Nokea
The nurse is conducting discharge teaching with a patient who has systemic lupus erythematosus. Which of the following information should the nurse discuss with this patient? (Select all that apply)
- A. Use of heat for arthralgia
- B. Avoidance of physical stress
- C. Use an unsented powder after bathing
- D. Refrain from daily exercise
- E. Use sunscreen when exposed to sun
Correct Answer: A,B,E
Rationale: Teaching about SLE includes the use of heat for arthralgia, avoidance of physical stress, and using sunscreen when exposed to the sun. Therapeutic exercise is recommended. The use of drying soaps, powders, and household chemicals should be avoided.
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The nurse is caring for a young adult patient suspected of having septic arthritis, is hospitalized with a fever and red, hot, painful knees. Which of the following information obtained during the nursing history indicates a risk factor for septic arthritis?
- A. Has a parent who has reactive arthritis.
- B. Is sexually active and has multiple partners.
- C. Recently returned from a trip to South America.
- D. Had several sports-related knee injuries as a teenager.
Correct Answer: B
Rationale: Neisseria gonorrhoeae is the most common cause for septic arthritis in sexually active young adults. The other information does not point to any risk for septic arthritis.
The nurse is caring for a patient with gout and takes losartan for control of the condition. Which of the following laboratory results should the nurse plan to monitor in the patient?
- A. Blood glucose
- B. Blood pressure
- C. Erythrocyte count
- D. Lymphocyte count
Correct Answer: B
Rationale: Losartan, an angiotensin II receptor antagonist, will lower blood pressure. It does not affect blood glucose, red blood cell count (RBC), or lymphocytes.
The home health nurse is visiting a patient who has rheumatoid arthritis (RA) and tells the nurse about having persistently dry eyes. Which of the following actions by the nurse is most appropriate?
- A. Reassure the patient that dry eyes are a common problem with RA.
- B. Provide more health teaching about adverse effects of the RA medications.
- C. Suggest that the patient start using over-the-counter (OTC) artificial tears.
- D. Ask the health care provider about lowering the methotrexate dose.
Correct Answer: C
Rationale: The patient's dry eyes are consistent with Sjögren syndrome, a common extra-articular manifestation of RA. Symptomatic therapy such as OTC eye drops is recommended. Dry eyes are not an adverse effect of methotrexate. Although dry eyes are common in RA, it is more helpful to offer a suggestion to relieve these symptoms than to offer reassurance. The dry eyes are not caused by RA treatment, but by the disease itself.
Which of the following statements by a young adult female patient with systemic lupus erythematosus (SLE) indicates that the patient has understood the nurse's teaching about management of the condition?
- A. I will use a sunscreen whenever I am outside.
- B. I will try to keep exercising even if I am tired.
- C. I should take birth control pills to keep from getting pregnant.
- D. I should not take Aspirin or nonsteroidal anti-inflammatory drugs.
Correct Answer: A
Rationale: Severe skin reactions can occur in patients with SLE who are exposed to the sun. Patients should avoid fatigue by balancing exercise with rest periods as needed. Oral contraceptives can exacerbate lupus. Aspirin and nonsteroidal anti-inflammatory drugs are used to treat the musculoskeletal manifestations of SLE.
The nurse is assisting a patient with rheumatoid arthritis (RA) to plan a daily routine. Which of the following information should the nurse include when discussing the most helpful way to start the day?
- A. A warm bath followed by a short rest
- B. A short routine of isometric exercises
- C. Active range-of motion (ROM) exercises
- D. Stretching exercises to relieve joint stiffness
Correct Answer: A
Rationale: Taking a warm shower or bath is recommended to relieve joint stiffness, which is worse in the morning. Isometric exercises would place stress on joints and would not be recommended. Stretching and ROM should be done later in the day, when joint stiffness is decreased.