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The nurse is discussing autoimmune diseases with a class of nursing students. Which signs and symptoms are shared by rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE)?
- A. Nodules in the subcutaneous layer and bone deformity.
- B. Renal involvement and pleural effusions.
- C. Joint stiffness and pain.
- D. Raynaud's phenomenon and skin rash.
Correct Answer: C
Rationale: Joint stiffness and pain are common to both RA and SLE. Nodules and deformities are RA-specific, renal/pleural issues are more SLE-specific, and Raynaud’s/rash are not universal in RA.
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The client diagnosed with Guillain-Barré syndrome asks the nurse, 'Will I ever get back to normal? I am so tired of being sick.' Which statement is the best response by the nurse?
- A. You should make a full recovery within a few months to a year.
- B. Most clients with this syndrome have some type of residual disability.
- C. This is something you should discuss with the health-care team.
- D. The rehabilitation is short and you should be fully recovered within a month.
Correct Answer: A
Rationale: Most clients with Guillain-Barré syndrome recover fully within months to a year. Residual disability is less common, deferring to the team avoids education, and one-month recovery is unrealistic.
The client diagnosed with Guillain-Barré syndrome is admitted to the rehabilitation unit after 23 days in the acute care hospital. Which interventions should the nurse implement? Select all that apply.
- A. Refer the client to the physical therapist.
- B. Include the speech therapist in the team.
- C. Request a social worker consult.
- D. Implement a regimen to address pain control.
- E. Refer the client to the Guillain-Barré Syndrome Foundation.
Correct Answer: A,C,D,E
Rationale: Physical therapy, social worker consult, pain control, and foundation referral address mobility, psychosocial needs, comfort, and education. Speech therapy is unnecessary without communication issues.
The health-care provider scheduled a lumbar puncture for a client admitted with rule-out Guillain-Barré syndrome. Which preprocedure intervention has priority?
- A. Keep the client NPO.
- B. Instruct the client to void.
- C. Place in the lithotomy position.
- D. Assess the client's pedal pulse.
Correct Answer: B
Rationale: Voiding before a lumbar puncture prevents discomfort and reduces complications. NPO is unnecessary, lithotomy is incorrect, and pedal pulse is irrelevant.
The client with acquired immunodeficiency syndrome (AIDS) dementia is referred to hospice. Which intervention has highest priority when caring for the client in the home?
- A. Assess the client's social support network.
- B. Identify the client's usual coping methods.
- C. Have consistent uninterrupted time with the client.
- D. Discuss and complete an advance directive.
Correct Answer: D
Rationale: Completing an advance directive ensures end-of-life wishes are honored, a priority in hospice. Support, coping, and time are secondary.
The client diagnosed with myasthenia gravis is being discharged home. Which intervention has priority when teaching the client's significant others?
- A. Discuss ways to help prevent choking episodes.
- B. Explain how to care for a client on a ventilator.
- C. Teach how to perform passive range-of-motion exercises.
- D. Demonstrate how to care for the client's feeding tube.
Correct Answer: A
Rationale: Preventing choking is critical due to dysphagia in myasthenia gravis. Ventilator care, ROM, and feeding tubes are less common or secondary.