Print Page - Case Study

1.
Which data, obtained during the intake assessment and interview, indicates that Kat has an increased risk for osteoporosis?
A) Recent death of her husband of 30 years.
INCORRECT
Stressful events, such as the death of a spouse, do not increase the risk for osteoporosis.

B) Gave birth to her first and only child at age 30.
INCORRECT
Osteoporosis is not associated with the timing or number of pregnancies.

C) Body mass index of 19.
CORRECT
A thin body build, evidenced by a body mass index of 19, is a risk factor for osteoporosis. Additional risk factors include being female and of Caucasian or Asian ethnicity.

D) Blood pressure of 150/90.
INCORRECT
Hypertension is not associated with increased risk for osteoporosis.

Kat is seen by the healthcare provider, who recommends osteoporosis screening since Kat is at risk for osteoporosis. The nurse meets with Kat to provide client teaching. Kat tells the nurse that she played a lot of sports as a child and teenager. She states, "I guess I just put too much stress on my bones over the years."

2.
How should the nurse respond?
A) "Excessive wear and tear during the growth years can weaken your bones as an adult."
INCORRECT
Physical activity helps build bone mass, strengthening the bones.

B) "Being active in sports only increases the risk for osteoporosis if your bones break a lot."
INCORRECT
Multiple fractures do not increase the risk for osteoporosis.

C) "Brittle bones are primarily inherited and are not often affected by your level of activity."
INCORRECT
A positive family history is considered a risk factor for osteoporosis. However, osteoporosis is not primarily inherited, and can be affected by activity.

D) "Participating in sports activities often helps the bones become stronger and denser."
CORRECT
Building maximal bone mass as a child and adolescent is very important to reduce the risk of osteoporosis as an adult. Physical activity, along with adequate nutrient intake, is essential to strengthen bone density.

The nurse reviews Kat's medical history for other risk factors.

3.
Which aspect of her medication history is most likely to impact Kat's risk for osteoporosis?
A) Discontinued use of estrogen therapy 4 years ago, 8 years after a hysterectomy.
CORRECT
Estrogen deficiency contributes to the onset of osteoporosis by causing an increase in osteoclastic activity, resulting in bone breakdown which occurs faster than bone formation (osteoblastic activity).

B) Took an antidepressant for 6 months immediately following her husband's death.
INCORRECT
Antidepressant use is not associated with osteoporosis.

C) Began treatment for hyperlipidemia with simvistatin (Lipitor) 6 months ago.
INCORRECT
The use of statins for hyperlipidemia is not associated with osteoporosis.

D) Has occasionally taken ibuprofen (Motrin) for lower back pain for the last 2 years.
INCORRECT
The use of NSAIDs, such as ibuprofen, is not associated with osteoporosis.

Diagnostic Testing
The nurse calls to schedule Kat's appointment for dual energy x-ray absorptiometry (DXA) of the hip and spine. An appointment is available in 30 minutes. The next available appointment is in 3 weeks.

4.
What action should the nurse implement?
A) Advise the client that an immediate appointment will not allow adequate time to maintain NPO status before the test.
INCORRECT
It is not necessary to be NPO prior to DXA.

B) Provide the client with the available choices of appointment times and allow the client to select the desired appointment.
CORRECT
The nurse should promote client autonomy by offering the client safe, reasonable choices. Since no special preparation is needed prior to the test, the client may choose to have the test completed immediately. Even though the client has recently experienced a fracture this is not an emergency situation, so the client may prefer to wait for the appointment in three weeks.

C) Schedule the client for the immediate appointment so that emergency treatment can be started, based on the test results.
INCORRECT
Osteoporosis management does not require emergency treatment.

D) Instruct the client that it may be desirable to have a family member available following the test to drive her home.
INCORRECT
There is no sedation involved with the DXA, so the client can safely drive home following the test.

After the appointment for DXA is scheduled, Kat reminds the nurse that she has a number of food allergies, including shellfish, red food color, peanuts, and strawberries.

5.
What information should the nurse provide the client concerning the effects of food allergies on osteoporosis screening?
A) Advise the client that an ultrasound or CT scan may need to be prescribed, rather than the scheduled DXA.
INCORRECT
Ultrasounds and CT scans can be used to screen for osteoporosis, but are not needed in this situation.

B) Reassure the client that there are no dyes or products containing iodine used during a DXA.
CORRECT
DXA is a non-invasive procedure that does not involve the use of any dyes or cleansing agents that might contain allergens such as iodine.

C) Advise the client that her allergy to multiple food products increases her risk for hypersensitivity to the medication used during the test.
INCORRECT
No medication is used during this procedure.

D) Contact the DXA technician to ensure that the contrast medium used does not contain any of these allergens.
INCORRECT
There is no contrast medium used during this procedure.

Clinical Manifestations
Kat returns to the office 1 month later to discuss the results of her test with the provider and learns that her T-score (- 1.0) indicates that she has osteopenia. Kat states, "I guess I am not having any symptoms because I don't have osteoporosis yet."

6.
How should the nurse respond?
A) "Both terms mean the same thing, so you do have osteoporosis."
INCORRECT
The term osteopenia indicates decreased bone mass without the clinically increased risk of fracture that defines osteoporosis. However, osteopenia often leads to osteoporosis.

B) "Many persons with osteoporosis do not have any symptoms."
CORRECT
Osteoporosis is often first detected following a fracture, since there are frequently no symptoms associated with osteoporosis.

C) "Weakness and fatigue often increase as the condition worsens."
INCORRECT
Weakness and fatigue are not symptoms of osteoporosis.

D) "You are fortunate that you are not having any symptoms yet."
INCORRECT
This statement does not accurately reflect the symptoms of osteoporosis and is also patronizing.

Further conversation with Kat reveals that she has been experiencing lower back pain off and on for the last 2 years for which she occasionally takes ibuprofen.

7.
What action should the nurse implement first upon learning of this problem?
A) Reassure the client that her lower back pain is the result of her osteopenia.
INCORRECT
Remember that lower back pain can have many causes.

B) Teach the client exercises that will strengthen her abdominal muscles.
INCORRECT
Strengthening the abdominal muscles often helps reduce lower back pain, but another intervention should be taken first.

C) Determine if the client's PRN use of ibuprofen provides adequate pain relief.
INCORRECT
This is an important intervention, but another intervention should be taken first.

D) Ask the client if she has discussed this symptom with her healthcare provider.
CORRECT
Lower back pain can be the result of many problems. The healthcare provider should first evaluate the cause of the pain before the nurse provides client teaching regarding exercises or pain management.

8.
In addition to evaluating for the presence of subjective symptoms, what assessment technique should the nurse include in the ongoing assessment of Kat's bone density?
A) Record her grip strengths.
INCORRECT
Grip strength is not typically affected by the client's degree of osteoporosis.

B) Perform an Allen's test.
INCORRECT
An Allen's test is performed to determine adequacy of ulnar artery perfusion.

C) Observe her feet and toes.
INCORRECT
Osteoporosis does not impact the size or appearance of the feet and toes.

D) Measure her height.
CORRECT
Persons with osteoporosis often loose height over time as the vertebrae are compressed.

Client Teaching
Kat's healthcare provider recommends a regimen of exercise and diet. The nurse meets with Kat to provide related client teaching. Kat and the nurse discuss the need for adequate calcium intake.

9.
To increase Kat's dietary intake of calcium, which snack should the nurse recommend?
A) A large apple.
INCORRECT
Apples are a poor source of calcium, providing approximately 10 mg of calcium.

B) A cup of fruit-flavored yogurt.
CORRECT
A cup of yogurt is a good source of calcium, providing as much as 400 mg of calcium.

C) Twenty cheese-flavored crackers.
INCORRECT
The cheese-flavoring in crackers is not a source of calcium.

D) An ounce of low-fat cream cheese on a bagel.
INCORRECT
An ounce of cream cheese is a poor source of calcium, providing only 25 mg of calcium.

Kat tells the nurse that she started taking a 500 mg calcium supplement daily after she stopped her post-hysterectomy estrogen therapy.

10.
What instruction should the nurse provide?
A) "500 mg is adequate for women taking estrogen, but you now need at least 2 grams of calcium every day."
INCORRECT
Two grams of calcium every day is more than the recommended amount of calcium for postmenopausal women.

B) "As long as your vitamin supplement also contains Vitamin D, you will be receiving adequate supplementation."
INCORRECT
An intake of 500 mg of calcium is insufficient for postmenopausal women, even with additional Vitamin D supplementation.

C) "By taking 3 of your calcium tablets each day you will receive adequate amounts of calcium for your needs."
CORRECT
The RDA for calcium for postmenopausal women is 1200 - 1500 mg. Three 500 mg tablets provide 1500 mg of calcium every day. Vitamin D supplementation may also be recommended by the healthcare provider.

D) "Any additional calcium supplementation could cause you to have harmful symptoms of calcium toxicity."
INCORRECT
An intake of 500 mg of calcium per day is insufficient for post-menopausal women.

Kat tells the nurse that she loves to hike and walks 2 miles every weekend to stay in shape.

11.
How should the nurse respond?
A) "It sounds as if your long walks provide plenty of weight-bearing exercise."
INCORRECT
The nurse should encourage Kat to alter her exercise regimen for maximal benefit.

B) "It is important to increase the frequency of your walks to at least 5 times per week."
CORRECT
Regular exercise, 5 times per week for 30 to 60 minutes, provides the best protection against further loss of bone mass. In addition, regular exercise improves muscle strength and coordination, reducing the client's risk for falls.

C) "Walking more than a mile at one time is likely to increase your risk for another fracture."
INCORRECT
Increased weight-bearing exercise will not increase the risk for fracture.

D) "The best way to increase your bone strength is by lengthening your weekly walk by another mile."
INCORRECT
Increasing the length of a once-a week walk is not the best approach to increase bone strength.

A repeat DXA the following year indicates that Kat has progressed to osteoporosis. Kat states she has adhered to her dietary and exercise regimen faithfully.

12.
To help determine why osteoporosis has developed, what question should the nurse ask Kat?
A) What medications have you taken during the last year?
CORRECT
Medications can contribute to the loss of bone density.

B) How many hours of sleep do you get per night?
INCORRECT
This question is unlikely to elicit relevant information about the loss of bone density.

C) Have you experienced any infections recently?
INCORRECT
This question is unlikely to elicit relevant information about the loss of bone density.

D) Do your hands or feet ever swell when you exercise?
INCORRECT
This question is unlikely to elicit relevant information about the loss of bone density.

Pharmacologic Therapy
Kat reports that she has ulcerative colitis and experienced an acute exacerbation during the past year. She states that she has taken a number of medications during the last year to manage her ulcerative colitis.

13.
Which medication is most likely to have contributed to the decrease in Kat's bone density?
A) Diphenoxylate (Lomotil), an antidiarrheal, taken prior to the acute exacerbation for occasional episodes of diarrhea.
INCORRECT
Antidiarrheal medications, such as Lomotil, do not typically impact bone density.

B) Sulfasalazine (Azulfidine), an antiinflammatory sulfonamide, administered during the acute exacerbation.
INCORRECT
This medication does not typically impact bone density.

C) Prednisone (Deltasone), a corticosteroid, taken during the acute exacerbation and for several months following.
CORRECT
Glucocorticoids, such as prednisone, taken over a prolonged time period, are the most common class of medications associated with osteoporosis.

D) Propantheline (Pro-Banthine), an anticholinergic, administered during the acute exacerbation.
INCORRECT
Anticholinergic medications do not typically impact bone density.

The healthcare provider prescribes alendronate (Fosamax) PO once a week. The nurse instructs Kat to select a specific day of the week when she can take the medication first thing in the morning. Kat states, "Is that really necessary? I'm not much of a morning person."

14.
How should the nurse respond?
A) "The medication is much better absorbed when taken on an empty stomach."
CORRECT
Fosamax should be taken on an empty stomach with a full glass of water to promote the best absorption.

B) "Increased nausea often occurs when the medication is taken late in the day."
INCORRECT
This is not the rationale for why the medication should be taken in the morning.

C) "You may prefer to take the medication with a specific meal once a week."
INCORRECT
Fosamax should not be taken with a meal.

D) "It is important to have a weekly routine so you won't forget to take the medication."
INCORRECT
A weekly routine is important. However, the nurse needs to explain the rationale for taking the medication in the morning.

Six weeks after starting the medication, Kat leaves a message for the nurse that she is experiencing increasingly frequent and severe heartburn.

15.
What action should the nurse take?
A) Advise Kat to go to the emergency department immediately.
INCORRECT
These symptoms do not require emergency care.

B) Ask Kat to describe her method of Fosamax administration.
CORRECT
After taking a dose of Fosamax, the client must remain in an upright position for 30 minutes to prevent esophageal irritation and erosion.

C) Instruct Kat to use an antacid PRN 2 hours after her Fosamax dose.
INCORRECT
This instruction will not resolve her problem.

D) Reassure Kat that heartburn is a common side effect of Fosamax.
INCORRECT
Kat's symptoms require further intervention.

A Complication Occurs
Three weeks later, Kat goes to the emergency department of the local medical center, where she reports that she fell off a ladder the previous day and is experiencing increasing pelvic tenderness. X-ray reveals a pelvic fracture, and Kat is transferred to the orthopedic unit for fracture management.

While being admitted to the orthopedic unit, Kat develops chest pain. Her vital signs are: T 99.8° F, P 122, R 40, BP 110/74. While obtaining her vital signs, the nurse notes that Kat is pale and has petechiae on her anterior chest and neck.

16.
What action should the nurse implement first?
A) Apply oxygen via mask.
CORRECT
Kat's vital signs and manifestations indicate that fat embolization syndrome has occurred. Typical symptoms include chest pain, tachycardia, tachypnea, dyspnea, pallor, and petechiae on the anterior chest, neck and axilla. Symptoms are the result of poor oxygenation, so the nurse's first interventions should include measures to improve oxygenation, such as the application of oxygen.

B) Observe for hematuria.
INCORRECT
A pelvic fracture can damage other organs, so assessment of urinary function is important. However, another action is of greater priority.

C) Measure abdominal girth.
INCORRECT
Pelvic fractures can cause intraabdominal injury, so assessment of bowel function and intraabdominal bleeding are important. However, another action is of greater priority.

D) Administer an analgesic.
INCORRECT
Kat is experiencing pain and should receive an analgesic. However, another action is of greater priority.

After taking initial action, the nurse notes that Kat is becoming cyanotic and appears restless, anxious, and disoriented. Her SaO2 is decreasing.

17.
What is the priority nursing action?
A) Prepare the client for a blood transfusion.
INCORRECT
The client with fat embolus and pelvic fracture may experience sufficient hemorrhage to require a blood transfusion; however, Kat's symptoms indicate a higher priority problem.

B) Initiate cardiopulmonary resuscitation.
INCORRECT
CPR is not indicated, since there has not yet been a loss of pulse or respiration.

C) Ensure that intubation equipment is readily available.
CORRECT
The fat globules transported to the lungs can result in acute respiratory distress syndrome (ARDS). Acute deterioration of respiratory function may result in the need for endotracheal intubation and mechanical ventilation, so the nurse should ensure that this emergency equipment is readily available.

D) Position the client on her right side with her head down.
INCORRECT
This position is useful for the client experiencing an air embolus, but is not useful during management of a fat embolus.

Management Issues
Kat's condition stabilizes after initial treatment with oxygen and IV fluids. Mechanical ventilation is not needed, but Kat's healthcare provider prescribes a transfer to the critical care unit where Kat can be more closely monitored for the next 24 hours. The house supervisor notifies the orthopedic unit charge nurse that no beds are available in the critical care unit and there are no clients stable enough to be transferred out of the critical care unit. The supervisor also notifies the healthcare provider, who agrees that Kat can remain on the orthopedic unit if Kat receives one-to-one care.

While arrangements are being made for one-to-one care, the nurse currently assigned to care for Kat requests assistance with other client care responsibilities, and provides a report about the clients. An RN and two LPNs are working on the unit.

18.
Which reported information indicates the need to assign the client to the RN?
A) There is no drainage in the hemovac drain of a client 2 days following an open reduction and internal fixation of the hip.
INCORRECT
This client is experiencing an expected decrease in postoperative drainage and does not require the expertise of the RN.

B) Six hours following a hip arthroplasty, the client's autotransfusion collection device is full of sanguinous drainage.
CORRECT
This client is experiencing a large amount of postoperative drainage and may require a transfusion, as well as close monitoring. This client requires the expertise of the RN for assessment and transfusion management.

C) Twenty-four hours following a vertebral khyphoplasty, a client needs the surgical dressing changed.
INCORRECT
This sterile dressing change can be performed by the LPN.

D) Twelve hours following a knee arthroplasty, a client reports pain when using the prescribed continuous passive motion device.
INCORRECT
Pain is expected when moving the joint following arthroplasty, and can be treated by the LPN.

The supervisor agrees to send additional nursing staff to the unit so that Kat can receive one-to-one care.

19.
Arrangements should be made for which nurse to provide care for Kat?
A) An experienced critical care RN who is scheduled off for the day.
CORRECT
Fat embolism syndrome can quickly deteriorate and requires a high level of critical care expertise to effectively assess for subtle changes in the client's status.

B) An experienced orthopedic unit RN who is scheduled off for the day.
INCORRECT
The orthopedic unit RN does not have the best expertise to manage the care of a critically ill client.

C) A graduate nurse serving a critical care internship who is at work but does not have a client care assignment.
INCORRECT
A graduate nurse serving an internship does not have the expertise to be assigned independently in a situation where no other critical care nurses are available.

D) An experienced orthopedic LPN who is already at work and has requested to work overtime whenever possible.
INCORRECT
The orthopedic unit LPN does not have the best expertise to manage the care of a critically ill client, despite the request to work additional hours.

Pelvic Fracture Management
Kat's respiratory status gradually improves and one-on-one monitoring is no longer required. Kat's pelvic fracture involves a weight-bearing aspect of the pelvis and Kat is receiving traction with a pelvic sling.

20.
In planning Kat's care, which problem has the highest priority?
A) Fatigue.
INCORRECT
This problem is important, but is not of the highest priority.

B) Acute pain.
CORRECT
Pelvic fractures can be extremely painful, impacting all aspects of the client's well-being, contributing to fatigue, sleep pattern disturbance, and impaired physical mobility.

C) Sleep pattern disturbance.
INCORRECT
This problem is important, but is not of the highest priority.

D) Impaired physical mobility.
INCORRECT
This problem is important, but is not of the highest priority.

The nurse also includes, "Risk for peripheral neurovascular dysfunction" in the plan of care.

21.
Which nursing action should be implemented to address this potential problem?
A) Assign an LPN to take the client's vital signs every 2 hours.
INCORRECT
Vital sign assessment provides data regarding over-all homeostasis but does not provide data specific to peripheral neurovascular function.

B) Observe the client's pupillary response to light every 8 hours.
INCORRECT
Assessment of the pupillary response to light provides data regarding neurologic function but does not provide data regarding peripheral neurovascular function.

C) Measure and compare calf circumferences every 12 hours.
INCORRECT
This action provides data related to the development of deep vein thrombosis but does not provide data regarding peripheral neurovascular function.

D) Assess for sensation and movement of the feet every 4 hours.
CORRECT
Diminished sensation and movement of the feet, along with diminished pedal pulses, pallor, and pain indicate impaired peripheral neurovascular function. Remember the five Ps!

Ethical-Legal Considerations
Since Kat's respiratory status has stabilized, she undergoes an open reduction and internal fixation of the pelvis. Following surgery, Kat receives patient-controlled analgesia for 24 hours. When this prescription is discontinued, a new prescription is written for Morphine 2 mg every 4 hours PRN.

The nurse caring for Kat is concerned about the amount of opioid analgesics that Kat has received since her fracture occurred. The nurse administers a dose of normal saline IV the next time Kat requests pain medication and reports to the charge nurse that the client indicates that she is pain free.

22.
What action should the charge nurse implement?
A) Request that a social worker meet with the client to arrange drug abuse counseling.
INCORRECT
There is no evidence of drug abuse by the client. Therefore, this action is not indicated.

B) Discuss the implications of placebo use with the nurse who administered the saline.
CORRECT
Placebo use is ethically questionable, and may be construed as fraud. The use of placebos is considered unacceptable in the management of pain by the American Pain Society. Additionally, the nurse administering the placebo does not have a prescription for this treatment.

C) Notify the surgeon that this technique has reduced the client's need for Morphine.
INCORRECT
Another action by the charge nurse is indicated.

D) Encourage the nurse to continue the placebo use, alternating with the Morphine.
INCORRECT
There is no prescription for placebo use, so the nurse should not be encouraged to continue its administration.

The charge nurse later overhears the nurse conversing with another staff member in the break room. The nurse states that Kat is dependent on her pain meds and that her healthcare provider is a "quack" who has caused Kat's drug addiction.

23.
What action should the charge nurse take?
A) Encourage the nurse to visit with the client's daughter to share these concerns.
INCORRECT
This is an invasion of the client's privacy and supports further slander of the healthcare provider.

B) Meet privately with the nurse at once to discuss the conversation that was overheard.
CORRECT
The nurse is engaging in slander of the healthcare provider. The charge nurse must end the break room conversation and discuss the nurse's behavior. This should be conducted in a private setting to maintain the nurse's right to privacy.

C) Quietly leave the area and allow the nurse to ventilate these concerns in the break room.
INCORRECT
This supports unethical and illegal behavior by the nurse.

D) Immediately confront the nurse in the break room about the negative remarks.
INCORRECT
This action does not provide sufficient protection of the rights of the nurse.

Parathyroid Hormone (PTH) Injections
One week following surgery, Kat is discharged and goes to stay with her daughter to complete her surgical recovery. During her next visit to her healthcare provider, she receives a prescription for daily subcutaneous injections of teriparatide (Forteo), parathyroid hormone, to treat her osteoporosis.

24.
In providing client teaching, the nurse discusses the need for periodic monitoring of which diagnostic serum lab value?
A) Calcium.
CORRECT
PTH is the primary regulator of calcium and phosphate metabolism in bone and kidney, and can result in increased serum calcium levels. Serum calcium levels, alkaline phosphatase, and uric acid should be monitored periodically during treatment.

B) Potassium.
INCORRECT
PTH does not impact serum potassium levels.

C) Platelet count.
INCORRECT
PTH does not impact platelets.

D) Hemoglobin.
INCORRECT
PTH does not impact hemoglobin levels.

The nurse also discusses the adverse effects of the medication.

25.
The nurse stresses the importance of reporting which problem?
A) Headache.
INCORRECT
Headache is an adverse effect that can occur with PTH administration, but is of less significance than another manifestation.

B) Dyspepsia.
INCORRECT
Dyspepsia is an adverse effect that can occur with PTH administration, but is of less significance than another manifestation.

C) Rhinitis.
INCORRECT
Rhinitis is an adverse effect that can occur with PTH administration, but is of less significance than another manifestation.

D) Bone pain.
CORRECT
The client should be instructed to report bone pain and unexplained leg cramps, which may be indications of altered serum calcium levels.

The nurse observes Kat as she demonstrates the procedure for subcutaneous self-injection. Kat performs the procedure correctly, but states that she feels very nervous about giving herself a daily injection.

26.
What action should the nurse take?
A) Consult with the healthcare provider about a prescription for a different route of medication administration.
INCORRECT
PTH is only available for subcutaneous administration.

B) Encourage the client to practice the injection technique again under the supervision of the nurse.
CORRECT
An opportunity to repeat a practice injection under the nurse's supervision will increase the learner's confidence.

C) Suggest that the client come to the provider's office to receive the injections for the duration of the treatment.
INCORRECT
Treatment of osteoporosis with PTH typically lasts 1 to 2 years, and is administered every day.

D) Perform another demonstration of the injection procedure so the client can carefully observe the steps.
INCORRECT
This is not the most effective teaching strategy to promote learner confidence.

Therapeutic Communication
Kat decides to attempt the self-injections at home, beginning the following day. A week later, she calls the nurse to report that she is able to administer the injections, and has also taught her daughter how to perform the injection. Kat states, "It is so comforting to be able to stay with my daughter while I recover. I hope I am not a burden to her."

27.
How should the nurse respond?
A) "What other responsibilities does your daughter have?"
INCORRECT
This is not the best response to address the client's concerns about feeling like a burden to her daughter.

B) "Why would your daughter find you to be a burden?"
INCORRECT
This response may be perceived as challenging by the client rather than helpful.

C) "I am sure your daughter is glad to be able to help you."
INCORRECT
This response is patronizing and is unlikely to help the client deal with her concerns about feeling like a burden.

D) "It sounds as if your daughter has been really helpful."
CORRECT
This open-ended response encourages the client to continue to discuss her relationship with her daughter.

Further conversation reveals that Kat is also worried about experiencing another fracture.

28.
How should the nurse respond?
A) "Your daughter is nearby in case you need help in the future."
INCORRECT
This response is not the most helpful in guiding the client to a resolution of her concern about experiencing another fracture.

B) "How do you envision your lifestyle in the years ahead?"
CORRECT
Using this broad question to respond to the client's concern can help her identify her goals, and the actions needed to meet her goals and reduce her risks.

C) "Try not to worry about that right now while you are still healing."
INCORRECT
Responding by telling people what they "should" do (stated or implied) is generally not helpful in resolving problems.

D) "Most people your age have some health problem to cope with."
INCORRECT
This response does not encourage further communication and problem-solving.

Case Outcome
Kat stays with her daughter until her surgical recovery is complete and continues the PTH injections for a year. During that time her bone density improves and she remains fracture free. She continues to exercise every day and has resumed her frequent hiking trips in the mountains.

Biology Forums - Study Force

Others Free Notes Topic started by: nurs3158 on Nov 21, 2013