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A client with rheumatoid arthritis tells the nurse that she feels 'quite alone' in adjusting to changes in her lifestyle. Which of the following nursing actions is most appropriate in response to this statement?
- A. Refer the client and her husband for counseling to decrease her sense of isolation.
- B. Suggest the client develop a hobby to occupy her time.
- C. Tell the client about her community's arthritis support group.
- D. Suggest that the client discuss her feelings with her minister.
Correct Answer: C
Rationale: A community arthritis support group provides peer support, reducing feelings of isolation and addressing specific needs.
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The nurse is teaching a client about warfarin (Coumadin) therapy. Which food should the client avoid?
- A. Spinach
- B. Chicken breast
- C. Brown rice
- D. Apples
Correct Answer: A
Rationale: Spinach is high in vitamin K, which can antagonize warfarin's anticoagulant effect, requiring dietary consistency to maintain therapeutic INR levels.
After your assessment of your client and the need to transfer your client from the bed to the chair, what is the best and safest way to transfer this paralyzed client when you suspect that you will need the help of another for the client's first transfer out of bed?
- A. Use a slide board.
- B. Use a mechanical lift.
- C. Use a gait belt.
- D. Notify the client's doctor that the client cannot be safely transferred by you.
Correct Answer: B
Rationale: For a paralyzed client requiring assistance, a mechanical lift is the safest transfer method, minimizing risk of injury to both the client and staff.
The nurse is assessing a teenage girl. According to the fi gure below, the nurse should note that the girl has:
- A. Kyphosis.
- B. Arthritis.
- C. Developmental dysplasia of the hip.
- D. Scoliosis.
Correct Answer: D
Rationale: The teenage girl has scoliosis, the lateral deviation of the spine. Kyphosis is noted by a forward curvature of the shoulders. Arthritis is diagnosed by radiographs. Hip dysplasia is noted in older children by pain, but is usually diagnosed before the child walks by noting excessive gluteal folds and limited hip abduction.
A client with a history of chronic lymphocytic leukemia is prescribed prednisone. The nurse should monitor the client for which of the following side effects?
- A. Hypoglycemia.
- B. Weight gain.
- C. Hypotension.
- D. Hair loss.
Correct Answer: B
Rationale: Prednisone, a corticosteroid, commonly causes weight gain due to fluid retention and increased appetite.
Clozapine (Clozaril) therapy has been initiated for a client with schizophrenia who has been unresponsive to other antipsychotics. The client states, 'Why do I have to have a blood test every week?' Which of the following responses by the nurse would be most appropriate?
- A. Weekly blood tests are necessary to determine safe dosage and to monitor the effect of the medication on the blood.'
- B. Weekly blood tests are done so that you can receive another week's supply of the medication.'
- C. Your physician will want to know how well you are personally progressing with the medication therapy.'
- D. Everyone who takes this drug must go through the same procedure because it is required by the drug company.'
Correct Answer: A
Rationale: Weekly blood tests monitor for agranulocytosis, a serious side effect of clozapine, ensuring safe dosing and early detection of blood abnormalities.