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Which clinical manifestations are seen in clients with connective tissue diseases? (Select all that apply.)
- A. Dry, scaly skin rash: Systemic lupus erythematosus
- B. Esophageal motility problems: Systemic sclerosis
- C. Vasculitis leading to organ damage: Rheumatoid arthritis
- D. Foot drop and paresthesias: Rheumatoid arthritis
- E. Gout caused by hyperuricemia
Correct Answer: A,B,C,D,E
Rationale: A dry, scaly skin rash is common in SLE. Systemic sclerosis can lead to esophageal motility problems. Vasculitis leads to organ damage in rheumatoid arthritis. Foot drop and paresthesias occur in rheumatoid arthritis. Gout is caused by hyperuricemia.
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A nurse is caring for a client after joint replacement surgery. What action by the nurse is most important to prevent wound infection?
- A. Assess the client's white blood cell count
- B. Inspect the client's white blood cell count
- C. Monitor the client's temperature every 4 hours
- D. Use aseptic technique for dressing changes
Correct Answer: D
Rationale: Preventing surgical wound infection is a primary responsibility of the nurse, who must use aseptic technique to prevent wound infection. Other actions do not prevent infection but can lead to early detection of an infection that is already present.
A client with fibromyalgia is in the hospital for an unrelated issue. The client reports that sleep, which is always difficult, is even harder now. What actions by the nurse are most appropriate? (Select all that apply.)
- A. Allow uninterrupted rest time
- B. Adhere to the client's usual bedtime routine
- C. Limit noise and light
- D. Offer a strong sleeping pill
- E. Provide a warm shower
Correct Answer: A,B,C,E
Rationale: Clients with fibromyalgia often have sleep disturbances, which can be exacerbated by the hospital environment. Allowing uninterrupted rest time, adhering to the client's usual bedtime routine, limiting noise and light, and offering a warm shower can help. A strong sleeping pill should be a last resort.
A client is on the postoperative unit after a total hip replacement. The client reports a sudden onset of shortness of breath, chest pain, and coughing. What action by the nurse is best?
- A. Assess neurovascular status of both legs
- B. Elevate the affected leg and apply ice
- C. Prepare to administer pain medication
- D. Try to place the affected leg in abduction
Correct Answer: A
Rationale: This client has manifestations of hip dislocation, a critical complication of this surgery. Hip dislocation can cause neurovascular compromise. The nurse should assess neurovascular status, comparing both legs. The nurse should not try to move the extremity to elevate or abduct it. Pain medication may be administered if possible, but first the nurse should thoroughly assess this client.
A nurse is working with a community group promoting healthy aging. What recommendation is best to help prevent osteoarthritis (OA)?
- A. Avoid contact sports
- B. Get plenty of calcium
- C. Get plenty of calcium
- D. Engage in weight-bearing exercise
Correct Answer: C
Rationale: Obesity can lead to OA, and if the client is overweight, losing weight can help prevent OA or reduce symptoms once it occurs. Arthritis can be caused by contact sports, but this is less common than obesity. Calcium and weight-bearing exercise are both important for osteoporosis.
A nurse is teaching a client with rheumatoid arthritis (RA) who is prescribed etanercept (Enbrel). What information is most important for the nurse to teach this client?
- A. Administer the medication via subcutaneous injection twice a week
- B. Use heat on the injection site to reduce pain
- C. Avoid large crowds or people who are ill
- D. Monitor for signs of infection daily
Correct Answer: A
Rationale: Etanercept is given as a subcutaneous injection twice a week. The nurse should teach the client how to self-administer the medication. The other options are not appropriate for etanercept.