A client has come to the orthopedic clinic for a follow-up appointment 6 weeks after fracturing his ankle. Diagnostic imaging reveals that bone union is not taking place. What factor most likely contributed to this complication?

Inadequate immobilization

Venous thromboembolism

Inadequate vitamin D intake

Bleeding at the injury site

Answer and Explanation

The Correct Answer is A

A. Inadequate immobilization: Proper immobilization is essential for fractured bones to heal correctly. Immobilization, often achieved through casts, splints, or other orthopedic devices, stabilizes the broken bone fragments, allowing them to fuse back together. If the immobilization is not sufficient or if the patient doesn't follow the prescribed immobilization protocol, there can be excessive movement at the fracture site, hindering the healing process.

B. Venous thromboembolism: Venous thromboembolism (VTE) refers to the formation of blood clots in veins, usually in the legs (deep vein thrombosis) that can travel to the lungs (pulmonary embolism). While VTE is a potential complication after a fracture, it is not a direct cause of delayed bone union.

C. Inadequate vitamin D intake: Vitamin D is essential for bone health as it helps the body absorb calcium, which is crucial for bone formation and maintenance. Inadequate vitamin D levels can weaken bones and impair the healing process, but it's not a common cause of delayed bone union unless there are severe deficiencies or underlying medical conditions.

D. Bleeding at the injury site: Bleeding at the injury site occurs immediately after the fracture and is a natural part of the body's response to injury. While excessive bleeding can lead to complications, it is not a likely cause of delayed bone union six weeks after the injury. In the early stages of healing, bleeding is replaced by the formation of a hematoma, which eventually transforms into a callus and aids in the bone healing process.

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Correct Answer is A

Explanation

A. Sedentary lifestyle - Lack of weight-bearing exercise and physical activity is a significant risk factor for the development of osteoporosis. Weight-bearing exercises help maintain bone density and strength. Sedentary individuals are more prone to osteoporosis.

B. Long-term use of diuretics - Long-term use of certain medications, such as corticosteroids, can increase the risk of osteoporosis. Diuretics are not typically associated with osteoporosis risk, although some medications can affect bone health.

C. Prolonged stress - Chronic stress can have negative effects on overall health, but it is not a direct risk factor for osteoporosis.

D. Obesity - Obesity is generally considered a protective factor against osteoporosis. Individuals with higher body weight tend to have stronger bones due to the mechanical load placed on the bones, reducing the risk of osteoporosis.

A. Restrict calcium intake to one serving per day. B. Take 3.000 mg of vitamin C daily. C. The nurse should instruct the client to limit foods high in purines. D. Eat 12 oz of animal protein daily.

Correct Answer is C

Explanation

A. Restrict calcium intake to one serving per day:
This statement is not accurate. Adequate calcium intake is essential for bone health. Calcium-rich foods are important for maintaining strong bones and are not directly related to gout or uric acid kidney stones. It's crucial to differentiate between dietary recommendations for different health conditions.

B. Take 3,000 mg of vitamin C daily:
High doses of vitamin C can increase urinary oxalate and uric acid levels, which might contribute to the formation of kidney stones. It is generally not recommended for individuals with a history of uric acid kidney stones.

C. The nurse should instruct the client to limit foods high in purines.
Dietary changes are important in managing gout and preventing uric acid kidney stones. Purines are natural substances found in many foods, especially animal products, and purine-rich foods can contribute to increased uric acid levels, leading to gout attacks and kidney stones.

D. Eat 12 oz of animal protein daily:
Consuming excessive amounts of animal protein, particularly red meat, can lead to higher purine intake, which is not advisable for individuals prone to gout and uric acid kidney stones. High animal protein intake can increase uric acid production and may exacerbate these conditions. Moderation in protein intake, especially from animal sources, is recommended.

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A client has come to the orthopedic clinic for a follow-up appointment 6 weeks after fracturing his ankle. Diagnostic imaging reveals that bone union is not taking place. What factor most likely contributed to this complication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in a provider's office is collecting a health history from a client who is at risk for primary osteoporosis. Which of the following findings is a risk factor for the development of osteoporosis?

Correct Answer is A

Explanation

A nurse is providing dietary teaching to a client who has a history of gout and recurring uric acid kidney stones. Which of the following instructions should the nurse include in the teaching?

Correct Answer is C

Explanation

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