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The nurse is caring for a client with rheumatoid arthritis. Which of the following lifestyle modifications should the nurse recommend to the client?
- A. Avoid the use of ice on painful joints.
- B. Allow for periods of rest in the afternoon.
- C. Perform range-of-motion exercises daily.
- D. Place a pillow under the knees before sleep.
- E. Use moist heat packs to relax stiff joints as needed.
Correct Answer: B,C,E
Rationale: Rest (B), range-of-motion exercises (C), and moist heat (E) manage rheumatoid arthritis symptoms. Ice (A) can reduce inflammation, and a pillow under knees (D) may worsen stiffness.
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The nurse is teaching a client with dysrhythmia about the electrical pathway of an impulse as it travels through the heart. Which of these describes the normal pathway?
- A. AV node, SA node, Bundle of His, Purkinje fibers
- B. Purkinje fibers, SA node, AV node, Bundle of His
- C. Bundle of His, Purkinje fibers, SA node
- D. SA node, AV node, Bundle of His, Purkinje fibers
Correct Answer: D
Rationale: SA node, AV node, Bundle of His, Purkinje fibers. This is the normal pathway of an electrical impulse through the heart.
Prior to administering a feeding, the nurse checks for placement of a feeding tube. What is the best way to do this?
- A. Check for residual
- B. Measure the pH of aspirated gastrointestinal fluid
- C. Inject 10 to 20 mL of air while auscultating over the epigastric area
- D. Ask the client to talk or hum
Correct Answer: B
Rationale: Measuring the pH of aspirated fluid (pH <5.5) confirms gastric placement, the most reliable method to prevent aspiration.
The nurse is collecting data from a client with suspected panic disorder. Which of the following findings would be consistent with the condition?
- A. sweating
- B. dizziness
- C. compulsions
- D. heart palpitations
- E. shortness of breath
Correct Answer: A,B,D,E
Rationale: Panic disorder is characterized by sudden, intense fear accompanied by physical symptoms such as sweating (A), dizziness (B), heart palpitations (D), and shortness of breath (E). Compulsions (C) are associated with obsessive-compulsive disorder, not panic disorder.
An elderly client is admitted with an acute exacerbation of chronic obstructive pulmonary disease. Pulse oximetry is 84% on room air. The client is restless, has expiratory wheezing and a productive cough, and is using the accessory muscles to breathe. Which prescription should the nurse question?
- A. Albuterol 2.5 mg by nebulizer
- B. IV methylprednisolone 125 mg now and every 6 hours
- C. IV morphine 2 mg now, may repeat every 2 hours
- D. Oxygen at 2 L/min by nasal cannula
Correct Answer: C
Rationale: Morphine (C) can depress respiration in COPD, worsening hypoxia, and should be questioned. Albuterol (A) relieves bronchospasm, methylprednisolone (B) reduces inflammation, and oxygen (D) addresses hypoxia, all appropriate for COPD exacerbation.
The nurse in a college health clinic is teaching the male students testicular self-examination. Which statement made by one of the young men indicates a need for more teaching?
- A. I should do a testicular self-examination every month.'
- B. When I am taking a shower is a good time to do the self-exam.'
- C. If I feel any lumps, I should report it to the physician.'
- D. Testicular cancer is usually found in older men.'
Correct Answer: D
Rationale: Testicular cancer primarily affects younger men (15–35 years), not older men, indicating a need for more teaching. Monthly exams, shower timing, and reporting lumps are correct.