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The nurse is determining the type of arthritis a patient is experiencing. Which assessment finding would be present if the patient has rheumatoid arthritis?
- A. Stiffness is relieved by activity
- B. Health history includes weight loss and fever
- C. Abnormal joint findings are limited to the hands
- D. Heberden’s nodes are located on the finger joints
Correct Answer: B
Rationale: In rheumatoid arthritis, the health history often includes systemic symptoms such as weight loss and fever. Rheumatoid arthritis is a chronic inflammatory autoimmune disease that affects multiple joints symmetrically. Unlike osteoarthritis where joint stiffness is often relieved by activity, stiffness in rheumatoid arthritis is typically worse in the morning and after inactivity. In rheumatoid arthritis, joint deformities can occur in various joints, not just limited to the hands. Heberden's nodes are characteristic of osteoarthritis, not rheumatoid arthritis.
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A client with primary hypertension is prescribed terazosin (Hytrin) to treat this condition. What is the mechanism of action of this drug?
- A. Prevents conversion of angiotensin I to angiotensin II
- B. Prevents beta-receptor stimulation in the heart
- C. Inhibits the flow of calcium ions across the cell membrane of vascular tissue and cardiac cells
- D. Blocks alpha-receptors in the vascular smooth muscle
Correct Answer: D
Rationale: Terazosin is an alpha-1 adrenergic receptor blocker. By blocking alpha-1 receptors in the vascular smooth muscle, terazosin causes dilation of both arteries and veins, leading to reduced peripheral vascular resistance and decreased blood pressure. This dilation effect is achieved by preventing the binding of norepinephrine to alpha-1 receptors, thereby inhibiting vasoconstriction. Terazosin is commonly used in the treatment of hypertension to help lower blood pressure by reducing the workload on the heart and improving blood flow to organs and tissues.
A client with cardiomyopathy receiving diuretic therapy has a urine output of 200 mL in 8 hours. Which action by the nurse is correct?
- A. Assist the client to ambulate.
- B. Document a normal urine output.
- C. Notify the healthcare provider.
- D. Measure abdominal girth.
Correct Answer: C
Rationale: A urine output of 200 mL in 8 hours is considered low, especially for a client with cardiomyopathy who is receiving diuretic therapy. This could indicate inadequate cardiac output or worsening heart failure. It is crucial for the nurse to notify the healthcare provider promptly so that appropriate interventions can be initiated to address the underlying cause and prevent further complications. Waiting for improvement without taking action could lead to deterioration in the client's condition.
An adult client is experiencing paroxysmal supraventricular tachycardia. Which nursing interventions are appropriate based on the data provided? Select all that apply.
- A. Initiate oxygen therapy
- B. Prepare for cardioversion
- C. Begin anticoagulation therapy as prescribed
- D. Administer intravenous adenosine as prescribed
Correct Answer: A
Rationale: A. Initiate oxygen therapy: Providing oxygen therapy is appropriate to ensure adequate oxygenation and tissue perfusion during episodes of paroxysmal supraventricular tachycardia.
The nurse hears a grating sound while assessing the range of motion of a patient’s hip. How should the nurse document this finding?
- A. Crackles
- B. Arthritis
- C. Synovitis
- D. Crepitation
Correct Answer: D
Rationale: Crepitation refers to a grating sound or sensation that occurs when there is rubbing together of the roughened articular surfaces of bones within a joint. It is commonly associated with conditions such as osteoarthritis or joint injury. Therefore, if the nurse hears a grating sound while assessing the range of motion of a patient's hip, the appropriate documentation of this finding would be crepitation.
After a stroke, sensory-perceptual changes increase the client's risk for what?
- A. Aspiration
- B. Injury
- C. Bleeding
- D. Infection
Correct Answer: B
Rationale: After a stroke, sensory-perceptual changes such as impaired proprioception, altered sensation, and decreased awareness of the affected side can increase the client's risk for injury. These changes can result in difficulties with balance, coordination, and spatial awareness, making the individual more prone to falls and accidents. It is important to implement safety measures and interventions to minimize the risk of injury in these clients, such as providing a structured environment, using assistive devices, and encouraging regular monitoring and assistance as needed.