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The client with rheumatoid arthritis is to receive prednisone 2.5 mg P.D. before meals and at bedtime. What is the primary expected action of the drug?
- A. Maintenance of sodium and potassium balance
- B. Improvement of carbohydrate metabolism
- C. Production of androgen-like effects
- D. Interference with inflammatory reactions
Correct Answer: D
Rationale: Prednisone's primary action in rheumatoid arthritis is to interfere with inflammatory reactions, reducing joint inflammation.
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The emergency department nurse is caring for a client with a compound fracture of the right ulna. Which interventions should the nurse implement? List in order of priority.
- A. Apply a sterile, normal saline-soaked gauze to the arm.
- B. Send the client to radiology for an x-ray of the arm.
- C. Assess the fingers of the client’s right hand.
- D. Stabilize the arm at the wrist and the elbow.
- E. Administer a tetanus toxoid injection.
Correct Answer: C,A,D,B,E
Rationale: Priority: 1) Assess fingers (neurovascular status); 2) Cover wound with sterile gauze (prevent infection); 3) Stabilize arm (reduce damage); 4) X-ray (confirm fracture); 5) Tetanus (prevent infection).
The nurse is to give the client with gout one tablet of colchicine every hour until relief or toxicity occurs. Which of the following is an indication for stopping the colchicine?
- A. Ringing in the ears
- B. Nausea and vomiting
- C. A rash on the client's hips
- D. A temperature of 101°F
Correct Answer: B
Rationale: Nausea and vomiting are signs of colchicine toxicity, indicating the need to stop the medication.
When planning the client's discharge, the nurse must help the client obtain which essential piece of equipment for home care?
- A. A wheelchair
- B. A hospital bed
- C. A raised toilet seat
- D. A mechanical lift
Correct Answer: C
Rationale: A raised toilet seat prevents excessive hip flexion, reducing dislocation risk.
What should the nurse do after noting serosanguineous drainage on the cast of a child with myelodysplasia post-TEV repair?
- A. Cut a window where the drainage is seeping through the cast.
- B. Petal the cast to minimize skin irritation and decrease leakage.
- C. Measure the area of drainage on the cast and document this.
- D. Telephone the surgeon to report the serosanguineous drainage.
Correct Answer: C
Rationale: Measuring and documenting the drainage allows monitoring without compromising the cast's integrity.
The nurse is caring for the client 2 days post-right THR in which the traditional posterior approach was used. Which interventions should the nurse implement?
- A. Checks that an elevated toilet seat is in place and assists the client to the bathroom using a walker
- B. Removes the wedge pillow at the client's request and places pillows to maintain right leg adduction
- C. Reinfuses the 400-mL wound autotransfusion drainage system returns that collected in the past 24 hours
- D. Assists the client to get out of bed on the left side so the client can stand to place and use the urinal
Correct Answer: A
Rationale: A. The client should be able to ambulate with the use of a walker. An elevated toilet seat is used to prevent hip flexion of greater than 90 degrees when the client sits.