Musculoskeletal System > Medical Surgical
Exam Review
Paget’s Disease
Total Questions : 45
Showing 45 questions, Sign in for moreWhat is Paget's disease?
Explanation
Paget's disease is a metabolic bone disorder that involves abnormal bone remodeling, leading to areas of increased bone density and disorganized bone formation. It is not a genetic disorder, autoimmune disease, or neurological disorder.
a. A genetic disorder characterized by abnormal bone density: While Paget's disease has a genetic component, it is not solely a genetic disorder. The condition involves both genetic and environmental factors.
b. An autoimmune disease affecting the joints and connective tissues: Paget's disease is not an autoimmune disease. It primarily affects bone structures, not joints and connective tissues.
d. A degenerative neurological disorder causing muscle weakness: Paget's disease is not a neurological disorder. It does not directly affect the nervous system or cause muscle weakness.
What is the most common age group affected by Paget's disease?
Explanation
Paget's disease most commonly affects older adults, typically those over the age of 60. While it can occur at any age, the prevalence increases with age.
a. Children and adolescents: Paget's disease is rare in children and adolescents. It is more commonly seen in older individuals.
b. Young adults (ages 20-40): While Paget's disease can occur in young adults, it is less common in this age group compared to older adults.
c. Middle-aged adults (ages 40-60): While Paget's disease can occur in middle-aged adults, it is more commonly seen in older individuals.
Which of the following bones is often affected in Paget's disease?
Explanation
The femur, which is the thigh bone, is often affected in Paget's disease. The condition commonly involves the axial skeleton, such as the skull, spine, and pelvis, as well as the long bones like the femur.
a. Humerus (arm bone): The humerus can be affected in Paget's disease, but it is not as commonly involved as the femur.
b. Radius (forearm bone): The radius can be affected in Paget's disease, but it is not as commonly involved as the femur.
d. Fibula (lower leg bone): The fibula can be affected in Paget's disease, but it is not as commonly involved as the femur.
What are the typical clinical manifestations of Paget's disease?
Explanation
The typical clinical manifestations of Paget's disease include bone pain, bone deformities (e.g., enlarged skull, bowed legs), and an increased risk of fractures due to the weakened and structurally abnormal bones. Joint pain and gastrointestinal disturbances are not primary features of Paget's disease.
a. Joint pain and stiffness: Joint pain and stiffness are more characteristic of arthritis or other joint-related conditions, not the primary clinical manifestations of Paget's disease.
b. Muscle weakness and fatigue: While Paget's disease can cause discomfort and reduced mobility, it is not primarily associated with muscle weakness and fatigue.
d. Gastrointestinal disturbances and weight loss: Paget's disease primarily affects bone structures, and gastrointestinal disturbances and weight loss are not typical clinical manifestations of the condition.
What is the etiology of Paget's disease?
Explanation
The etiology of Paget's disease involves a combination of genetic factors and environmental triggers. There is evidence of a genetic predisposition, but environmental factors also play a role in the development of the condition. Viral and bacterial infections, as well as dietary deficiencies, are not considered primary causes of Paget's disease.
a. Viral infection: Paget's disease is not caused by a viral infection.
b. Bacterial infection: Paget's disease is not caused by a bacterial infection.
d. Dietary deficiencies: While nutrition is important for bone health, dietary deficiencies are not the primary cause of Paget's disease. Genetic and environmental factors are more influential in its development.
What is the underlying pathophysiology of Paget's disease?
Explanation
The underlying pathophysiology of Paget's disease involves increased bone turnover and disordered bone remodeling. Osteoclasts, the bone-resorbing cells, become overactive, leading to excessive bone resorption. Osteoblasts, the bone-forming cells, attempt to repair the resorbed bone, but their activity is disordered, resulting in the formation of structurally abnormal bone.
a. Decreased bone density due to calcium deficiency: This is the pathophysiology of osteoporosis, not Paget's disease. In Paget's disease, bone density can be normal or increased due to the disordered bone remodeling.
c. Excessive collagen production leading to bone deformities: Excessive collagen production is not a characteristic feature of Paget's disease. The condition primarily involves abnormal bone remodeling by osteoclasts and osteoblasts.
d. Autoimmune attack on osteoblasts causing bone destruction: Paget's disease is not an autoimmune disorder. The disease is characterized by increased bone resorption and disordered bone formation, not an immune-mediated attack on osteoblasts.
Which cell type is primarily responsible for the increased bone resorption seen in Paget's disease?
Explanation
Osteoclasts are the primary cell type responsible for bone resorption in Paget's disease. These cells become overactive, leading to excessive bone breakdown, which is a hallmark of the condition.
a. Osteocytes: Osteocytes are mature bone cells embedded in the bone matrix. While they play a role in maintaining bone health, they are not directly responsible for bone resorption.
b. Osteoblasts: Osteoblasts are bone-forming cells. In Paget's disease, they attempt to repair the resorbed bone but their activity is disordered, leading to structurally abnormal bone formation.
d. Osteoprogenitor cells: Osteoprogenitor cells are undifferentiated cells that can differentiate into osteoblasts. They are not directly involved in the increased bone resorption seen in Paget's disease.
What is the typical pattern of bone involvement in Paget's disease?
Explanation
The typical pattern of bone involvement in Paget's disease is characterized by patchy areas of increased bone density (osteosclerosis) and disorganized bone formation. These areas of abnormal bone remodeling result in structurally weak and misshapen bones.
a. Uniform increase in bone density throughout the skeleton: This pattern of bone density is not characteristic of Paget's disease. The condition involves localized areas of increased density rather than uniform changes.
b. Focal areas of bone demineralization scattered throughout the skeleton: This pattern of bone demineralization is more characteristic of osteoporosis, not Paget's disease.
c. Diffuse increase in bone density with areas of focal bone loss: This pattern is not typical of Paget's disease. The condition primarily involves areas of increased bone density and disordered bone remodeling.
Which bone structures are commonly affected by Paget's disease?
Explanation
Paget's disease commonly affects the axial skeleton, including the skull, spine, and pelvis. The bones in these areas are often involved in the patchy areas of increased bone density and disorganized bone remodeling seen in the condition.
a. Long bones of the extremities: While long bones can be affected by Paget's disease, the axial skeleton is more commonly involved.
c. Hands and feet: The hands and feet can be affected by Paget's disease, but the axial skeleton is more frequently involved.
d. Ribs and sternum: The ribs and sternum can be affected by Paget's disease, but the axial skeleton, including the skull, spine, and pelvis, is more commonly affected.
How does Paget's disease differ from osteoporosis?
Explanation
The main difference between Paget's disease and osteoporosis is in the underlying bone remodeling. Paget's disease is characterized by increased bone turnover and disordered bone formation, while osteoporosis involves decreased bone formation and increased bone resorption.
a. Paget's disease is characterized by decreased bone density, while osteoporosis is associated with increased bone density: This statement is incorrect. In Paget's disease, bone density can be normal or increased due to the disordered bone remodeling.
b. Paget's disease primarily affects trabecular bone, while osteoporosis affects cortical bone: This statement is incorrect. Both Paget's disease and osteoporosis can affect both trabecular and cortical bone.
d. Paget's disease is an autoimmune disorder, while osteoporosis is caused by hormonal imbalances: This statement is incorrect. Paget's disease is not an autoimmune disorder, and osteoporosis is not solely caused by hormonal imbalances. Both conditions have complex multifactorial etiologies.
A client with Paget's disease presents with bone pain. What other clinical manifestation should the nurse expect to find during the assessment?
Explanation
Bone pain is a common clinical manifestation of Paget's disease, but another hallmark of the condition is the development of bone deformities. The abnormal bone remodeling in Paget's disease can lead to enlarged, misshapen bones, particularly in weight-bearing areas such as the skull, pelvis, and long bones.
a. Muscle weakness: While bone pain can lead to discomfort and reduced mobility, muscle weakness is not a specific clinical manifestation of Paget's disease.
b. Hypercalcemia: Hypercalcemia (elevated blood calcium levels) is not typically associated with Paget's disease. Instead, the condition is characterized by disorganized bone remodeling.
c. Joint swelling: Joint swelling is not a primary clinical manifestation of Paget's disease. Bone deformities are more characteristic of the condition.
The nurse is assessing a client with suspected Paget's disease. Which skeletal finding should the nurse prioritize during the physical examination?
Explanation
Bowing of long bones is a characteristic skeletal finding in Paget's disease. The abnormal bone remodeling can lead to bone bowing and misalignment, particularly in the long bones of the arms and legs.
a. Scoliosis: Scoliosis is a lateral curvature of the spine and is not directly associated with Paget's disease. It may be related to other musculoskeletal conditions.
b. Kyphosis: Kyphosis is an excessive forward curvature of the spine, often seen in conditions like osteoporosis, but it is not a primary finding in Paget's disease.
c. Bone tenderness: Bone tenderness may be present due to the bone inflammation and pain associated with Paget's disease, but it is not a specific skeletal finding.
The nurse is performing a physical assessment on a client with Paget's disease. Which finding should the nurse attribute to the increased bone turnover and remodeling characteristic of this condition?
Explanation
The increased bone turnover and remodeling in Paget's disease can cause warmth and erythema (redness) over the affected bones. This is due to the increased blood flow and metabolic activity in the affected areas.
a. Cool, clammy skin: Cool, clammy skin is not directly related to the increased bone turnover and remodeling in Paget's disease. It may be related to other factors, such as circulation or environmental conditions.
b. Pulsating chest pain: Pulsating chest pain is not a typical finding in Paget's disease. It may be related to other cardiac or respiratory conditions.
d. Enlarged skull circumference: An enlarged skull circumference is a common manifestation of Paget's disease, but it is not directly related to the increased bone turnover and remodeling. It results from excessive bone growth in the skull bones.
A client with Paget's disease experiences frequent headaches. Which cranial finding should the nurse assess for during the neurological examination?
Explanation
Enlarged frontal bossing (prominent forehead) is a cranial finding often seen in clients with Paget's disease due to increased bone growth in the skull bones. This can cause pressure and contribute to headaches.
a. Nystagmus: Nystagmus is an involuntary, rhythmic movement of the eyes and is not directly associated with Paget's disease.
b. Diplopia: Diplopia, or double vision, is not a typical finding in Paget's disease. It may be related to other neurological or ocular conditions.
c. Papilledema: Papilledema is swelling of the optic disc due to increased intracranial pressure. While headaches can be associated with Paget's disease, papilledema is not a common manifestation of the condition.
A client with Paget's disease complains of bone pain that worsens with activity. What is the underlying cause of this pain?
Explanation
The bone pain experienced by clients with Paget's disease is often due to microfractures and inflammation in the affected bones. The increased bone turnover and remodeling lead to weaker bones, making them more susceptible to microfractures. The inflammation at the site of these microfractures contributes to the pain, which worsens with activity.
a. Decreased blood flow to bones: Paget's disease does not typically cause decreased blood flow to bones. Instead, the condition leads to increased vascularity in affected bones.
b. Bone infarction: Bone infarction (death of bone tissue due to inadequate blood supply) is not a characteristic feature of Paget's disease. Microfractures and inflammation are more common causes of bone pain in this condition.
d. Compression of nerve roots: While nerve compression can cause bone pain, it is not a primary mechanism of pain in Paget's disease. The pain is primarily related to bone remodeling and inflammation.
A client presents with bone pain, joint stiffness, and an enlarged skull. Which diagnostic test is most likely to confirm the diagnosis of Paget's disease?
Explanation
A bone scan is the most appropriate diagnostic test for confirming the diagnosis of Paget's disease. It can reveal increased bone turnover and abnormal bone remodeling patterns characteristic of the condition. The bone scan can show "hot spots" of increased uptake in affected bones.
a. Complete blood count (CBC): While a CBC can be useful in ruling out other conditions, it does not directly diagnose Paget's disease. Specific bone imaging is required for confirmation.
c. Liver function tests (LFTs): Liver function tests are not used to diagnose Paget's disease. The condition primarily affects bone structures, and liver involvement is not a primary concern.
d. Magnetic resonance imaging (MRI): While an MRI can provide detailed images of bones and soft tissues, it may not be the initial choice for diagnosing Paget's disease. A bone scan is more specific to evaluate bone turnover and remodeling.
The healthcare provider suspects a client may have Paget's disease based on clinical presentation. Which laboratory test should be ordered to aid in the diagnosis?
Explanation
An elevated alkaline phosphatase (ALP) level is a common finding in patients with Paget's disease. ALP is an enzyme present in bone cells, and its increased activity is indicative of increased bone turnover and remodeling seen in Paget's disease.
a. Serum calcium level: Serum calcium levels may be affected in Paget's disease due to abnormal bone remodeling, but they are not specific enough to confirm the diagnosis on their own.
b. Erythrocyte sedimentation rate (ESR): The ESR is a marker of inflammation and is not specific to Paget's disease. While it may be elevated due to bone inflammation, it does not confirm the diagnosis.
d. Serum creatinine level: Serum creatinine levels are not directly related to the diagnosis of Paget's disease. They are typically assessed to evaluate kidney function.
The healthcare provider orders an X-ray of a patient's bones due to suspicion of Paget's disease. What finding on the X-ray would support the diagnosis?
Explanation
The characteristic X-ray finding in Paget's disease is bony overgrowth and thickening of the affected bones. This is due to the increased bone turnover and abnormal remodeling associated with the condition.
a. Decreased bone density: Decreased bone density is associated with osteoporosis, not Paget's disease. In Paget's disease, bone density is often normal or increased due to the disorganized bone remodeling.
b. Erosions and bone cysts: Erosions and bone cysts are not specific to Paget's disease and may be seen in other bone conditions. Bony overgrowth is more characteristic of Paget's disease.
d. Presence of osteoporotic fractures: Osteoporotic fractures are not typically associated with Paget's disease. The increased bone density and thickening in Paget's disease can actually make bones more resistant to fractures.
The healthcare provider suspects Paget's disease in a patient. Which imaging modality is most useful for assessing the extent and severity of bone involvement?
Explanation
X-rays are the most useful imaging modality for assessing the extent and severity of bone involvement in Paget's disease. X-rays can reveal the characteristic bony overgrowth and thickening, as well as any bone deformities and fractures.
b. Computed tomography (CT) scan: CT scans can provide detailed images of bones and soft tissues, but they may not be the initial choice for evaluating Paget's disease. X-rays are more specific for the condition.
c. Magnetic resonance imaging (MRI): While an MRI can provide detailed images of bones and soft tissues, it may not be the first-line imaging choice for evaluating Paget's disease. X-rays are more specific for bone involvement.
d. Bone densitometry (DXA scan): Bone densitometry is used to assess bone mineral density and is commonly used for conditions like osteoporosis. It may not provide the necessary information for evaluating Paget's disease.
A patient with suspected Paget's disease undergoes a bone biopsy. What is the primary purpose of the bone biopsy in diagnosing this condition?
Explanation
The primary purpose of a bone biopsy in diagnosing Paget's disease is to examine bone tissue for characteristic changes that confirm the diagnosis. Microscopic examination of the bone tissue can reveal the disorganized bone remodeling and other characteristic features of the condition.
a. To assess calcium levels in the bone: Bone biopsies are not performed to assess calcium levels in the bone. Other diagnostic tests, such as blood tests, are used for that purpose.
b. To confirm the presence of bone tumors: Paget's disease is not a bone tumor, and the biopsy is not performed to confirm the presence of tumors. The biopsy confirms the specific bone changes associated with the condition.
c. To evaluate bone density and strength: Bone biopsies do not directly evaluate bone density and strength. Other imaging modalities, such as X-rays and DXA scans, are used for assessing bone density.
The nurse is providing education about medication management for a client with Paget's disease. Which medication is commonly used as the first-line treatment for this condition?
Explanation
Bisphosphonates are commonly used as the first-line treatment for Paget's disease. They work by slowing down bone resorption and promoting more balanced bone remodeling, helping to control the excessive bone turnover characteristic of the condition.
a. Calcium supplements: While calcium supplements are essential for overall bone health, they are not the first-line treatment for Paget's disease. Bisphosphonates specifically target the abnormal bone remodeling associated with the condition.
b. Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs may help manage pain and inflammation associated with Paget's disease, but they do not directly address the underlying bone remodeling abnormalities. Bisphosphonates are more effective in treating the condition.
d. Vitamin D supplements: Vitamin D is necessary for calcium absorption and bone health, but it is not the primary treatment for Paget's disease. Bisphosphonates are the mainstay of therapy.
The nurse is discussing dietary recommendations with a client diagnosed with Paget's disease. What dietary modification is important for this client?
Explanation
Increasing calcium intake is important for individuals with Paget's disease to support bone density and strength. Adequate calcium intake is essential for overall bone health and can help counteract the effects of abnormal bone remodeling seen in Paget's disease.
a. Increase sodium intake to promote bone health: High sodium intake can lead to calcium excretion, which may be detrimental to bone health. Reducing sodium intake is beneficial for overall bone health.
b. Limit caffeine consumption to reduce bone resorption: While excessive caffeine intake may affect calcium absorption, moderate caffeine consumption is not directly related to Paget's disease. Calcium intake is more critical for managing the condition.
c. Reduce protein intake to prevent bone deformities: Protein intake is essential for tissue repair and bone health. Restricting protein intake is not recommended for individuals with Paget's disease, as it can impact overall health.
The nurse is monitoring a client receiving bisphosphonate therapy for Paget's disease. Which laboratory parameter should the nurse prioritize monitoring during treatment?
Explanation
Monitoring serum calcium levels is important during bisphosphonate therapy for Paget's disease. Bisphosphonates can affect calcium metabolism, and monitoring calcium levels helps ensure appropriate dosing and prevent complications such as hypocalcemia or hypercalcemia.
a. Liver function tests (LFTs): Bisphosphonates generally do not have a significant impact on liver function. Monitoring LFTs is not a primary concern during bisphosphonate therapy.
c. Blood glucose levels: Bisphosphonate therapy is not known to affect blood glucose levels. Monitoring blood glucose is not directly related to Paget's disease treatment.
d. Complete blood count (CBC): Bisphosphonate therapy does not typically have a major effect on blood cell counts. Monitoring a CBC is not a primary concern during bisphosphonate treatment for Paget's disease.
The nurse is instructing a client with Paget's disease about self-care measures to manage bone pain. Which self-care measure should the nurse recommend?
Explanation
Engaging in gentle stretching exercises can help relieve bone pain and improve joint flexibility for individuals with Paget's disease. These exercises promote joint mobility and may help alleviate discomfort associated with bone deformities.
a. Applying cold compresses to affected areas: Applying cold compresses may provide some temporary relief for pain, but they do not address the underlying bone remodeling abnormalities in Paget's disease.
b. Limiting physical activity to reduce pain: While excessive physical activity may need to be moderated to prevent fractures, limiting all physical activity is not advisable for patients with Paget's disease. Gentle exercises can support bone health and overall well-being.
c. Taking hot baths to relieve discomfort: Hot baths may provide temporary relief for muscle discomfort, but they do not directly address bone pain associated with Paget's disease.
The nurse is assessing a client with Paget's disease for potential complications. Which complication should the nurse prioritize monitoring?
Explanation
A potential complication of Paget's disease is an increased risk of pathologic fractures. The abnormal bone remodeling weakens the bones, leading to an increased susceptibility to fractures.
a. Hypertension: Hypertension is not a direct complication of Paget's disease. The condition primarily affects bone structures.
c. Hyperthyroidism: Hyperthyroidism is not associated with Paget's disease. It is a separate condition related to thyroid gland dysfunction.
d. Type 2 diabetes mellitus: Type 2 diabetes mellitus is not a complication of Paget's disease. The conditions are unrelated and have different underlying causes.
The nurse is providing patient education to a client with Paget's disease. Which statement by the client indicates an understanding of the condition?
Explanation
Bisphosphonate medications are commonly prescribed for Paget's disease to slow down bone resorption and promote more balanced bone remodeling. Taking bisphosphonates with a full glass of water or milk helps ensure proper absorption and reduce the risk of gastrointestinal irritation.
a. "Paget's disease is a type of cancer that affects the bones." This statement is incorrect. Paget's disease is not a type of cancer but a chronic, non-cancerous condition characterized by abnormal bone remodeling.
b. "This condition is caused by a deficiency in vitamin D." This statement is incorrect. While vitamin D plays a role in bone health, Paget's disease is primarily a result of genetic factors that lead to abnormal bone remodeling.
c. "I should avoid weight-bearing exercises to prevent fractures." This statement is incorrect. Moderate weight-bearing exercises, under healthcare provider guidance, can help maintain bone strength and reduce the risk of fractures in individuals with Paget's disease.
The nurse is teaching a client with Paget's disease about potential complications. What complication should the nurse prioritize?
Explanation
A potential complication of Paget's disease is an increased risk of bone fractures. The abnormal bone remodeling in Paget's disease weakens the bones, leading to an increased susceptibility to fractures.
a. Hypertension: Hypertension is not a direct complication of Paget's disease. The condition primarily affects bone structures.
c. Hypothyroidism: Hypothyroidism is not associated with Paget's disease. It is a separate condition related to thyroid gland dysfunction.
d. Kidney stones: While kidney stones may be unrelated to Paget's disease, they can be a complication of other conditions or metabolic disorders.
The nurse is discussing self-care measures with a client newly diagnosed with Paget's disease. Which self-care measure is appropriate for the client to implement?
Explanation
Engaging in low-impact exercises is an appropriate self-care measure for individuals with Paget's disease. Low-impact exercises, such as walking and swimming, can help support bone health, joint mobility, and overall physical well-being.
a. Massaging affected areas to reduce swelling: Massaging affected areas may exacerbate bone deformities and lead to increased pain. It is not recommended for individuals with Paget's disease.
b. Taking over-the-counter anti-inflammatory medications: Over-the-counter anti-inflammatory medications may not be sufficient to manage the inflammation and pain associated with Paget's disease. Prescribed medications are more effective in managing the condition.
d. Applying heat to affected joints to relieve pain: Applying heat may provide temporary relief for some individuals, but it is not the primary method for managing bone pain in Paget's disease. Prescribed medications and exercises are more effective approaches.
The nurse is educating a client with Paget's disease about the importance of calcium and vitamin D intake. What is the rationale for this education?
Explanation
Calcium and vitamin D help reduce the risk of bone fractures in Paget's disease.
Explanation: Adequate calcium and vitamin D intake are essential for maintaining bone health and reducing the risk of bone fractures, especially in individuals with Paget's disease. While these nutrients do not cure Paget's disease, they play a crucial role in supporting bone strength and density.
a. Calcium and vitamin D can prevent the development of Paget's disease: This statement is incorrect. Paget's disease is primarily a result of genetic factors, and calcium and vitamin D intake do not prevent its development.
c. Calcium and vitamin D can cure Paget's disease: This statement is incorrect. While calcium and vitamin D are important for bone health, they do not cure Paget's disease. Treatment usually involves medications to manage the condition.
d. Calcium and vitamin D decrease bone turnover in Paget's disease: This statement is not entirely accurate. Calcium and vitamin D do not directly decrease bone turnover in Paget's disease. Medications like bisphosphonates are prescribed to address bone remodeling.
The nurse is teaching a client with Paget's disease about the importance of regular follow-up appointments with the healthcare provider. What is the rationale for this education?
Explanation
Regular follow-up appointments with the healthcare provider are essential for clients with Paget's disease to monitor for potential complications and disease progression. Periodic evaluations help assess bone health, check for bone deformities, and adjust the treatment plan if necessary.
b. To obtain prescriptions for pain medications: While pain management may be addressed during follow-up appointments, it is not the primary reason for regular visits. Pain medications can be prescribed as needed.
c. To receive physical therapy for bone pain: Physical therapy may be part of the treatment plan for managing bone pain, but it does not solely warrant regular follow-up appointments.
d. To assess calcium and vitamin D levels: Calcium and vitamin D levels may be assessed, but they are not the main focus of regular follow-up appointments. The primary purpose is to monitor the condition's progression and assess for potential complications.
When caring for a patient with Paget's disease, the nurse should prioritize which intervention?
Explanation
Assisting with range-of-motion exercises is an important nursing consideration for patients with Paget's disease. Paget's disease can lead to bone deformities and limited joint mobility. Range-of-motion exercises can help prevent joint contractures and maintain joint function.
a. Encouraging high-impact exercises to strengthen bones: High-impact exercises can put excessive stress on weakened bones in patients with Paget's disease, increasing the risk of fractures. Low-impact exercises are preferred to promote bone health.
b. Monitoring serum calcium levels regularly: While monitoring calcium levels may be important in certain conditions, it is not a priority nursing consideration for Paget's disease. The primary focus should be on managing bone deformities and maintaining joint mobility.
d. Administering corticosteroids to reduce inflammation: Corticosteroids are not used in the treatment of Paget's disease. The disease primarily involves abnormal bone remodeling, and corticosteroids do not address this underlying issue.
Which precaution is essential when caring for a patient with Paget's disease?
Explanation
Contact precautions are essential when caring for a patient with Paget's disease. The disease involves abnormal bone remodeling, leading to bone deformities and increased bone turnover. Close contact with the patient's body or potentially contaminated objects should be minimized to prevent transmission of the disease.
a. Airborne precautions: Paget's disease is not transmitted through the airborne route. Airborne precautions are used for diseases that spread through respiratory droplets.
b. Droplet precautions: Paget's disease is not transmitted through droplets. Droplet precautions are used for diseases spread through respiratory droplets.
c. Standard precautions: While standard precautions are essential for all patients to prevent transmission of infections, specific precautions for Paget's disease involve contact precautions.
The nurse should encourage patients with Paget's disease to maintain which dietary intake?
Explanation
Patients with Paget's disease should be encouraged to maintain a high-calcium diet to support bone health. Adequate calcium intake is essential for bone strength and density, and it can help counteract the effects of abnormal bone remodeling seen in Paget's disease.
b. High-phosphorus diet: While phosphorus is also important for bone health, a high-phosphorus diet is not specific to Paget's disease. It is more relevant for patients with renal disorders.
c. High-vitamin D diet: Vitamin D is necessary for calcium absorption and bone health. However, a high-vitamin D diet is not specific to Paget's disease. Vitamin D supplements may be recommended if a deficiency is present.
d. Low-potassium diet: Potassium intake is not directly related to Paget's disease. Potassium is an essential mineral for various bodily functions, but it is not a focus in the management of the condition.
Which symptom should the nurse closely monitor for in patients with Paget's disease?
Explanation
Joint stiffness is a common symptom in patients with Paget's disease, especially when bone deformities are present. The nurse should closely monitor for any changes in joint mobility and range of motion, as joint stiffness can impact the patient's ability to perform daily activities.
a. Weight gain: Weight gain is not a specific symptom of Paget's disease. It is not directly related to the condition.
c. Hyperactivity: Hyperactivity is not a characteristic symptom of Paget's disease. The condition primarily affects bone structures.
d. Blurred vision: Blurred vision is not associated with Paget's disease. It is not a symptom commonly observed in individuals with the condition.
Which nursing intervention is essential when caring for a patient with Paget's disease experiencing bone pain?
Explanation
Administering nonsteroidal anti-inflammatory drugs (NSAIDs) is an essential nursing intervention for managing bone pain in patients with Paget's disease. NSAIDs can help reduce inflammation and alleviate pain associated with bone deformities.
a. Applying cold compresses to the affected area: Applying cold compresses may provide some temporary relief, but it is not the primary intervention for managing bone pain in Paget's disease. NSAIDs are more effective for managing inflammation and pain.
c. Elevating the affected extremity: Elevating the affected extremity is not a specific intervention for managing bone pain in Paget's disease. It may be useful for managing other conditions, such as edema, but not for addressing bone pain.
d. Encouraging bed rest: While rest is important for managing pain, encouraging prolonged bed rest is not advisable for patients with Paget's disease. Moderate physical activity is essential for overall bone health and joint mobility.
Paget's disease is a disorder primarily affecting which part of the body?
Explanation
Paget's disease is a bone disorder that causes abnormal bone remodeling, leading to enlarged, weak, and deformed bones.
a. Muscles: Paget's disease primarily affects bones, not muscles. While muscles surrounding affected bones may be impacted indirectly, they are not the primary target of the disease.
c. Skin: Paget's disease does not affect the skin. It is a bone disorder and does not involve the skin.
d. Lungs: Paget's disease does not directly affect the lungs. The disease primarily involves bone remodeling, not lung function.
Which of the following is a common clinical manifestation of Paget's disease?
Explanation
The most common clinical manifestation of Paget's disease is bone pain and deformities due to abnormal bone remodeling and increased bone turnover.
a. Severe joint pain: While joint pain can occur in Paget's disease due to bone involvement, it is not the most common manifestation. Bone pain and deformities are more characteristic.
b. Unexplained weight loss: Unexplained weight loss is not a typical symptom of Paget's disease. It is not directly related to the bone disorder.
c. Visual disturbances: Visual disturbances are not associated with Paget's disease. This condition primarily affects bones, not the eyes or vision.
Which diagnostic test is commonly used to confirm the diagnosis of Paget's disease?
Explanation
X-ray imaging is commonly used to confirm the diagnosis of Paget's disease. X-rays can show characteristic bone changes, such as bone enlargement, thickening, and deformities, which are indicative of Paget's disease.
a. Bone density scan: While bone density scans may be useful to assess bone health in other conditions, they are not the primary diagnostic tool for Paget's disease. X-rays are preferred.
b. Magnetic resonance imaging (MRI): MRI may provide detailed images of bones and surrounding soft tissues, but it is not the first-line diagnostic test for Paget's disease. X-rays are more commonly used.
d. Blood glucose test: A blood glucose test is used to diagnose and monitor diabetes, not Paget's disease. These conditions are unrelated.
Paget's disease can lead to an increased risk of which complication?
Explanation
Paget's disease can weaken bones, leading to an increased risk of bone fractures. The abnormal bone remodeling and increased bone turnover can result in bones that are more susceptible to breaking.
a. Heart attack: Paget's disease primarily affects bones, not the cardiovascular system. There is no direct association between Paget's disease and an increased risk of heart attacks.
b. Stroke: Paget's disease does not increase the risk of stroke. Stroke is a condition primarily related to the brain and blood vessels, not bones.
c. Osteoporosis: While both Paget's disease and osteoporosis involve changes in bone density, they are distinct conditions. Paget's disease leads to enlarged and weakened bones, while osteoporosis leads to decreased bone density and increased fracture risk.
Which of the following is the goal of treatment for Paget's disease?
Explanation
The goal of treatment for Paget's disease is to relieve pain and prevent complications associated with bone deformities and fractures. There is no cure for Paget's disease, but treatment aims to manage symptoms and reduce the risk of complications.
a. Cure the disease completely: Paget's disease is a chronic condition with no known cure. Treatment focuses on symptom management and preventing complications.
c. Restore normal bone density: While treatment may aim to reduce abnormal bone remodeling, restoring normal bone density is not typically achievable. The focus is on pain relief and preventing complications.
d. Regenerate damaged bones: While treatment may improve bone health and reduce deformities, regenerating damaged bones to their original state is not feasible. Treatment aims to manage the disease and its consequences effectively.
Which nursing intervention is important when caring for a patient with Paget's disease?
Explanation
Assisting with range-of-motion exercises is important when caring for a patient with Paget's disease. Range-of-motion exercises can help maintain joint mobility and prevent joint contractures, which may occur due to bone changes in the disease.
a. Encouraging bed rest to prevent fractures: Bed rest is not recommended for individuals with Paget's disease, as it can lead to muscle weakness and joint stiffness.
c. Administering corticosteroids to reduce inflammation: Corticosteroids are not typically used to treat Paget's disease, as they do not address the underlying bone changes.
d. Providing a high-calcium diet: While adequate calcium intake is important for bone health, a high-calcium diet is not a specific nursing intervention for Paget's disease. Bisphosphonates are typically prescribed to address bone changes.
What is a potential complication of Paget's disease?
Explanation
A potential complication of Paget's disease is an increased risk of fractures. The abnormal bone remodeling and weakening of bone structures in Paget's disease can lead to an increased susceptibility to fractures.
a. Hypertension: Hypertension is not a direct complication of Paget's disease. The condition primarily affects bone structures.
b. Osteoporosis: Paget's disease is not a form of osteoporosis. While both conditions involve bone changes, they have distinct pathophysiological mechanisms.
d. Type 2 diabetes mellitus: Type 2 diabetes mellitus is not a complication of Paget's disease. The conditions are unrelated and have different underlying causes.
Paget's disease is most commonly observed in which age group?
Explanation
Paget's disease is most commonly observed in older adults, typically over the age of 40. It is more prevalent in the elderly population.
a. Children and adolescents: While Paget's disease can occur in younger individuals, it is much more common in older adults.
b. Young adults: Paget's disease is not commonly observed in young adults. It typically develops later in life.
c. Middle-aged adults: While Paget's disease can occur in middle-aged adults, it is more commonly seen in older adults.
Which of the following statements about Paget's disease is true?
Explanation
Paget's disease has a genetic component, and there is evidence of familial inheritance. Individuals with a family history of Paget's disease are at a higher risk of developing the condition.
b. It is caused by vitamin D deficiency: Paget's disease is not caused by vitamin D deficiency. It is primarily a result of genetic factors leading to abnormal bone remodeling.
c. It primarily affects the hands and feet: Paget's disease can affect various bones in the body, not just the hands and feet. It commonly involves the pelvis, vertebrae, and ribs.
d. It is a rare condition with a prevalence of less than 1%: Paget's disease is not considered rare. It is relatively common, particularly in older adults, with a prevalence estimated to be around 1-3% in individuals over the age of 40.
Which of the following activities should individuals with Paget's disease be encouraged to perform to promote bone health?
Explanation
Individuals with Paget's disease should be encouraged to engage in walking and low-impact exercises to promote bone health. These activities are less likely to cause fractures or stress on the bones while still supporting bone strength and density.
a. Participating in high-impact sports: High-impact sports can put excessive stress on the bones and increase the risk of fractures in individuals with Paget's disease. It is not recommended.
b. Limiting physical activity to avoid fractures: While excessive physical activity may need to be moderated to prevent fractures, limiting all physical activity is not advisable. Moderate exercise is essential for overall health and bone strength.
d. Heavy weightlifting: Heavy weightlifting can increase the risk of fractures in individuals with Paget's disease. It is not recommended, as it can put excessive stress on the bones.
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