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A client with rheumatoid arthritis tells the nurse, 'I know it is important to exercise my joints so that I won't lose mobility, but my joints are so stiff and painful that exercising is difficult.' Which of the following responses by the nurse would be most appropriate?
- A. You are probably exercising too much. Decrease your exercise to every other day.'
- B. Tell the physician about your symptoms. Maybe your analgesic medication can be increased.'
- C. Stiffness and pain are part of the disease. Learn to cope by focusing on activities you enjoy.'
- D. Take a warm tub bath or shower before exercising. This may help with your discomfort.'
Correct Answer: D
Rationale: Warm baths or showers can reduce joint stiffness and pain, making exercise more tolerable and effective for maintaining mobility.
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Which of the following is significant data to gather from a client who has been diagnosed with pneumonia? Select all that apply.
- A. Quality of breath sounds.
- B. Presence of bowel sounds.
- C. Occurence of chest pain.
- D. Amount of peripheral edema.
- E. Color of nail beds.
Correct Answer: A,C,E
Rationale: Breath sounds (A) indicate lung involvement. Chest pain (C) may signal pleurisy or complications. Nail bed color (E) reflects oxygenation. Bowel sounds and peripheral edema are less relevant to pneumonia assessment.
The nurse is taking care of a client with Clostridium difficile (C. difficile). The nurse should do which of the following to prevent the spread of infection? Select all that apply.
- A. Wear a particulate respirator.
- B. Wear sterile gloves when providing care.
- C. Cleanse hands with alcohol-based hand sanitizer.
- D. Wash hands with soap and water.
- E. Wear a protective gown when in the client's room.
Correct Answer: D,E
Rationale: To prevent the spread of C. difficile, washing hands with soap and water (D) is essential as alcohol-based sanitizers are ineffective against its spores, and wearing a protective gown (E) prevents contamination. A respirator (A) is unnecessary, sterile gloves (B) are not required (clean gloves suffice), and alcohol sanitizer (C) is ineffective. CN: Safety and infection control; CL: Create
Which of the following is an assessment finding associated with internal bleeding with disseminated intravascular coagulation?
- A. Bradycardia.
- B. Hypertension.
- C. Increasing abdominal girth.
- D. Petechiae.
Correct Answer: C
Rationale: Internal bleeding in DIC can cause blood accumulation in the abdominal cavity, leading to increasing abdominal girth. Bradycardia and hypertension are not typical, and petechiae are associated with cutaneous bleeding.
A client has driven himself to the emergency department. He is 50 years old, has a history of hypertension, and informs the nurse that his father died from a heart attack at age 60. The client is presently complaining of indigestion. The nurse connects him to an electrocardiogram monitor and begins administering oxygen at 2 L/minute per nasal cannula. The nurse's next action would be to:
- A. Call for the physician.
- B. Start an I.V. line.
- C. Obtain a portable chest radiograph.
- D. Draw blood for laboratory studies.
Correct Answer: A
Rationale: Indigestion in a client with cardiac risk factors may indicate an MI. Calling the physician promptly ensures rapid evaluation and intervention, such as ECG or medications.
A client who has been diagnosed with gastroesophageal reflux disease (GERD) complains of heartburn. To decrease the heartburn, the nurse should instruct the client to eliminate which of the following items from the diet?
- A. Lean beef.
- B. Air-popped popcorn.
- C. Hot chocolate.
- D. Raw vegetables.
Correct Answer: C
Rationale: Hot chocolate contains caffeine and fat, both of which can relax the lower esophageal sphincter and worsen GERD-related heartburn. The other options are less likely to trigger symptoms.