Question

A patient comes to the clinic complaining of severe pain in his left great toe. Which of the following assessments would not be appropriate for the nurse to make?

1. Assess his vital signs
2. Assess his toe for color changes and heat
3. Assess for history of a tick bite
4. Assess his urinary output

The nurse is caring for a nine-year-old patient diagnosed with Duchenne’s muscular dystrophy. Which of the following statements would the nurse expect to find in the patient's medical history?

                A. The patient has been dependent on a ventilator to breathe since birth.

                B. The patient is able to walk but falls frequently and has difficulty running.

                C. The patient had normal physical activity until approximately a year ago.

                D. The patient has never been able to stand or walk.

The nurse is caring for a client who was also diagnosed with a compression fracture of the fourth lumbar vertebra (L4).   This type of fracture is not uncommon in patients with osteoporosis because the vertebrae:

                A. Collapses due to porous bone

                B. Splinters into fragments due to pressure

                C. Bends and splinters but is still secure on one side

                D. Cracks directly across but does not break completely

Answer 1

1. A patient comes to the clinic complaining of severe pain in his left great toe. Which of the following assessments would not be appropriate for the nurse to make?

• Assess his urinary output.
• Assess the physical apperance in the toe for color changes and heat is the first observation to be noted. The reason cannot ne oin pointed by this obervation alone. However, ruling out the reasons of the toe pain can be done.
• Assess for history of a tick bite can also be a method to check for an inflamation of the toe or pain. swelling and pain in the bite site is very comman. In case of vital signs, abnormal values observed can emphasize on the reason of pain. eg, elevated temperture
• However a urine profile may not directly help to determine the reason for toe pain.
• https://www.healthline.com/health/sharp-pain-in-big-toe#Bunion-|-Bunion, https://www.medicinenet.com/ticks/article.htm

2. The nurse is caring for a nine-year-old patient diagnosed with Duchenne’s muscular dystrophy. Which of the following statements would the nurse expect to find in the patient's medical history?

• The patient is able to walk but falls frequently and has difficulty running: DMD is a X linked disorder most often seen in males. Initially there are certain symptoms observed in young patients. these include: Gower’s sign,Trouble with running, jumping and other activities, leg pain, learning issues etc.
• Therefore in the above mentioned scenario, there are more chances of the patient showing problems in carrying out activities like running etc, even though the child is able to walk.
• https://www.cedars-sinai.org/health-library/diseases-and-conditions---pediatrics/d/duchenne-muscular-dystrophy.html

3. The nurse is caring for a client who was also diagnosed with a compression fracture of the fourth lumbar vertebra (L4).   This type of fracture is not uncommon in patients with osteoporosis because the vertebrae:

• Collapses due to porous bone : In conditions where a patient suffers from osteoporosis, the bones become thinner making them sensitive to pressure . Therefore in these patients, a compression fracture of the fourth lumbar vertebra (L4) is very comman. Daily activities like lifting heavy objects or bending can also lead to fracture conditions
• https://www.cedars-sinai.edu/Patients/Programs-and-Services/Imaging-Center/For-Patients/Exams-by-Procedure/Interventional-Neuroradiology/Spinal-Compression-Fractures/Spinal-Compression-Fractures.aspx