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 is scheduled for surgery in the morning and is NPO. Which statement indicates that the client understands the reason for being NPO?
- A. Being NPO helps reduce the risk of nausea.
- B. I should not eat or drink anything to prevent complications during surgery.
- C. NPO reduces the risk of aspiration during surgery.
- D. NPO helps ensure the stomach is empty during surgery.
Correct Answer: C
Rationale: The correct answer is C: 'NPO reduces the risk of aspiration during surgery.' When a client is NPO (nothing by mouth) before surgery, it is to prevent aspiration, which can lead to serious complications such as pneumonia. Choice A is incorrect because being NPO is more about preventing aspiration than nausea. Choice B is a general statement without specifying the reason for being NPO. Choice D is partially correct but does not emphasize the crucial aspect of preventing aspiration, which is the primary reason for fasting before surgery.
A client with hyperkalemia is receiving insulin and glucose. Which laboratory value should the nurse monitor closely?
- A. Monitor the client's blood glucose level.
- B. Monitor the client's sodium level.
- C. Monitor the client's calcium level.
- D. Monitor the client's potassium level.
Correct Answer: D
Rationale: The correct answer is to monitor the client's potassium level. When administering insulin and glucose in hyperkalemia, the aim is to shift potassium from the bloodstream into the cells, lowering elevated levels. Therefore, monitoring potassium levels closely is essential to prevent hypokalemia or further complications. Monitoring blood glucose levels (Choice A) is important but not the priority in this scenario. Monitoring sodium (Choice B) and calcium levels (Choice C) is not directly related to the treatment of hyperkalemia with insulin and glucose.
A 66-year-old woman is retiring and needs health insurance. To which agency should the employee health nurse refer her?
- A. Medicaid
- B. Medicare
- C. COBRA
- D. Private insurance
Correct Answer: B
Rationale: The correct answer is B: Medicare. Medicare is the federal health insurance program for individuals aged 65 and older, so it is the most suitable option for the 66-year-old woman retiring. Medicaid (choice A) is a state and federally funded program for low-income individuals and families, not specifically for retirees. COBRA (choice C) allows employees to continue their employer-sponsored health insurance for a limited time after leaving employment. Private insurance (choice D) refers to health insurance plans purchased directly from private insurance companies.
While changing a client's chest tube dressing, the nurse notes a cracking sensation when gentle pressure is applied to the skin at the insertion site. What is the best action for the nurse to take?
- A. Apply a pressure dressing around the chest tube site.
- B. Administer an oral antihistamine.
- C. Assess for allergies to topical cleaning agents.
- D. Measure the area of swelling and crackling.
Correct Answer: D
Rationale: When a nurse observes crepitus around a chest tube site, it could indicate subcutaneous emphysema, a potentially serious condition where air gets trapped under the skin. Measuring the area of swelling and crackling is important as it helps monitor the progression of subcutaneous emphysema. Applying a pressure dressing (choice A) might not address the underlying cause and could potentially worsen the condition. Administering an oral antihistamine (choice B) is not indicated for crepitus at a chest tube site. Assessing for allergies to topical cleaning agents (choice C) is important but not the immediate priority when crepitus is observed.
A client is admitted with a diagnosis of schizophrenia. The client refuses to take medication and states 'I don't think I need those medications. They make me too sleepy and drowsy. I insist that you explain their use and side effects.' The nurse should understand that
- A. A referral is needed to the psychiatrist who is to provide the client with answers
- B. The client has a right to know about the prescribed medications
- C. Such education is an independent decision of the individual nurse whether or not to teach clients about their medications
- D. Clients with schizophrenia are at a higher risk of psychosocial complications when they know about their medication side effects
Correct Answer: B
Rationale: The correct answer is B. The client has a legal right to be informed about their treatment, including medication uses and side effects, as part of informed consent. This helps ensure that the client can make an informed decision about their care. Choice A is incorrect because the nurse can provide the client with information about their medications. Choice C is incorrect as it is not an independent decision of the nurse but a professional responsibility to educate clients. Choice D is incorrect as knowledge about medication side effects can actually empower clients to manage their condition effectively.