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How should the nurse explain the purpose of methotrexate in treating a child with juvenile arthritis?
- A. Improves functional ability
- B. Controls the febrile response
- C. Minimizes the effects of uveitis
- D. Decreases the inflammatory response
Correct Answer: D
Rationale: Methotrexate is a disease-modifying antirheumatic drug that reduces inflammation in juvenile arthritis.
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Which description by the nurse most accurately states the purpose of halo-cervical traction?
- A. It restricts neck movement but enables physical activity.
- B. It allows head movement while immobilizing the spine.
- C. It accelerates healing by facilitating physical therapy.
- D. It promotes faster bone repair within a shorter time span.
Correct Answer: A
Rationale: Halo-cervical traction immobilizes the cervical spine to promote healing while allowing some physical activity (e.g., walking), unlike other options that inaccurately describe its function.
The nurse gently elevates the client's newly casted arm on a pillow and explains that this is necessary for the first 24 to 48 hours after casting. What is the chief purpose of this action?
- A. It helps a damp cast to dry more evenly.
- B. It reduces the amount of pain medication needed.
- C. Venous return is enhanced, and edema is decreased.
- D. It is more comfortable than keeping the arm dependent.
Correct Answer: C
Rationale: Elevation enhances venous return and reduces edema, the primary reason for this action. It does not directly affect cast drying, pain medication needs, or comfort alone.
The nurse correctly instructs the client to avoid which type of fluid?
- A. Milk
- B. Alcohol
- C. Cranberry juice
- D. Carbonated drinks
Correct Answer: B
Rationale: Alcohol, especially beer, increases uric acid production and reduces its excretion, worsening gout. Milk, cranberry juice, and carbonated drinks are generally safe unless otherwise contraindicated.
Which technique is the best strategy for assessing circulation in the leg in Buck's traction?
- A. Observe whether the client can wiggle or move the toes.
- B. Palpate for pulsation of the dorsalis pedis artery.
- C. Take the client's blood pressure with a thigh cuff positioned on the affected leg.
- D. Determine whether the client can feel sharp and dull sensations.
Correct Answer: B
Rationale: Palpating the dorsalis pedis pulse directly assesses arterial circulation in the leg, providing the most accurate indication of blood flow. Toe movement and sensation are less specific, and blood pressure measurement is not relevant.
The client is now over an acute episode of gout. He is to be discharged on allopurinol (Zyloprim). What instruction must the nurse give to this client?
- A. Take your medicine on an empty stomach.'
- B. Report any nausea to your physician at once.'
- C. Drink two to three quarts of fluids daily.'
- D. Do not take over-the-counter cold medicine.'
Correct Answer: C
Rationale: Drinking 2-3 quarts of fluids daily prevents uric acid stone formation, a key instruction for clients on allopurinol.