ATI-AMS ATI Adult medical surgical Exam - Set 3 - Part 3

Correct Answer: A sedentary lifestyle

A sedentary lifestyle increases osteoporosis risk, because weight-bearing activity is needed to maintain bone density. Without regular load placed on the bones, resorption outpaces formation, which accelerates the loss of bone mass and weakens the skeleton over time. Option b is incorrect because jogging is a weight-bearing activity that decreases osteoporosis risk by stimulating bone formation. Far from being a risk factor, regular jogging strengthens bone, so it actually protects against the very loss that this client is now being screened for. Option c is incorrect because one glass of wine daily is not a risk factor, since the concern begins at roughly three or more drinks per day. A single daily serving falls below the threshold that contributes to urinary calcium loss and bone weakening. Option d is incorrect because a thin, lean build raises osteoporosis risk, not a high body mass index. Greater body weight tends to load the bones, so an elevated index would not be the risk fact

Correct Answer: Stay upright after taking the dose

Bisphosphonates can cause esophagitis, so the client should remain upright for about half an hour after taking the dose. Staying vertical keeps the medication moving through the esophagus and prevents irritation of the delicate esophageal lining. Option a is incorrect because bisphosphonates are taken early in the morning, not at bedtime, because the client must stay upright afterward. Taking it before lying down to sleep would let the drug linger in the esophagus and cause the very irritation the timing prevents. Option c is incorrect because the medication should be taken with a full glass of water, not a small sip. Adequate fluid helps carry the tablet into the stomach and reduces the esophageal irritation that too little water would otherwise allow to develop. Option d is incorrect because lying down after the dose is the opposite of the correct instruction and increases the risk of esophagitis. The client must stay upright so the medication does not rest against the esophageal lin

Correct Answer: Keep the client supine and flat

After vertebroplasty the client should remain supine with the bed flat for a couple of hours so the injected bone cement hardens. Lying still during this period allows the cement to set properly within the fractured vertebra. Option a is incorrect because cold, not heat, is applied to the vertebroplasty site after the procedure. A heating pad would increase circulation and discomfort at the site, whereas a cold application is the measure used once the cement has been placed. Option b is incorrect because the client should not ambulate within the first hour, because the cement needs time to harden while lying flat. Walking immediately could disturb the setting cement before it has stabilized the treated vertebra and undermine the repair. Option c is incorrect because frequent turning is avoided right after the procedure so the cement can harden undisturbed. Moving the client side to side during this critical window could interfere with the cement setting properly within the vertebra and

Correct Answer: Heberden's nodes on the fingers

Heberden's nodes at the distal interphalangeal joints are characteristic of osteoarthritis, reflecting bony enlargement from cartilage deterioration. These nodes accompany crepitus, joint pain with activity, and asymmetrical joint involvement in this degenerative, noninflammatory disorder of the joints. Option b is incorrect because symmetrical swelling of all joints points to rheumatoid arthritis, an inflammatory and systemic disease. Osteoarthritis is degenerative and localized, affecting the joints asymmetrically rather than producing the widespread, symmetrical pattern that the other arthritis condition characteristically causes in clients. Option c is incorrect because clients with osteoarthritis are usually overweight, since the excess weight stresses the weight-bearing joints over time. A small, underweight frame is more typical of rheumatoid arthritis, so this body type simply does not fit the usual osteoarthritis presentation here. Option d is incorrect because a positive

Correct Answer: Williams position with knees flexed

The Williams position, a semi-Fowler's posture with the knees flexed and elevated on a pillow, relieves sharp back and leg pain. Flexing the knees reduces tension on the lower spine and eases the nerve compression causing the radiating pain. Option a is incorrect because the prone position does not relieve radiating low-back pain and can strain the lumbar spine. Lying face down fails to flex the knees, so it does not reduce the nerve tension producing the sharp pain down the leg. Option b is incorrect because high-Fowler's position does not address the lumbar nerve compression behind this pain. Sitting nearly upright lacks the knee flexion that the Williams position provides, so it offers no specific relief for the radiating discomfort felt now. Option c is incorrect because lying flat supine keeps the legs extended and does not ease sciatic pain. Without the knee flexion needed to relax the lower back, this position fails to relieve the sharp pain radiating down the leg from

Correct Answer: Handle the cast with the palms

A wet plaster cast should be handled with the palms rather than the fingertips, because finger pressure creates indentations that can press on the skin and cause breakdown. Using the palms preserves the cast's smooth interior surface against the limb. Option a is incorrect because gripping a wet cast with the fingertips leaves dents that press into the underlying tissue and risk skin injury. The flat surface of the palms must be used instead to support the cast without deforming its interior surface. Option b is incorrect because covering a drying plaster cast with a heavy blanket traps heat and slows the even drying of the cast. It should be left uncovered to allow air to circulate, so insulating it works against the proper hardening of the plaster. Option d is incorrect because the casted arm should be elevated above heart level during the first day or two to reduce swelling. Keeping it dependent below the heart would promote edema, the opposite of the elevation that a new extre

Correct Answer: Ensure the weights hang freely

Buck's traction maintains alignment and reduces muscle spasms before hip surgery, and the weights must hang freely to keep a constant pull. Allowing the weights to swing unobstructed preserves the therapeutic traction force on the fractured limb at all times. Option a is incorrect because the nurse should never lift or remove the traction weights, because doing so interrupts the continuous pull needed to stabilize the fracture. Repositioning is done while keeping the prescribed traction intact, rather than by taking the weights off the system. Option b is incorrect because letting the weights rest on the floor releases the traction force and defeats its very purpose. The weights must hang freely off the end of the bed so their pull stays constant against the fractured limb at all times. Option c is incorrect because the traction ropes must remain free of knots so they move smoothly over the pulleys. A knot would catch and disrupt the steady pull of the system, so the ropes are kep

Correct Answer: Compartment syndrome

Intense pain unrelieved by opioids and worsened by passive movement is a hallmark of compartment syndrome, in which pressure within a fascial compartment compromises circulation. This finding signals the need to relieve the constriction before neuromuscular damage develops. Option a is incorrect because a fat embolism presents with dyspnea, low oxygen saturation, altered mental status, and later petechiae, not localized pain worsened by passive stretch. Its respiratory and cerebral signs differ sharply from the limb-focused pain pattern that this client is describing now. Option b is incorrect because severe pain that opioids barely touch is not an expected, normal response to a cast. Treating these clear warning signs as routine would dangerously delay care for a true limb-threatening emergency, so dismissing them as a normal reaction is incorrect. Option d is incorrect because a deep vein thrombosis typically causes a swollen, reddened, tender calf rather than excruciating pain on pa

Correct Answer: Petechiae over the chest and neck

Cutaneous petechiae over the neck, chest, and arms are a distinguishing late sign of fat embolism, appearing alongside dyspnea, hypoxemia, and altered mental status. This finding helps separate a fat embolism from a pulmonary embolism in this client. Option a is incorrect because reduced bowel sounds more often reflect opioid use or decreased gastrointestinal motility, not a fat embolism. This gastrointestinal finding does not contribute to the respiratory and neurologic picture that characterizes embolized fat following a long-bone or hip fracture in clients. Option b is incorrect because swelling of the distal toes below a cast suggests a constrictive dressing or a cast that has become too tight. This localized circulatory sign points toward a different problem than the systemic embolic event described in this client. Option c is incorrect because a capillary refill within normal limits does not indicate a fat embolism. The relevant warning signs here are the respiratory distress, th

Correct Answer: I will take antibiotics for several months

Osteomyelitis is a deep bone infection that requires a long antibiotic course, typically continuing for several months. Understanding this extended duration helps the client complete the full therapy and fully eradicate the infection from the bone. Option a is incorrect because relief of pain does not mean the infection is gone, so stopping antibiotics early risks an incomplete cure and a relapse. The full course must be finished regardless of how the client feels along the way during treatment. Option b is incorrect because osteomyelitis calls for contact precautions, not airborne precautions, when isolation is indicated. Airborne measures target pathogens that spread through the air, which does not match the way this bone infection is actually transmitted from person to person. Option d is incorrect because a bone infection does not resolve within a week, since it demands months of antibiotic therapy to clear. Expecting a one-week recovery greatly underestimates the persistence of os