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The 10-year-old, who is Chinese, is scheduled to receive methotrexate to treat IRA. Which information in the medical record of a 10-year-old Chinese child scheduled to receive methotrexate for JRA should prompt the nurse to withhold the dose and contact the HCP?
- A. H&P documentation
- B. Laboratory findings
- C. Vital signs abnormalities
- D. Physical assessment findings
Correct Answer: B
Rationale: Abnormal laboratory findings, such as liver or kidney dysfunction, may contraindicate methotrexate administration.
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The nurse is assessing the client diagnosed with a left femoral neck fracture. Which findings should the nurse expect? Select all that apply.
- A. Left leg is in an abducted position.
- B. Left leg is externally rotated.
- C. Left leg is shorter than the right.
- D. Pain is in the lateral left knee.
- E. Pain is in the groin area.
Correct Answer: B,C,E
Rationale: B. With a left femoral neck fracture, the leg is externally rotated. C. With a left femoral neck fracture, the leg is shortened. E. With a left femoral neck fracture, pain is experienced in the groin area.
The nurse documents the admission assessment for the client who is to have a left total hip arthroplasty to treat chronic degenerative joint disease. Which statements indicate that the client uses alternative therapies for CA treatment? Select all that apply.
- A. I take ibuprofen every 4 to 6 hours.'
- B. I wear a copper bracelet all the time.'
- C. I take glucosamine sulfate 1000 mg daily.'
- D. I apply special magnets to the hip joint.'
- E. I sleep on the unaffected hip, turning often.'
Correct Answer: B,C,D
Rationale: B. Wearing a copper bracelet is an alternative therapy used by some with CA for pain control and reduction of joint stiffness. C. Taking glucosamine sulfate is an alternative therapy used by some with CA. Glucosamine is taken to modify cartilage structure, but studies supporting this have been inconclusive. D. Using magnets designed for body application is an alternative therapy used by some with CA for pain control and reduction of joint stiffness.
What interventions should the nurse implement for a child who sustained a twisting injury of the right arm?
- A. Elevate the arm and apply ice at the site of the child's injury.
- B. Wrap the child's arm with an elastic bandage.
- C. Telephone the child's parent to discuss the injury.
- D. Call the health care provider identified by the child.
- E. Make arrangements to obtain an x-ray of the child's arm.
- F. Meet with the student who caused the child's injury.
Correct Answer: A,B,C
Rationale: Elevation, ice, and wrapping reduce swelling; contacting the parent ensures proper follow-up.
The physician orders prednisone for a client with rheumatoid arthritis for painful wrists and joints. Which instruction is it essential for the nurse to give the client?
- A. Take the pills with milk or food.'
- B. Be sure to take the medication between meals.'
- C. Stop the pills at once if your face begins to get puffy.'
- D. Your urine may turn pinkish while taking this.'
Correct Answer: A
Rationale: Taking prednisone with food or milk reduces gastrointestinal irritation, a key instruction for safe administration.
When planning the client's postoperative care, which is the least desirable position in which the nurse can place the client?
- A. Lying supine
- B. Sitting in a chair
- C. Lying on the side
- D. Standing to shower
Correct Answer: D
Rationale: Standing to shower is least desirable post-below-the-knee amputation due to the risk of falls and weight-bearing on the stump, which could disrupt healing. Other positions are safer.