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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.
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A client has been diagnosed with rheumatoid arthritis. The client has experienced increased fatigue and worsening physical status and is finding it difficult to maintain the role of elder in his cultural community. The elder is expected to attend social events and make community decisions. Stress seems to exacerbate the client's condition. What action by the nurse is best?
- A. Assess the client's culture more thoroughly
- B. Assess options for performing duties
- C. Suggest the client attend a community meeting
- D. Suggest the client give up the role of elder
Correct Answer: A
Rationale: The nurse needs a more thorough understanding of the client's culture, including the meaning of illness and the ramifications of the elder not being able to perform traditional duties. This must be done prior to offering any possible solutions.
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 client has a continuous passive motion (CPM) device after a total knee replacement. What action does the nurse delegate to the unlicensed assistive personnel (UAP) after the affected leg is placed in the machine while the client is in bed?
- A. Assess the distal circulation in 30 minutes
- B. Change the settings based on a range of motion
- C. Raise the lower siderail on the affected side
- D. Remind the client to do quad-setting exercises
Correct Answer: C
Rationale: Because the client's leg is strapped into the CPM, if it falls off the bed due to movement, the client's leg (and knee) could be injured. Raising the siderail prevents this. Assessment is a nursing responsibility. Only the surgeon, physical therapist, or specially trained technician adjust the CPM settings. Quad-setting exercises are not related to the CPM machine.
A nurse works with several clients who have gout. Which types of gout and their drug treatments are correctly matched? (Select all that apply.)
- A. Allopurinol (Zyloprim): Acute gout
- B. Colchicine (Colcrys): Acute gout
- C. Febuxostat (Uloric): Chronic gout
- D. Probenecid: Chronic gout
- E. Indomethacin: Acute gout
Correct Answer: B,C,D,E
Rationale: Colchicine and indomethacin are used for acute gout attacks. Febuxostat and probenecid are used for chronic gout management. Allopurinol is also used for chronic gout, not acute gout.
A client with rheumatoid arthritis (RA) is on the postoperative nursing unit after having elective surgery. The client reports that the arm feels like pins and needles and that the neck is painful since returning from surgery. What action by the nurse is best?
- A. Assist the client to change positions
- B. Encourage range of motion of the neck
- C. Notify the provider immediately
- D. Provide pain medication as ordered
Correct Answer: C
Rationale: Clients with RA can have cervical joint involvement. This can lead to an emergent situation due to potential spinal cord compression. The nurse should notify the provider immediately to assess for this serious complication.