A 40-year-old client reports chronic lower back pain and stiffness. X-rays of the lumbar spine confirm the diagnosis of moderate to severe osteoarthritis. The nurse identifies which predisposing factor may have led to these degenerative changes?

Weekly aerobic exercise at a gym

Vitamin D deficiency

Weight of <60 kg

Trauma

Answer and Explanation

The Correct Answer is B

Choice A Reason:
Weekly aerobic exercise at a gym is generally beneficial for joint health and is not a predisposing factor for osteoarthritis. Regular physical activity helps maintain joint flexibility, muscle strength, and overall health, which can actually help prevent the development of osteoarthritis.

Choice B Reason:
Vitamin D deficiency has been associated with an increased risk of osteoarthritis. Vitamin D is essential for bone health, and a deficiency can lead to changes in bone structure and strength, potentially contributing to the development and progression of osteoarthritis.

Choice C Reason:
A weight of less than 60 kg does not typically predispose an individual to osteoarthritis. In fact, maintaining a healthy weight can reduce the risk of developing osteoarthritis, as excess body weight can increase the stress on joints.

Choice D Reason:
Trauma can lead to post-traumatic osteoarthritis, which is a form of osteoarthritis that develops after an injury to a joint. Traumatic injuries can damage the cartilage and bone, leading to degenerative changes and osteoarthritis.

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Correct Answer is A

Explanation

Choice A reason:
Duloxetine is a medication that should not be stopped abruptly due to the risk of withdrawal symptoms. Gradual tapering is recommended to minimize these symptoms. This understanding by the client indicates effective medication teaching.

Choice B reason:
The statement about the medication being safe with herbal supplements is incorrect. Patients should consult their healthcare provider before using herbal supplements with duloxetine, as there can be interactions.

Choice C reason:
The need to avoid aged cheese is associated with monoamine oxidase inhibitors (MAOIs), not duloxetine, which is a selective serotonin and norepinephrine reuptake inhibitor (SNRI). This statement does not reflect accurate medication teaching for duloxetine.

Choice D reason:
Taking extra doses for anxiety without consulting a healthcare provider is not recommended. Duloxetine dosing should be consistent and as prescribed by a healthcare provider. This statement suggests a misunderstanding of medication management.

A. Provide bright lighting and check on the client's mental status hourly. B. Keep the lights dim and keep a radio on continuously. C. Have the client sit by the nurse's desk while awake and provide rest periods in a room with the television on. D. Provide a well-lit room without glare or shadows and limit noise.

Correct Answer is D

Explanation

Choice A Reason:
Bright lighting can be overwhelming for clients experiencing perceptual alterations. While regular checks on the client's mental status are important, excessive brightness can exacerbate sensory overload. The goal is to create an environment that is calming and reduces sensory stimuli to manageable levels.

Choice B Reason:
Keeping the lights dim may help to soothe some clients, but continuous noise from a radio can contribute to sensory overload. It's crucial to tailor the environment to the individual needs of the client, which often means providing a quiet space with minimal auditory distractions.

Choice C Reason:
Having the client sit by the nurse's desk may provide necessary supervision, but it can also expose the client to high levels of activity and noise, which can be disorienting. Rest periods with the television on can be distracting and may not offer the tranquil environment needed for a client with perceptual alterations.

Choice D Reason:
Providing a well-lit room without glare or shadows and limiting noise is the most appropriate environmental change for a client with perceptual alterations. This approach helps to reduce the risk of misperceptions and hallucinations, which can be triggered by shadows and glare. A quiet and well-lit environment supports better sensory processing and helps to maintain orientation.

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A 40-year-old client reports chronic lower back pain and stiffness. X-rays of the lumbar spine confirm the diagnosis of moderate to severe osteoarthritis. The nurse identifies which predisposing factor may have led to these degenerative changes?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client diagnosed with depression is prescribed duloxetine. Which statement made by the client would allow the nurse to assess that the medication teaching has been effective?

Correct Answer is A

Explanation

What environmental changes should the nurse make for a client who is experiencing perceptual alterations?

Correct Answer is D

Explanation

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