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The client with early-stage RA is being discharged from the outpatient clinic. Which discharge instruction should the nurse teach regarding the use of nonsteroidal anti-inflammatory drugs (NSAIDs)?
- A. Take with an over-the-counter medication for the stomach.
- B. Drink a full glass of water with each pill.
- C. If a dose is missed, double the medication at the next dosing time.
- D. Avoid taking the NSAID on an empty stomach.
Correct Answer: D
Rationale: Taking NSAIDs with food prevents gastric irritation. OTC stomach meds are not routine, water volume is secondary, and doubling doses is dangerous.
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Which assessment intervention should the nurse implement specifically for the diagnosis of Guillain-Barré syndrome?
- A. Assess deep tendon reflexes.
- B. Complete a Glasgow Coma Scale.
- C. Check for Babinski's reflex.
- D. Take the client's vital signs.
Correct Answer: A
Rationale: Decreased deep tendon reflexes are a hallmark of Guillain-Barré syndrome due to peripheral nerve involvement. Glasgow Coma Scale, Babinski’s reflex, and vital signs are less specific.
Which signs/symptoms should the nurse expect to assess in the client diagnosed with Sjögren's syndrome?
- A. Complaints of dry mouth and eyes.
- B. Complaints of peripheral joint pain.
- C. Complaints of muscle weakness.
- D. Complaints of severe itching.
Correct Answer: A
Rationale: Dry mouth and eyes (sicca symptoms) are hallmark signs of Sjögren’s syndrome. Joint pain, weakness, and itching are less specific.
The nurse is caring for a client diagnosed with Systemic Inflammatory Response syndrome after an extensive abdominal surgery. Which nursing interventions could prevent the development of Multi Organ Dysfunction Syndrome (MODS)?
- A. Place the client on strict intake and output.
- B. Administer pain medication via patient-controlled analgesia.
- C. Keep the head of the bed elevated at all times.
- D. Practice therapeutic communication.
Correct Answer: A
Rationale: Strict intake and output monitoring detects early renal dysfunction, preventing MODS progression. Pain control, head elevation, and communication are less specific.
Which interventions should the nurse discuss with the female client who is positive for human immunodeficiency virus (HIV)? Select all that apply.
- A. Recommend the client not to engage in unprotected sexual activity.
- B. Instruct the client not to inform past sexual partners of HIV status.
- C. Tell the client to not donate blood, organs, or tissues.
- D. Suggest the client not get pregnant.
- E. Explain the client does not have to tell health-care personnel of HIV status.
Correct Answer: A,C,D
Rationale: Unprotected sex, blood/organ donation, and pregnancy risk HIV transmission or complications. Partner notification and informing healthcare personnel are recommended.
The client diagnosed with an acute exacerbation of SLE is being discharged with a prescription for an oral steroid which will be discontinued gradually. Which statement is the scientific rationale for this type of medication dosing?
- A. Tapering the medication prevents the client from having withdrawal symptoms.
- B. So the thyroid gland starts working, because this medication stops it from working.
- C. Tapering the dose allows the adrenal glands to begin to produce cortisol again.
- D. This is the health-care provider's personal choice in prescribing the medication.
Correct Answer: C
Rationale: Tapering steroids allows adrenal glands to resume cortisol production, preventing adrenal insufficiency. Withdrawal symptoms are secondary, thyroid is unaffected, and it’s not provider preference.