Prepare for your test with
1. Question
Category: Physiological Integrity
The elderly client is admitted to the emergency room. Which symptom is
the client with a fractured hip most likely to exhibit?
A. Pain
B. Misalignment
C. Cool extremity
D. Absence of pedal pulses
Correct Answer: B. Misalignment
,The client with a hip fracture will most likely have a misalignment. Most hip
fractures can be diagnosed, or at least suspected, from history alone.
Classically a fall leads to a painful hip with an associated inability to walk.
Clinicians should explore potentially sinister causes of the fall, such as
syncope, stroke, or myocardial infarction.
Option A: Pain is a prominent feature in all fractures. The physical
examination will demonstrate pain, immobility, and potentially a deformed
limb. The degree of deformity seen is dependent on both the anatomical
configuration of the fracture and the degree of displacement. The classically
described presentation is a shortened and externally rotated limb due to
the unopposed pull of the iliopsoas muscle that attaches to the lesser
trochanter.
Option C: Coolness of the extremities is indicative of compartment
syndrome. Further examination often reveals pain on any, or all, of the
following: palpation in the groin or greater trochanter, axial loading of the
hip, and ‘pin rolling of the leg. It is recommended that a cognitive
assessment be performed in all patients presenting with hip fractures.
,Ideally, this should be done both on admission and post-operatively. The
aim of this is to recognize patients with underlying dementia or those who
are developing an acute delirium, both of which are associated with a
poorer prognosis.
Option D: The absence of pulses is indicative of peripheral vascular disease.
A full primary trauma and secondary trauma assessment should be
performed to assess the patient for other injuries. It is always useful to
assess the patient’s cardiovascular and respiratory status prior to
undergoing surgery. Specific examinations to identify the cause of the fall
should also be considered.
2. Question
Category: Health Promotion and Maintenance
The nurse knows that a 60-year-old female client’s susceptibility to
osteoporosis is most likely related to:
A. Lack of exercise
B. Hormonal disturbances
, C. Lack of calcium
D. Genetic predisposition
Correct Answer: B. Hormonal disturbances
After menopause, women lack hormones necessary to absorb and utilize
calcium. Primary osteoporosis is related to the aging process in conjunction
with decreasing sex hormones. The bones have deterioration in
microarchitecture leading to loss of bone mineral density and increased risk
of a fracture. Osteoporosis is defined as low bone mineral density caused
by altered bone microstructure ultimately predisposing patients to low-
impact, fragility fractures. Osteoporotic fractures lead to a significant
decrease in quality of life, with increased morbidity, mortality, and disability.
Option A: Risk factors for osteoporosis include increasing age, body weight
less than 128 pounds, smoking, family history of osteoporosis, white or
Asian race, early menopause, low levels of physical activity and a personal
history of a fracture from a ground-level fall or minor trauma after the age
of forty. Patients afflicted with conditions affecting overall mobility level,
such as spinal cord injuries (SCI), can experience rapid deterioration of bone
1. Question
Category: Physiological Integrity
The elderly client is admitted to the emergency room. Which symptom is
the client with a fractured hip most likely to exhibit?
A. Pain
B. Misalignment
C. Cool extremity
D. Absence of pedal pulses
Correct Answer: B. Misalignment
,The client with a hip fracture will most likely have a misalignment. Most hip
fractures can be diagnosed, or at least suspected, from history alone.
Classically a fall leads to a painful hip with an associated inability to walk.
Clinicians should explore potentially sinister causes of the fall, such as
syncope, stroke, or myocardial infarction.
Option A: Pain is a prominent feature in all fractures. The physical
examination will demonstrate pain, immobility, and potentially a deformed
limb. The degree of deformity seen is dependent on both the anatomical
configuration of the fracture and the degree of displacement. The classically
described presentation is a shortened and externally rotated limb due to
the unopposed pull of the iliopsoas muscle that attaches to the lesser
trochanter.
Option C: Coolness of the extremities is indicative of compartment
syndrome. Further examination often reveals pain on any, or all, of the
following: palpation in the groin or greater trochanter, axial loading of the
hip, and ‘pin rolling of the leg. It is recommended that a cognitive
assessment be performed in all patients presenting with hip fractures.
,Ideally, this should be done both on admission and post-operatively. The
aim of this is to recognize patients with underlying dementia or those who
are developing an acute delirium, both of which are associated with a
poorer prognosis.
Option D: The absence of pulses is indicative of peripheral vascular disease.
A full primary trauma and secondary trauma assessment should be
performed to assess the patient for other injuries. It is always useful to
assess the patient’s cardiovascular and respiratory status prior to
undergoing surgery. Specific examinations to identify the cause of the fall
should also be considered.
2. Question
Category: Health Promotion and Maintenance
The nurse knows that a 60-year-old female client’s susceptibility to
osteoporosis is most likely related to:
A. Lack of exercise
B. Hormonal disturbances
, C. Lack of calcium
D. Genetic predisposition
Correct Answer: B. Hormonal disturbances
After menopause, women lack hormones necessary to absorb and utilize
calcium. Primary osteoporosis is related to the aging process in conjunction
with decreasing sex hormones. The bones have deterioration in
microarchitecture leading to loss of bone mineral density and increased risk
of a fracture. Osteoporosis is defined as low bone mineral density caused
by altered bone microstructure ultimately predisposing patients to low-
impact, fragility fractures. Osteoporotic fractures lead to a significant
decrease in quality of life, with increased morbidity, mortality, and disability.
Option A: Risk factors for osteoporosis include increasing age, body weight
less than 128 pounds, smoking, family history of osteoporosis, white or
Asian race, early menopause, low levels of physical activity and a personal
history of a fracture from a ground-level fall or minor trauma after the age
of forty. Patients afflicted with conditions affecting overall mobility level,
such as spinal cord injuries (SCI), can experience rapid deterioration of bone
