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After a painful exacerbation of rheumatoid arthritis, a patient is to begin a walking and exercise program.
An appropriate outcome would be that the patient:
- A. Avoids exercising when there is some discomfort.
- B. Is pain free while engaging in the activity program.
- C. Walks and exercise even when the pain is severe.
- D. Exercise unless the discomfort becomes too great.
Correct Answer: D
Rationale: Exercising until discomfort becomes too great balances activity with joint protection, promoting safe participation.
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A client's vision is to be evaluated using the Ishihara exam. The nurse recognizes that the client will be checked for:
- A. Macular degeneration
- B. Astigmatism
- C. Color blindness
- D. Glaucoma
Correct Answer: C
Rationale: The Ishihara exam tests for color blindness by assessing color perception. It does not evaluate macular degeneration, astigmatism, or glaucoma.
The nurse should recognize that further teaching is needed when a patient with glaucoma states, 'it would be dangerous for me to:
The nurse should recognize that further teaching is needed when a patient with glaucoma states, 'it would be dangerous for me to:
- A. use any sedatives.
- B. become constipated.
- C. use atropine in any form.
- D. release my emotions by crying.
Correct Answer: C
Rationale: Atropine increases intraocular pressure, worsening glaucoma, indicating correct understanding.
A client in the ICU is given procainamide HCl (Pronestyl) slowly IV push. The nurse should withhold the next dose if which of the following was observed?
- A. Presence of premature ventricular contractions.
- B. Occurrence of severe hypotension.
- C. Recurring paroxysmal atrial tachycardia.
- D. A sedimentation rate of 10.
Correct Answer: B
Rationale: Procainamide treats ventricular and atrial arrhythmias, but severe hypotension is an adverse reaction requiring the dose to be withheld. PVCs (A) and atrial tachycardia (C) are indications for use, and a normal sedimentation rate (D) is irrelevant.
Patients with myasthenia gravis, Guillain-Barre syndrome, or amyotrophic lateral sclerosis experience:
Patients with myasthenia gravis, Guillain-Barre syndrome, or amyotrophic lateral sclerosis experience:
- A. Progressive deterioration until death.
- B. Increased risk of respiratory complications.
- C. Deficiencies of essential neurotransmitters.
- D. Involuntary twitching of small muscle groups.
Correct Answer: B
Rationale: These conditions impair respiratory muscles, increasing the risk of complications.
The nurse is caring for a client who had knee surgery this morning. Postoperative orders include a narcotic every three to four hours as needed for operative site pain and an ice bag. At 7:00 P.M., the client asks for pain medication. He was last medicated at 3:30 P.M. What is the best initial nursing action?
- A. Administer the prescribed analgesic
- B. Assess the location and nature of the pain
- C. Refill the ice bag as needed
- D. Reposition the client
Correct Answer: B
Rationale: Assessing pain location and nature ensures the medication is appropriate for operative site pain, guiding safe administration. Administering without assessment, refilling ice, or repositioning are premature.