IGNATAVICIUS MEDICAL SURGICAL
NURSING ACTUAL TEST PAPER FULL
QUESTIONS AND ACCURATE ANSWERS
GRADED APLUS
●● ANS: C
Anyone who has osteoporosis is at risk for fragility fractures even if he
or she does not experience trauma like a fall. The client needs to keep
active rather than stay in bed where more bone could be lost. High-
calcium foods may not be helpful because bone loss is already severe.
There is no indication that the client needs assistance with ADLs.
Answer: The nurse teaches assistive personnel (AP) about care of an
older adult diagnosed with osteoporosis. What teaching would the nurse
include?
a. "Teach the client to eat high-calcium foods in the diet."
b. "Assist the client with activities of daily living."
c. "Osteoporosis places the client is at risk for fractures."
d. "The client should stay in bed to prevent falling."
●● ANS: A
Fear of falling can limit participation in activity. The nurse would first
assess if the client has this fear and then offer suggestions for dealing
with it. The client may or may not need extra calcium, other exercises, or
weight lifting.
,Answer: A client has been advised to perform weight-bearing exercises
to help slow bone loss, but has not followed this advice. What response
by the nurse is appropriate at this time?
a. Ask the client about fear of falling.
b. Instruct the client to increase calcium.
c. Suggest other exercises the client can do.
d. Tell the client to try weight lifting.
●● ANS: D
Clients on bisphosphonates must be able to sit upright for 30 to 60
minutes after taking them. The client who cannot tolerate sitting up is
not a good candidate for this class of drug. Poor renal function also
makes clients poor candidates for this drug, but the client with a
creatinine of 0.8 mg/dL (61 mcmol/L) is within normal range. Diabetes
and hypertension are not related unless the client also has renal disease.
The client who recently fell and sustained fractures is a good candidate
for this drug if the fractures are related to osteoporosis.
Answer: The nurse is caring for several clients with osteoporosis. For
which client would bisphosphonates not be a good option?
a. Client with diabetes who has a serum creatinine of 0.8 mg/dL (61
mcmol/L).
b. Client who recently fell and has vertebral compression fractures.
c. Hypertensive client who takes calcium channel blockers.
d. Client with a spinal cord injury who cannot tolerate sitting up.
,●● ANS: B
Denosumab is given by subcutaneous injection twice a year. The client
does not need to drink 8 ounces (240 mL) of water with this medication
as it is not taken orally. The client does not need to remain upright for 30
to 60 minutes after taking this medication, nor does the client need to
take the drug on an empty stomach.
Answer: A client has been prescribed denosumab. What health teaching
about this drug is most appropriate for the nurse to include?
a. "Drink at least 8 ounces (240 mL) of water with it."
b. "Make appointments to come get your injection."
c. "Sit upright for 30 to 60 minutes after taking it."
d. "Take the drug on an empty stomach."
●● ANS: C
The most common assessment finding is the client's report of severe
pain in the arch of the foot, especially when walking. The other findings
are not typical in clients with this health problem.
Answer: The nurse is performing an assessment of a client with possible
plantar fasciitis in the right foot. What assessment finding would the
nurse expect in the right foot?
a. Multiple toe deformities
b. Numbness and paresthesias
c. Severe pain in the arch of the foot
d. Redness and severe swelling
, ●● ANS: D
Rheumatoid arthritis often occurs in young female adults and can lead to
osteoporosis as a common complication. Cushing disease (rather than
Addison disease) and hyperthyroidism (rather than hypothyroidism) are
also risk factors. Osteoarthritis is a joint disease.
Answer: The nurse is caring for a young client who has been diagnosed
with osteopenia. Which risk factor in the client's history most likely
contributed to the bone loss?
a. Osteoarthritis
b. Hypothyroidism
c. Addison disease
d. Rheumatoid arthritis
●● ANS: C
In the presence of a heavily draining wound, the nurse would place the
client on Contact Precautions. If the client has discomfort,
acetaminophen can be used, but this client has not reported pain and is
afebrile. The client may or may not need an amputation in the future.
The wound care nurse may be consulted but not as the most appropriate
action.
Answer: An older client with diabetes is admitted with a heavily
draining leg wound. The client's white blood cell count is 38,000/mm3
(38 x 10^9/L) but the client is afebrile. Which nursing action is most
appropriate at this time?
a. Administer acetaminophen as needed.
NURSING ACTUAL TEST PAPER FULL
QUESTIONS AND ACCURATE ANSWERS
GRADED APLUS
●● ANS: C
Anyone who has osteoporosis is at risk for fragility fractures even if he
or she does not experience trauma like a fall. The client needs to keep
active rather than stay in bed where more bone could be lost. High-
calcium foods may not be helpful because bone loss is already severe.
There is no indication that the client needs assistance with ADLs.
Answer: The nurse teaches assistive personnel (AP) about care of an
older adult diagnosed with osteoporosis. What teaching would the nurse
include?
a. "Teach the client to eat high-calcium foods in the diet."
b. "Assist the client with activities of daily living."
c. "Osteoporosis places the client is at risk for fractures."
d. "The client should stay in bed to prevent falling."
●● ANS: A
Fear of falling can limit participation in activity. The nurse would first
assess if the client has this fear and then offer suggestions for dealing
with it. The client may or may not need extra calcium, other exercises, or
weight lifting.
,Answer: A client has been advised to perform weight-bearing exercises
to help slow bone loss, but has not followed this advice. What response
by the nurse is appropriate at this time?
a. Ask the client about fear of falling.
b. Instruct the client to increase calcium.
c. Suggest other exercises the client can do.
d. Tell the client to try weight lifting.
●● ANS: D
Clients on bisphosphonates must be able to sit upright for 30 to 60
minutes after taking them. The client who cannot tolerate sitting up is
not a good candidate for this class of drug. Poor renal function also
makes clients poor candidates for this drug, but the client with a
creatinine of 0.8 mg/dL (61 mcmol/L) is within normal range. Diabetes
and hypertension are not related unless the client also has renal disease.
The client who recently fell and sustained fractures is a good candidate
for this drug if the fractures are related to osteoporosis.
Answer: The nurse is caring for several clients with osteoporosis. For
which client would bisphosphonates not be a good option?
a. Client with diabetes who has a serum creatinine of 0.8 mg/dL (61
mcmol/L).
b. Client who recently fell and has vertebral compression fractures.
c. Hypertensive client who takes calcium channel blockers.
d. Client with a spinal cord injury who cannot tolerate sitting up.
,●● ANS: B
Denosumab is given by subcutaneous injection twice a year. The client
does not need to drink 8 ounces (240 mL) of water with this medication
as it is not taken orally. The client does not need to remain upright for 30
to 60 minutes after taking this medication, nor does the client need to
take the drug on an empty stomach.
Answer: A client has been prescribed denosumab. What health teaching
about this drug is most appropriate for the nurse to include?
a. "Drink at least 8 ounces (240 mL) of water with it."
b. "Make appointments to come get your injection."
c. "Sit upright for 30 to 60 minutes after taking it."
d. "Take the drug on an empty stomach."
●● ANS: C
The most common assessment finding is the client's report of severe
pain in the arch of the foot, especially when walking. The other findings
are not typical in clients with this health problem.
Answer: The nurse is performing an assessment of a client with possible
plantar fasciitis in the right foot. What assessment finding would the
nurse expect in the right foot?
a. Multiple toe deformities
b. Numbness and paresthesias
c. Severe pain in the arch of the foot
d. Redness and severe swelling
, ●● ANS: D
Rheumatoid arthritis often occurs in young female adults and can lead to
osteoporosis as a common complication. Cushing disease (rather than
Addison disease) and hyperthyroidism (rather than hypothyroidism) are
also risk factors. Osteoarthritis is a joint disease.
Answer: The nurse is caring for a young client who has been diagnosed
with osteopenia. Which risk factor in the client's history most likely
contributed to the bone loss?
a. Osteoarthritis
b. Hypothyroidism
c. Addison disease
d. Rheumatoid arthritis
●● ANS: C
In the presence of a heavily draining wound, the nurse would place the
client on Contact Precautions. If the client has discomfort,
acetaminophen can be used, but this client has not reported pain and is
afebrile. The client may or may not need an amputation in the future.
The wound care nurse may be consulted but not as the most appropriate
action.
Answer: An older client with diabetes is admitted with a heavily
draining leg wound. The client's white blood cell count is 38,000/mm3
(38 x 10^9/L) but the client is afebrile. Which nursing action is most
appropriate at this time?
a. Administer acetaminophen as needed.
