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The client is complaining of joint stiffness, especially in the morning. Which diagnostic tests should the nurse expect the health-care provider to order to R/O osteoarthritis?
- A. Full-body magnetic resonance imaging scan.
- B. Serum studies for synovial fluid amount.
- C. X-ray of the affected joints.
- D. Serum erythrocyte sedimentation rate (ESR).
Correct Answer: C
Rationale: X-rays reveal OA characteristic joint space narrowing and osteophytes. MRI is excessive, synovial fluid studies are not routine, and ESR is for inflammatory conditions, not OA.
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A client diagnosed with osteoporosis receives nursing instructions on methods to reduce disease progression. Which substances should the nurse advise the client to avoid?
- A. Aspirin and fiber-containing laxatives
- B. Tobacco products and carbonated beverages
- C. Orange juice and caffeinated drinks
- D. Calcium-enriched dairy products
Correct Answer: B
Rationale: Tobacco reduces bone density, and carbonated beverages (containing phosphoric acid) may interfere with calcium absorption, worsening osteoporosis. The other substances are not primarily harmful.
The 27-year-old client has a right above-the-elbow amputation secondary to a boating accident. Which statement to the rehabilitation nurse indicates the client has accepted the amputation?
- A. I am going to sue the guy who hit my boat.'
- B. The therapist is going to help me get retrained for another job.'
- C. I decided not to get a prosthesis. I don't think I need it.'
- D. My wife is so worried about me and I wish she weren't.'
Correct Answer: B
Rationale: Planning job retraining indicates acceptance and adaptation to amputation. Lawsuits, prosthesis refusal, and concern for others suggest denial or unresolved grief.
The client is postoperative open reduction and internal fixation (ORIF) of a fractured femoral neck. Which long-term goal should the nurse identify for the client?
- A. The client will maintain vital signs within normal limits.
- B. The client will have a decrease in muscle spasms in the affected leg.
- C. The client will have no signs or symptoms of infection.
- D. The client will be able to ambulate down to the nurse’s station.
Correct Answer: D
Rationale: Ambulation to the nurse’s station is a long-term goal post-ORIF, indicating restored mobility. Vital signs, spasms, and infection are short-term or secondary.
The nurse finds small, fluid-filled lesions on the margins of the client’s surgical dressing. Which statement is the most appropriate scientific rationale for this occurrence?
- A. These were caused by the cautery unit in the operating room.
- B. These are papular wheals from herpes zoster.
- C. These are blisters from the tape used to anchor the dressing.
- D. These macular lesions are from a latex allergy.
Correct Answer: C
Rationale: Tape blisters are common around surgical dressings due to skin irritation. Cautery causes burns, herpes zoster is unrelated, and latex allergies cause diffuse reactions.
Which laboratory test value, if elevated, is the best diagnostic indicator of rheumatoid arthritis?
- A. Erythrocyte sedimentation rate (ESR)
- B. Partial thromboplastin time (PTT)
- C. Partial thromboplastin time (PTT)
- D. Blood urea nitrogen (BUN)
Correct Answer: A
Rationale: An elevated ESR indicates inflammation, a hallmark of rheumatoid arthritis, making it a key diagnostic marker. PTT and BUN are unrelated to rheumatoid arthritis diagnosis.