A nurse is assessing a client who has Paget's disease of the bone. Which of the following findings should the nurse expect? (Select all that apply.)
Cold extremities
Skeletal pain
Visual loss
Cranial enlargement
Abnormal gait
Correct Answer : B,C,D,E
Choice A reason:
Cold extremities are not a typical symptom associated with Paget's disease of the bone. This condition usually does not affect the temperature of the limbs directly.
Choice B reason:
Skeletal pain is a common symptom in Paget's disease due to the abnormal bone remodeling process. The affected bones may become painful, especially in the pelvis, spine, skull, and long bones.
Choice C reason:
Visual loss can occur if Paget's disease affects the skull, leading to increased pressure on the nerves associated with vision. This pressure can result in visual impairment or loss.
Choice D reason:
Cranial enlargement is a possible finding in Paget's disease when the skull is involved. The abnormal bone growth can cause the skull to increase in size.
Choice E reason:
An abnormal gait may develop if Paget's disease affects the legs, causing the bones to bow and leading to difficulty walking.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason:
While gargling with warm saline can provide symptomatic relief for a sore throat, it does not address the underlying bacterial infection. Therefore, it is not the priority action once a diagnosis of group A streptococcus has been confirmed.
Choice B reason:
Identifying close contacts is important for public health tracking and potentially preventing the spread of the infection. However, the immediate priority for the client is the initiation of treatment to address the infection.
Choice C reason:
Taking antipyretics can help manage fever and provide comfort to the client. While managing symptoms is important, it is secondary to initiating antibiotic therapy, which addresses the cause of the symptoms.
Choice D reason:
The priority action is to notify the client to return to the clinic for initiation of antibiotic therapy. Group A streptococcus is a bacterial infection that requires antibiotics for treatment. Prompt initiation of antibiotics is crucial to prevent complications and promote recovery.
Correct Answer is C
Explanation
Choice A reason:
While explaining discharge instructions is an important part of patient education and ensuring safety after leaving the hospital, it is not the immediate priority. The nurse must first address any potential medical issues that could compromise the patient's health, such as circulation and nerve function in the affected limb.
Choice B reason:
Applying an ice pack to the casted leg can help reduce swelling and provide comfort to the client. This is often recommended for the first 24 to 72 hours after the cast is applied, especially if the cast is on a leg. However, this is secondary to assessing the neurovascular status of the limb.
Choice C reason:
Performing a neurovascular assessment is the priority action for the nurse. This assessment includes checking for sensation, warmth, capillary refill, pulses, and movement. It is crucial to identify any signs of compromised blood flow or nerve injury early to prevent further complications.
Choice D reason:
Providing reassurance to the client and parents is important for emotional support and can help alleviate anxiety. However, the nurse's immediate priority is to ensure the physical well-being of the client, which includes performing a neurovascular assessment to detect any urgent issues.
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