Nokea
A nurse is caring for a client with systemic sclerosis. The client's facial skin is very tight, limiting the ability to open the mouth. Besides a consultation with a registered dietitian for appropriate nutrition, what other consultation should the nurse facilitate?
- A. Dentist
- B. Massage therapist
- C. Occupational therapy
- D. Physical therapy
Correct Answer: A
Rationale: With limited ability to open the mouth, dental hygiene may be lacking. The nurse should encourage the client to see a dentist. The other referrals are not related to the mouth.
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A client is getting out of bed into the chair for the first time after an uncemented hip replacement. What action by the nurse is most important?
- A. Have adequate help to transfer the client
- B. Provide brown socks to transfer the client
- C. Tell the client full weight bearing is allowed
- D. Use a footstool to elevate the client's leg
Correct Answer: A
Rationale: The client with an uncemented hip will be on toe-touch only right after surgery. The nurse should ensure adequate help to transfer the client while preventing falls. Slippery socks and elevating the leg are not appropriate.
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 is receiving an opioid analgesic for postoperative pain after joint replacement surgery. The client is also on celecoxib for arthritis in other joints. What action by the nurse is most appropriate?
- A. Consult the provider about continuing celecoxib
- B. Discontinue the opioid analgesic
- C. Increase the dose of celecoxib
- D. Monitor for gastrointestinal bleeding
Correct Answer: A
Rationale: The nurse should consult the provider about continuing celecoxib while the client is in the hospital, as it can help with postoperative pain and arthritis management.
The nurse working in the orthopedic clinic knows that a client with which factor has an absolute contraindication for having a total joint replacement?
- A. Needs multiple dental fillings
- B. Over age 85
- C. Severe osteoporosis
- D. Urinary tract infection
Correct Answer: C
Rationale: Osteoporosis is a contraindication to joint replacement because the bones have a high risk of shattering as the new prosthesis is implanted. The client who needs fillings should have them done prior to the surgery. Age greater than 85 is not an absolute contraindication. A urinary tract infection can be treated prior to surgery.
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.