A client with a total hip replacement is progressing well and expects to be discharged tomorrow. On returning to bed after ambulating, he complains of a new onset of pain at the surgical site. What is the nurse's best action?

Administer pain medication as ordered

Assess the client for signs and symptoms of systemic infection

Assess the surgical site and the affected extremity

Reassure the client that pain is a direct result of increased activity

Notify the surgeon immediately

Answer and Explanation

The Correct Answer is C

Choice A reason: Administering pain medication as ordered is not the best action, as it does not address the cause of the new onset of pain. The nurse should first assess the client and the surgical site to rule out any complications or problems that may require immediate intervention.

Choice B reason: Assessing the client for signs and symptoms of systemic infection is not the best action, as it is not the most likely cause of the new onset of pain. Systemic infection would manifest with fever, chills, malaise, or leukocytosis, which are not mentioned in the scenario. The nurse should focus on the local signs and symptoms of the surgical site and the affected extremity.

Choice C reason: Assessing the surgical site and the affected extremity is the best action, as it allows the nurse to identify any potential complications or problems that may explain the new onset of pain. The nurse should look for signs of infection, inflammation, bleeding, hematoma, or dislocation of the hip prosthesis, such as redness, swelling, warmth, drainage, bruising, or deformity.

Choice D reason: Reassuring the client that pain is a direct result of increased activity is not the best action, as it may dismiss the client's concern and delay the detection of any serious complications or problems. The nurse should not assume that the pain is normal or expected, but rather investigate the cause and severity of the pain.

Choice E reason: Notifying the surgeon immediately is not the best action, as it is premature and unnecessary without first assessing the client and the surgical site. The nurse should gather relevant data and information before contacting the surgeon, unless there is an obvious or urgent problem that requires immediate attention.

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Correct Answer is C

Explanation

Choice A reason: Excess growth of bone formation does not cause the bones to weaken, but rather the opposite. Osteoporosis is a condition that causes the bones to lose density and become brittle due to the imbalance between bone resorption and formation. The bone resorption exceeds the bone formation, leading to low bone mass and increased fracture risk.

Choice B reason: Men are not less likely than women to have secondary causes of osteoporosis, but rather more likely. Secondary osteoporosis is a type of osteoporosis that is caused by other diseases or medications that affect the bone metabolism. Men are more likely to have secondary osteoporosis due to conditions such as hypogonadism, hyperparathyroidism, hyperthyroidism, or chronic kidney disease, or medications such as glucocorticoids, anticonvulsants, or anticoagulants.

Choice C reason: A modifiable risk factor for osteoporosis is a person's level of activity, as it affects the bone health and strength. Physical activity, especially weight-bearing and resistance exercises, can stimulate the bone formation and prevent the bone loss. It can also improve the muscle strength, balance, and coordination, which can reduce the risk of falls and fractures.

Choice D reason: Osteoporosis is not categorized as a disease for the elderly, but rather a disease that can affect people of any age. Osteoporosis is more common in older adults, especially postmenopausal women, due to the hormonal changes and the natural decline of bone mass with aging. However, osteoporosis can also occur in younger people due to genetic factors, lifestyle factors, or secondary causes.

Choice E reason: None of the above is not a correct choice, as there is one option that matches the most accurate statement related to osteoporosis.

A. Calcitriol (Fortica) B. Calcium (Caltrate) with Vitamin D (Caltria) C. Alendronate (Fosamax) D. Calcium (Caltrate) without Vitamin D (Calcio) E. None of the above

Correct Answer is D

Explanation

Choice A reason: Calcitriol (Fortica) is not the medication that will have the least effect in increasing the client's bone mass, as it is a synthetic form of vitamin D that helps the body absorb calcium and phosphorus, which are essential for bone health. Calcitriol also regulates the bone remodeling and prevents the bone resorption.

Choice B reason: Calcium (Caltrate) with Vitamin D (Caltria) is not the medication that will have the least effect in increasing the client's bone mass, as it is a combination of calcium and vitamin D that works synergistically to enhance the bone density and strength. Calcium is the main mineral component of the bone, and vitamin D helps the body absorb calcium and phosphorus.

Choice C reason: Alendronate (Fosamax) is not the medication that will have the least effect in increasing the client's bone mass, as it is a bisphosphonate that inhibits the activity of osteoclasts, which are the cells that break down the bone. Alendronate reduces the bone loss and increases the bone mass, and it is used to treat and prevent osteoporosis.

Choice D reason: Calcium (Caltrate) without Vitamin D (Calcio) is the medication that will have the least effect in increasing the client's bone mass, as it is a calcium supplement that does not contain vitamin D, which is necessary for the calcium absorption and utilization. Calcium alone may not be sufficient to prevent or treat osteoporosis, and it may also cause side effects such as constipation, kidney stones, or hypercalcemia.

Choice E reason: None of the above is not a correct choice, as there is one option that matches the medication that will have the least effect in increasing the client's bone mass.

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A client with a total hip replacement is progressing well and expects to be discharged tomorrow. On returning to bed after ambulating, he complains of a new onset of pain at the surgical site. What is the nurse's best action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing a class on osteoporosis at the local seniors' center. Which statement related to osteoporosis is most accurate?

Correct Answer is C

Explanation

A student is reviewing a client's medications for osteoporosis. Which medication(s) will have the least effect in increasing the client's bone mass?

Correct Answer is D

Explanation

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