A client with an acute exacerbation of rheumatoid arthritis (RA) has localized pain and inflammation of the fingers and feet, swelling, redness, restricted joint motion, and reports feeling fatigued. Which nursing problem has the highest priority for this client?
Fatigue related to disease exacerbation.
Pain related to joint inflammation
Impaired physical mobility related to joint pain.
Self-care deficit related to disease progression.
The Correct Answer is B
A. This is a valid nursing problem and directly related to the client's condition. However, while fatigue is a significant concern, it is often a symptom of other underlying issues.
B. This is the highest priority nursing problem. Pain is a primary symptom of acute RA exacerbation and significantly impacts the client's quality of life, mobility, and overall well-being. Addressing pain is crucial for immediate comfort and to facilitate other interventions.
C. This is also a valid nursing problem, directly linked to the client's symptoms. However, it is a consequence of the pain, not the primary issue. Addressing the pain will improve mobility.
D. This is a potential long-term concern but not the highest priority at this acute stage. The client's immediate needs related to pain and mobility are more pressing.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","E"]
Explanation
A. Pneumonia is an acute infection that causes inflammation in the lungs. While it can lead to significant respiratory symptoms and changes, it is not typically associated with clubbed nails. Clubbing usually develops over a longer period and is more common in chronic conditions.
B. Clubbing of the nails is often associated with lung cancer, particularly with bronchogenic carcinoma. The exact mechanism is not entirely clear, but it may relate to the presence of a malignancy causing systemic changes or the release of growth factors that affect nail tissue.
C. The flu is a viral respiratory infection that is usually acute and self-limiting. Clubbed nails are not a common manifestation of influenza. Clubbing is more associated with chronic respiratory and systemic conditions rather than acute viral infections.
D. COPD, which includes emphysema and chronic bronchitis, is not commonly associated with clubbing.
E. Chronic bronchitis, a type of COPD characterized by persistent cough and sputum production, may lead to clubbed nails in some cases. The chronic hypoxemia and long-term inflammation can contribute to this nail change, although it is less commonly seen than with other conditions.
Correct Answer is A
Explanation
A. This directly indicates that the lithotripsy procedure was successful in breaking down the stone into smaller fragments that can be passed through the urinary tract.
B. While the absence of these symptoms is a positive sign, it does not directly confirm the success of the lithotripsy procedure. These symptoms can be present even if the stone has been broken down.
C. Pale pink urine is expected after lithotripsy due to minor bleeding. The absence of blood clots is also a good sign, but it doesn't definitively confirm the procedure's success.
D. Serum creatinine and blood urea nitrogen (BUN) levels are within normal limits. These lab values are important indicators of kidney function but do not directly relate to the success of the lithotripsy procedure itself.
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