Nokea
Which of the following statements reflects appropriate teaching to prevent injury in a client with rheumatoid arthritis?
- A. Use heat applications to relieve swelling and stiffness.
- B. Take warm showers before activity.
- C. Use cold packs to relieve joint pain.
- D. Take prescribed anti-inflammatory medications with meals.
Correct Answer: C
Rationale: The correct answer is C. Using cold packs to relieve joint pain is appropriate for clients with rheumatoid arthritis as cold therapy is more effective at reducing inflammation and pain in these conditions. Heat applications may exacerbate the symptoms by increasing swelling. Taking warm showers before activity may provide comfort but does not directly address joint pain or prevent injury. While anti-inflammatory medications are commonly prescribed, they are not directly related to preventing injury in clients with rheumatoid arthritis.
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A client with a prescription for DNR begins to manifest signs of impending death. After notifying the family of the client's status, what priority action should the nurse implement?
- A. Inform the healthcare provider
- B. Determine the client's need for pain medication
- C. Begin comfort measures
- D. Ensure all life-saving equipment is removed
Correct Answer: B
Rationale: The correct priority action for the nurse to implement in this scenario is to determine the client's need for pain medication. Ensuring that the client is comfortable and free from pain is crucial in end-of-life care, especially for a client with a Do Not Resuscitate (DNR) order. This action prioritizes the client's comfort and dignity in their final moments. While informing the healthcare provider and beginning comfort measures are important aspects of care, pain management takes precedence as the immediate priority. Removing life-saving equipment is not appropriate at this stage as it goes against the client's wishes stated in the DNR order.
An older client is brought to the ED with a sudden onset of confusion that occurred after experiencing a fall at home. The client's daughter, who has power of attorney, has brought the client's prescriptions. Which information should the nurse provide first when reporting to the healthcare provider using SBAR communication?
- A. The client has been taking multiple medications
- B. The client is experiencing increasing confusion
- C. The client's vital signs are stable
- D. The client fell at home and has sustained bruises
Correct Answer: B
Rationale: When utilizing the SBAR communication method, the nurse should prioritize reporting the client's increasing confusion to the healthcare provider first. Sudden onset of confusion in an older adult following a fall can indicate serious underlying conditions like a head injury, medication reaction, or infection. Addressing the confusion as the primary concern ensures prompt assessment and appropriate treatment. Choices A, C, and D are not as urgent as the client's increasing confusion and may be addressed after ensuring immediate attention to the potential critical issue.
During a thyroid storm, what is the nurse's priority intervention for a client experiencing increased heart rate and tremors?
- A. Administer antithyroid medications as prescribed.
- B. Administer a beta-blocker to control the heart rate.
- C. Monitor the client's temperature closely.
- D. Prepare the client for an emergency thyroidectomy.
Correct Answer: A
Rationale: The correct answer is to administer antithyroid medications as prescribed during a thyroid storm. Antithyroid medications help control the overproduction of thyroid hormones, which is crucial in managing symptoms such as increased heart rate and tremors. These symptoms can be life-threatening if not promptly addressed. Administering a beta-blocker (Choice B) may help control the heart rate, but addressing the underlying cause with antithyroid medications is the priority. Monitoring the client's temperature (Choice C) is important but not the priority intervention during a thyroid storm. Lastly, preparing the client for an emergency thyroidectomy (Choice D) is not the initial intervention for managing symptoms of a thyroid storm.
A client is admitted to isolation with active tuberculosis. What infection control measures should the nurse implement?
- A. Initiate protective environment precautions.
- B. Use droplet precautions only.
- C. Ensure a positive pressure environment in the room.
- D. Implement negative pressure and contact precautions.
Correct Answer: D
Rationale: When caring for a client with active tuberculosis, it is crucial to implement negative pressure rooms and contact precautions to prevent the spread of infection. Choice A, initiating protective environment precautions, is incorrect as this is not the recommended approach for tuberculosis. Choice B, using droplet precautions only, is insufficient as tuberculosis requires additional precautions. Choice C, ensuring a positive pressure environment in the room, is incorrect because negative pressure rooms are necessary to contain airborne pathogens like tuberculosis. Therefore, the most appropriate measures include implementing negative pressure rooms and contact precautions.
A client with a ruptured spleen underwent an emergency splenectomy. Twelve hours later, the client's urine output is 25 ml/hour. What is the most likely cause?
- A. This is a normal finding after surgery.
- B. Oliguria signals tubular necrosis related to hypoperfusion.
- C. Oliguria signals dehydration and fluid loss.
- D. Urine output of 25 ml/hour is an expected finding after splenectomy.
Correct Answer: B
Rationale: Oliguria, or decreased urine output, after surgery can indicate tubular necrosis due to hypoperfusion, which may require intervention to restore renal function. Choice A is incorrect as oliguria is not a normal finding after surgery. Choice C is incorrect because dehydration is less likely in this context compared to tubular necrosis. Choice D is incorrect as a urine output of 25 ml/hour is not expected after splenectomy and should raise concern for renal impairment.