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A client has fibromyalgia and is prescribed duloxetine hydrochloride (Cymbalta). The client calls the clinic reporting sedation. What response by the nurse is most appropriate?
- A. A little sedation will help you get some rest
- B. Depression often accompanies fibromyalgia
- C. Duloxetine reduces pain by increasing serotonin and norepinephrine
- D. You will have more energy after taking this drug
Correct Answer: C
Rationale: Duloxetine works to increase the release of the neurotransmitters serotonin and norepinephrine, which reduces the pain from fibromyalgia. The other answers are inaccurate.
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A client comes to the family medicine clinic and reports joint pain and stiffness. The nurse is asked to assess the client for Heberden's nodules. What assessment technique is correct?
- A. Inspect the client's distal finger joints
- B. Palpate the client's upper body lymph nodes
- C. Assess the client's range of motion
- D. Perform a musculoskeletal strength test
Correct Answer: A
Rationale: Heberden's nodules are bony swellings at the distal interphalangeal joints, commonly associated with osteoarthritis. Inspecting the distal finger joints is the correct assessment technique.
A client with fibromyalgia is in the hospital for an unrelated issue. The client reports that sleep, which is always difficult, is even harder now. What actions by the nurse are most appropriate? (Select all that apply.)
- A. Allow uninterrupted rest time
- B. Adhere to the client's usual bedtime routine
- C. Limit noise and light
- D. Offer a strong sleeping pill
- E. Provide a warm shower
Correct Answer: A,B,C,E
Rationale: Clients with fibromyalgia often have sleep disturbances, which can be exacerbated by the hospital environment. Allowing uninterrupted rest time, adhering to the client's usual bedtime routine, limiting noise and light, and offering a warm shower can help. A strong sleeping pill should be a last resort.
A nurse in the family clinic is teaching a client newly diagnosed with osteoarthritis (OA) about drugs used to treat the disease. For which medication does the nurse plan primary teaching?
- A. Acetaminophen
- B. Cyclobenzaprine hydrochloride (Flexeril)
- C. Hydrocortisone (Hylan)
- D. Ibuprofen
Correct Answer: A
Rationale: All of the drugs are appropriate to treat OA. However, the first-line drug is acetaminophen. Cyclobenzaprine is a muscle relaxant given to treat muscle spasms. Hydrocortisone is a synthetic joint fluid implant. Ibuprofen is a non-steroidal anti-inflammatory drug.
A nurse is caring for a client after joint replacement surgery. What action by the nurse is most important to prevent wound infection?
- A. Assess the client's white blood cell count
- B. Inspect the client's white blood cell count
- C. Monitor the client's temperature every 4 hours
- D. Use aseptic technique for dressing changes
Correct Answer: D
Rationale: Preventing surgical wound infection is a primary responsibility of the nurse, who must use aseptic technique to prevent wound infection. Other actions do not prevent infection but can lead to early detection of an infection that is already present.
A client with rheumatoid arthritis (RA) is having difficulty completing activities of daily living (ADLs). What devices can the nurse suggest to increase the client's independence? (Select all that apply.)
- A. Grab bars
- B. Long-handled bath brushes
- C. Rocker-recliner
- D. Toothbrushes with built-up handles
- E. Wheelchair cushion
Correct Answer: A,B,D
Rationale: Grab bars, long-handled bath brushes, and toothbrushes with built-up handles all provide modifications for daily activities, making it easier for the client with RA to complete ADLs independently. The rocker-recliner and wheelchair cushion are comfort measures but do not help increase independence.