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To reduce symptoms of early morning stiffness in a ptient who has rheumatoid arthritis, the nurse can encourage the patient to:
- A. take a hot tub bath or shower in the morning
- B. put joints through passive ROM before tryoing to move them actively
- C. sleep with a hot pad
- D. take two aspirins before arising, and wait 15 minutes before attempting locomotion
Correct Answer: A
Rationale: Taking a hot tub bath or shower in the morning can help reduce symptoms of early morning stiffness in a patient with rheumatoid arthritis. The warmth from the water helps relax muscles and joints, making it easier for the patient to move and start their day. Heat therapy is a common recommendation for managing joint stiffness in arthritis patients. This simple and effective method can improve flexibility and decrease pain associated with morning stiffness.
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Which of the following patients should the nurse monitors because of increased risk for surgical complications?
- A. 25-year old with appendicitis
- B. patient 5'3" in height, weight 180 lbs
- C. 12-year old with fractured knee
- D. 17-year old with gallstone
Correct Answer: B
Rationale: The patient who is 5'3" in height and weighs 180 lbs is considered obese based on their body mass index (BMI). Obesity is a significant risk factor for surgical complications such as wound infections, blood clots, and respiratory issues. In obese patients, surgical procedures can be more challenging due to difficulties in accessing and visualizing surgical sites, longer surgery times, and increased stress on the body's organs. Therefore, this patient should be closely monitored for potential surgical complications.
What might you conclude if you notice a wide perineum and unequal gluteal and thigh folds when assessing a newborn?
- A. Osteogenesis imperfecta
- B. Torticollis
- C. Scoliosis
- D. Hip dysplasia
Correct Answer: D
Rationale: When assessing a newborn and noticing a wide perineum and unequal gluteal and thigh folds, it may signal the possibility of developmental dysplasia of the hip (DDH), also known as hip dysplasia. DDH is a condition where the hip joint does not properly form in newborns, leading to instability and potential dislocation. The wide perineum and unequal gluteal and thigh folds are physical signs that can be indicative of hip dysplasia. It is essential to diagnose and treat hip dysplasia early to prevent long-term complications like difficulty walking and osteoarthritis. Regular screening of newborns for hip dysplasia risk factors and physical exam findings is crucial for early detection and intervention.
A community nurse will perform chest physiotherapy for Mrs. Dy every 3 hours. It is important for the nurse to:
- A. slap the chest wall gently
- B. use vibration techniques to move secretions from affected lung areas during the inspiration phase
- C. perform CPT at least two hours after meals
- D. plan apical drainage at the beginning of the CPT session
Correct Answer: C
Rationale: Performing chest physiotherapy (CPT) at least two hours after meals is important to prevent potential risks such as vomiting and aspiration. This timing allows for better tolerance of the procedure and decreases the likelihood of complications. By waiting at least two hours after meals, the nurse ensures that the patient's stomach is not full, reducing the risk of regurgitation during the chest physiotherapy session. This practice promotes the safety and well-being of the patient while undergoing this treatment.
Which of the following is the most common cause of hyperaldosteronism?
- A. Excessive sodium intake
- B. Deficient potassium intake
- C. A pituitary adenoma
- D. An adrenal adenoma
Correct Answer: D
Rationale: The most common cause of hyperaldosteronism is an adrenal adenoma, which is a benign tumor of the adrenal gland. Adrenal adenomas produce excessive amounts of aldosterone, a hormone that regulates sodium and potassium balance in the body. This overproduction of aldosterone can lead to increased sodium retention and potassium excretion, resulting in hypertension and low potassium levels in the blood. Excessive sodium intake and deficient potassium intake are not common causes of hyperaldosteronism. Pituitary adenomas are associated with conditions such as Cushing's syndrome or acromegaly, but not hyperaldosteronism.
What is the best method to obtain a urine sample in an 8-month-old being evaluated for a UTI?
- A. Clean the perineum front-to-back and apply a urine collection bag.
- B. Insert an indwelling Foley catheter.
- C. Place a sterile cotton ball in the diaper and collect with a syringe.
- D. Perform an in-and-out (straight) catheterization.
Correct Answer: D
Rationale: For infants who are not toilet-trained, an in-and-out catheterization is the most reliable method for obtaining a sterile urine sample.