Nokea
A client with rheumatoid arthritis is experiencing fatigue. Which nursing intervention is most appropriate?
- A. Encourage high-intensity exercise.
- B. Plan rest periods throughout the day.
- C. Increase carbohydrate intake.
- D. Limit fluid intake to reduce swelling.
Correct Answer: B
Rationale: Planning rest periods conserves energy and reduces fatigue in rheumatoid arthritis.
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The nurse is instructing the client on insulin administration. The client is performing a return demonstration for preparing the insulin. The client's morning dose of insulin is 10 units of regular and 22 units of NPH. The nurse checks the dose accuracy with the client. The nurse determines that the client has measured the correct dose when the syringe reads how many units?
Correct Answer: 32 units.
Rationale: The total dose is 10 units regular + 22 units NPH = 32 units, which should be drawn into one syringe for administration.
In order to prevent recurrent vasospastic episodes with Raynaud's phenomenon, the nurse should instruct the client to:
- A. Keep the hands and feet elevated as much as possible
- B. Use a vibrating massage device on the hands
- C. Wear gloves when obtaining food from the refrigerator
- D. Increase coffee intake to 2 cups per day
Correct Answer: C
Rationale: Wearing gloves when obtaining food from the refrigerator prevents cold-triggered vasospasm in Raynaud's. Elevation is irrelevant, vibrating devices may worsen symptoms, and coffee (caffeine) can cause vasoconstriction, increasing episodes.
A young adult client has been diagnosed with type 1 diabetes. He has an insulin drip to aid in lowering the serum blood glucose level of 600 mg/dL. He is also receiving I.V. antibiotics for a urinary tract infection. After 4 hours, the physician orders discontinuation of the insulin drip. The nurse should next?
- A. Discontinue the insulin drip, as ordered.
- B. Hang the next I.V. dose of antibiotic before discontinuing the insulin drip.
- C. Inform the physician that the client has not received any subcutaneous insulin yet.
- D. Add glargine (Lantus) to the insulin drip before discontinuing it.
Correct Answer: C
Rationale: Discontinuing an insulin drip without initiating subcutaneous insulin risks rebound hyperglycemia in type 1 diabetes. The nurse should inform the physician to ensure a subcutaneous insulin order is in place.
A 74-year-old female is admitted to the telemetry unit for placement of a permanent pacemaker because of sinus bradycardia. A priority goal for the client within 24 hours after insertion of a permanent pacemaker is to:
- A. Maintain skin integrity.
- B. Maintain cardiac conduction stability.
- C. Decrease cardiac output.
- D. Increase activity level.
Correct Answer: B
Rationale: Maintaining cardiac conduction stability is the priority post-pacemaker insertion to ensure the device effectively manages bradycardia.
A daughter is concerned that her mother is in denial when discussing her diagnosis of breast cancer because she sometimes says that breast cancer isn't that serious and changes the subject. The nurse informs the daughter that denial can be a healthy defense mechanism if it is used:
- A. To permit her mother to seek unconventional treatments.
- B. When making decisions about her care.
- C. Alone and not in combination with other defense mechanisms.
- D. To allow her mother to continue in her role as a mother.
Correct Answer: D
Rationale: Denial can be healthy if it allows the client to maintain normal roles (e.g., as a mother) while gradually processing the diagnosis, as long as it doesn't interfere with treatment.