Nokea
How should the nurse explain the purpose of methotrexate in treating a child with juvenile arthritis?
- A. Improves functional ability
- B. Controls the febrile response
- C. Minimizes the effects of uveitis
- D. Decreases the inflammatory response
Correct Answer: D
Rationale: Methotrexate is a disease-modifying antirheumatic drug that reduces inflammation in juvenile arthritis.
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The client is being evaluated for osteoporosis. Which diagnostic test is the most accurate when diagnosing osteoporosis?
- A. X-ray of the femur.
- B. Serum alkaline phosphatase.
- C. Dual-energy x-ray absorptiometry (DEXA).
- D. Serum bone Gla-protein test.
Correct Answer: C
Rationale: DEXA is the gold standard for osteoporosis diagnosis, measuring bone mineral density. X-rays detect fractures, alkaline phosphatase is nonspecific, and bone Gla-protein is not diagnostic.
Postoperatively, the client screams obscenities at the nurse after realizing that the injured forearm is missing. Which nursing action is most appropriate at this time?
- A. Leave until the client works through the anger.
- B. Stay quietly with the client at the bedside.
- C. Tell the client to gain emotional control.
- D. Call the physician and request a sedative.
Correct Answer: B
Rationale: Staying quietly supports the client emotionally during grief.
The client who underwent a left above-the-knee amputation as a result of uncontrolled diabetes questions the nurse, asking, 'Why did this happen to me? I have always been a good person.' Which is the nurse’s most therapeutic response?
- A. Tell me about how it feels to have caused this to happen to you.'
- B. I know how you feel; having your leg cut off is sad.'
- C. Why do you think that you had to have your leg amputated?'
- D. I can see you are hurting. Would you like to talk?'
Correct Answer: D
Rationale: Acknowledging distress and offering to talk is therapeutic, validating emotions. Blaming the client, claiming empathy, or questioning beliefs is less supportive.
The nurse notes during an annual health screening for the 78-year-old client that the client is 1.5 inches shorter than at last year's visit. Which initial screening might the nurse best anticipate for this client?
- A. Bone mineral density (BMD) test
- B. An x-ray of both hips and spine
- C. A bone scan of the hips and spine
- D. A physical check for scoliosis
Correct Answer: A
Rationale: A. BMD testing will best determine if the loss of height is due to osteoporosis, a common finding with aging.
Which instruction should the nurse include when reinforcing teaching with the parents about safety considerations for a child with a surgically corrected myelomeningocele?
- A. Make sure braces lie smoothly against the child's skin.
- B. Ensure that the child shifts position at least every 3 hours.
- C. Place a blanket between the child and the wheelchair seat.
- D. Check all of the child's skin daily for redness or irritation.
Correct Answer: D
Rationale: Daily skin checks are essential to prevent pressure ulcers and other skin complications in children with myelomeningocele.