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 C

Explanation

Choice A Reason
While coronary artery spasm can cause chest pain, it is not the typical cause of unstable angina. Unstable angina is generally due to atherosclerotic heart disease, where plaque buildup in the coronary arteries restricts blood flow. This statement does not fully reflect an understanding of the condition.

Choice B Reason
Beta blockers are often prescribed to manage angina as they reduce the heart's workload and oxygen demand. However, they do not always prevent angina pain, especially in the case of unstable angina, which can occur unpredictably and not just during exertion. This statement shows partial understanding but lacks the urgency associated with unstable angina.

Choice C Reason
Seeking immediate medical attention when experiencing angina pain is crucial, especially in the case of unstable angina, which can signal an impending heart attack. This statement indicates that the client understands the seriousness of their condition and the need for prompt action.

Choice D Reason
While rest can help alleviate stable angina pain, unstable angina is less predictable and may not be relieved by rest. This type of angina requires medical evaluation to prevent more serious complications, such as myocardial infarction. This statement does not convey an adequate understanding of the condition.

A. The client is free of chest pain and dyspnea. B. The client describes the importance of increasing fluid intake. C. The client increases aerobic exercises to promote endurance. D. The client's acute pain is controlled at 3 on a standard pain scale.

Correct Answer is ["A","B","D"]

Explanation

Choice A reason:
Being free of chest pain and dyspnea is a significant indicator of successful nursing intervention in a sickle cell crisis. Chest pain and dyspnea can occur due to acute chest syndrome, a life-threatening complication of sickle cell disease characterized by vaso-occlusion in the pulmonary microcirculation. Effective pain management and oxygen therapy can alleviate these symptoms, reflecting improved respiratory function and gas exchange.

Choice B reason:
Educating the client on the importance of increasing fluid intake is crucial in managing sickle cell crisis. Adequate hydration helps to reduce blood viscosity and prevent sickling of red blood cells, which can lead to vaso-occlusive episodes. When a client verbalizes understanding and the importance of hydration, it demonstrates the effectiveness of patient education and the client's engagement in self-care.

Choice C reason:
While increasing aerobic exercises may promote endurance, it is not typically a short-term outcome measure for a sickle cell crisis. Exercise must be approached with caution in these clients, as it can increase the risk of a vaso-occlusive crisis due to dehydration and increased oxygen demand during a sickle cell crisis.

Choice D reason:
Control of acute pain to a level of 3 on a standard pain scale indicates successful pain management, a primary goal in the treatment of sickle cell crisis. Pain in sickle cell crisis is due to ischemia from obstructed blood flow by sickled cells. Effective analgesic administration and pain management strategies are essential to achieve this outcome.

Choice E reason:
A leukocyte count of 18,000/mm³ is above the normal range (4,500 to 11,000/mm³) and may indicate an infection or inflammation, which are common complications of sickle cell disease. However, this is not a direct outcome of nursing interventions aimed at managing a sickle cell crisis and thus is not a correct choice.

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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

Which statement, made by the client diagnosed with unstable angina, reflects an understanding of the nurse's discharge teaching?

Correct Answer is C

Explanation

How can the nurse determine that the outcomes of nursing interventions have been successful for the client diagnosed with a sickle cell crisis? (SELECT ALL THAT APPLY)

Correct Answer is ["A","B","D"]

Explanation

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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?