head placed on pillows for comfort. D. The head of the bed should be elevated 30 degrees with the head in neutral midline position.

Correct Answer is D

Explanation

A. The client's head should be turned to the side with the head of the bed elevated 60 degrees. Elevating the head of the bed too high can cause a decrease in venous return, which can increase intracranial pressure.

B. The client's head should be placed on a flat pillow with the foot of the bed higher than the head. This position would not help with reducing intracranial pressure and may worsen it.

C. The client should be placed in dorsal recumbent with the head placed on pillows for comfort. This position does not provide optimal head elevation to decrease intracranial pressure.

D. The head of the bed should be elevated 30 degrees with the head in neutral midline position. A head elevation of 30 degrees with the head in a neutral midline position is ideal for promoting venous drainage from the brain, which helps reduce intracranial pressure.

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The nurse is assessing a client with Paget's disease. Which finding would the nurse identify as being characteristic of this disease?

Nursing Test Bank

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