Nokea
The client with newly diagnosed rheumatoid arthritis asks what can happen if no treatment is done. The nurse knows that if rheumatoid arthritis is left untreated, which of the following would be most apt to develop?
- A. Bony ankylosis
- B. Chronic osteomyelitis
- C. Pathological fractures
- D. Joint hypermobility
Correct Answer: A
Rationale: Untreated rheumatoid arthritis can lead to bony ankylosis, where joints fuse due to chronic inflammation.
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The client and spouse were involved in a motorcycle accident in which the spouse was killed. The client, being treated for multiple rib fractures and a broken leg, asks the nurse in which room his wife is located. Which response is most appropriate?
- A. Unfortunately, your wife is not in the hospital at this time.'
- B. I'm sorry, but your wife did not survive the motorcycle accident.'
- C. Let me get your family so that you can talk to them about your wife.'
- D. The doctor will be talking to you to let you know where she is located.'
Correct Answer: B
Rationale: B. Because the nurse-client relationship is built on trust, the nurse should not withhold information from the client. The nurse should disclose that the spouse did not survive and be available for support.
The nurse is caring for an elderly client diagnosed with a herniated nucleus pulposus of L4-5. Which scientific rationale explains the incidence of a ruptured disk in the elderly?
- A. The client did not use good body mechanics when lifting an object.
- B. There is an increased blood supply to the back as the body ages.
- C. Older clients develop atherosclerotic joint disease as a result of fat deposits.
- D. Clients develop intervertebral disk degeneration as they age.
Correct Answer: D
Rationale: Intervertebral disk degeneration with aging reduces disk hydration and elasticity, increasing rupture risk. Poor body mechanics is a risk but not the primary cause, blood supply decreases, and atherosclerosis affects joints differently.
Which statement made by the client to the nurse provides the best evidence that the client understands the therapeutic plan?
- A. I should keep my hand as still as possible.
- B. I should stop playing golf for the time being.
- C. I can substitute playing miniature golf.
- D. I can wear a tight leather glove when golfing.
Correct Answer: B
Rationale: Tenosynovitis involves inflammation of the tendon sheath, often exacerbated by repetitive wrist motion. The physician recommends avoiding such motions temporarily. Stopping golf, which involves repetitive wrist actions, directly aligns with this plan, unlike miniature golf, which still requires wrist movement, or wearing a glove, which does not address motion.
During a physical exam on the 18-month-old, the nurse observes genu varum. What should the nurse do?
- A. Document the finding as normal
- B. Report this finding to the HCP
- C. Teach the parents about rickets
- D. Prepare the parent about using braces
Correct Answer: A
Rationale: Genu varum (bowlegs) is a normal finding in children up to 2 years old and should be documented as normal.
The nurse assesses that the client has some finger swelling of a newly casted right arm fracture with no other abnormal findings. Which is the nurse's priority action?
- A. Notify the HCP immediately.
- B. Split the cast to prevent constriction.
- C. Elevate the casted arm on pillows.
- D. Document the degree of finger swelling.
Correct Answer: C
Rationale: C. Swelling is an expected finding; elevating the extremity decreases edema.