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.
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The nurse is working with a client who has rheumatoid arthritis (RA). The nurse has identified the priority problem of poor body image for the client. What finding by the nurse indicates goals for this client problem are being met?
- A. Attends book club meetings regularly
- B. Takes medication as directed
- C. Uses assistive devices to protect joints
- D. Engages in regular physical therapy
Correct Answer: A
Rationale: All of the activities are appropriate for a client with RA. Clients who have a poor body image are often reluctant to appear in public, so attending public book club meetings indicates that goals for this client problem are being met.
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 nurse works in the rheumatology clinic and sees clients with rheumatoid arthritis (RA). Which client should the nurse see first?
- A. Client who reports jaw pain when eating
- B. Client with a red, hot, swollen right wrist
- C. Client who has a puffy-looking area behind the knee
- D. Client with a worse joint deformity since the last visit
Correct Answer: B
Rationale: All of the options are possible manifestations of RA. However, the presence of one joint that is much redder, hotter, or more swollen than other joints may indicate infection. The nurse needs to see this client first.
The clinic nurse assesses a client with diabetes during a checkup. The client also has osteoarthritis (OA). The nurse notes the client's blood glucose readings have been elevated. What question by the nurse is most appropriate?
- A. Are you compliant with following the diabetic diet?
- B. Have you been taking glucosamine supplements?
- C. How much exercise do you really get each week?
- D. You're still taking your diabetic medication, right?
Correct Answer: B
Rationale: All of the topics are appropriate for a client whose blood glucose readings have been higher than usual. However, since this client also has OA, and glucosamine can increase blood glucose levels, the nurse should ask about its use. The other questions all have an element of nontherapeutic communication in them.
The nurse is teaching a client with gout dietary strategies to prevent exacerbations or other problems. Which statement by the nurse is most appropriate?
- A. Drink 1 to 2 liters of water daily
- B. Have 10 to 12 ounces of juice daily
- C. Liver is a good source of iron
- D. Avoid alcohol consumption
Correct Answer: A
Rationale: Kidney stones are common in clients with gout, so drinking plenty of water will help prevent this from occurring. Citrus juice is high in acid, which can help prevent the formation of stones, but the value of this recommendation is not clear. Clients with gout should not consume organ meats or fish with bones, such as sardines.
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