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The clinic nurse assesses a client with diabetes during a checkup. The client also has osteoarthritis (OA). The nurse notes the client's blood glucose readings have been elevated. What question by the nurse is most appropriate?
- A. Are you compliant with following the diabetic diet?
- B. Have you been taking glucosamine supplements?
- C. How much exercise do you really get each week?
- D. You're still taking your diabetic medication, right?
Correct Answer: B
Rationale: All of the topics are appropriate for a client whose blood glucose readings have been higher than usual. However, since this client also has OA, and glucosamine can increase blood glucose levels, the nurse should ask about its use. The other questions all have an element of nontherapeutic communication in them.
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Which clinical manifestations are seen in clients with connective tissue diseases? (Select all that apply.)
- A. Dry, scaly skin rash: Systemic lupus erythematosus
- B. Esophageal motility problems: Systemic sclerosis
- C. Vasculitis leading to organ damage: Rheumatoid arthritis
- D. Foot drop and paresthesias: Rheumatoid arthritis
- E. Gout caused by hyperuricemia
Correct Answer: A,B,C,D,E
Rationale: A dry, scaly skin rash is common in SLE. Systemic sclerosis can lead to esophageal motility problems. Vasculitis leads to organ damage in rheumatoid arthritis. Foot drop and paresthesias occur in rheumatoid arthritis. Gout is caused by hyperuricemia.
A nurse in the family clinic is teaching a client newly diagnosed with osteoarthritis (OA) about drugs used to treat the disease. For which medication does the nurse plan primary teaching?
- A. Acetaminophen
- B. Cyclobenzaprine hydrochloride (Flexeril)
- C. Hydrocortisone (Hylan)
- D. Ibuprofen
Correct Answer: A
Rationale: All of the drugs are appropriate to treat OA. However, the first-line drug is acetaminophen. Cyclobenzaprine is a muscle relaxant given to treat muscle spasms. Hydrocortisone is a synthetic joint fluid implant. Ibuprofen is a non-steroidal anti-inflammatory drug.
After a total knee replacement, a client is on the postoperative nursing unit with a continuous femoral nerve block. On assessment, the nurse notes the client's pulses are 2+/4 bilaterally, the skin is pale pink, warm, and dry, and the client is unable to dorsiflex or plantarflex the affected foot. What action does the nurse take?
- A. Document the findings and monitor as prescribed
- B. Increase the frequency of monitoring the client
- C. Notify the surgeon or anesthesia provider immediately
- D. Palpate the client's bladder to perform a bladder scan
Correct Answer: C
Rationale: With the femoral nerve block, the client should still be able to dorsiflex and plantarflex the affected foot. Since this client has an abnormal finding, the nurse should notify either the surgeon or the anesthesia provider immediately. Documentation is the last priority. Increasing the frequency of assessment may be a good idea, but first the nurse must notify the appropriate person. Palpating the bladder is not related.
A client has been diagnosed with rheumatoid arthritis. The client has experienced increased fatigue and worsening physical status and is finding it difficult to maintain the role of elder in his cultural community. The elder is expected to attend social events and make community decisions. Stress seems to exacerbate the client's condition. What action by the nurse is best?
- A. Assess the client's culture more thoroughly
- B. Assess options for performing duties
- C. Suggest the client attend a community meeting
- D. Suggest the client give up the role of elder
Correct Answer: A
Rationale: The nurse needs a more thorough understanding of the client's culture, including the meaning of illness and the ramifications of the elder not being able to perform traditional duties. This must be done prior to offering any possible solutions.
A client has newly diagnosed systemic lupus erythematosus (SLE). What instruction by the nurse is most important?
- A. Be sure you get enough sleep at night
- B. Eat plenty of high-protein, high-iron foods
- C. Notify your provider at once if you get a fever
- D. Weigh yourself every day on your home scale
Correct Answer: C
Rationale: A fever is a classic sign of a lupus flare and should be reported immediately. Rest and nutrition are important but do not take priority over teaching the client what to do if they develop an elevated temperature.