A nurse is caring for a client diagnosed with rheumatoid arthritis (RA). The nurse is assessing the client to determine the effectiveness of the current treatment regimen. Which finding would be the best indicator that the client's RA management is effective?
The client expresses feelings of frustration and difficulty coping with the chronic nature of RA.
The client's C-reactive protein (CRP) levels have remained stable since the initiation of treatment.
The client demonstrates improved range of motion in the affected joints during physical therapy sessions.
The client's radiographic images show no progression of joint erosion compared to images from six months ago.
The Correct Answer is D
A. The client expresses feelings of frustration and difficulty coping with the chronic nature of RA: This indicates the client is struggling emotionally, which is common in chronic illnesses but does not directly reflect the effectiveness of the RA treatment regimen.
B. The client's C-reactive protein (CRP) levels have remained stable since the initiation of treatment: While stable CRP levels can indicate control of inflammation, they do not show improvement. Ideally, effective treatment would reduce CRP levels.
C. The client demonstrates improved range of motion in the affected joints during physical therapy sessions: Improved range of motion is a positive outcome, but it may not fully represent the overall effectiveness of the RA treatment, as joint damage can still progress.
D. The client's radiographic images show no progression of joint erosion compared to images from six months ago: This is the best indicator of effective RA management as it directly shows that the treatment is preventing further joint damage, which is a primary goal in managing RA.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Administration of erythropoietin (Epoetin): In chronic renal disease, the kidneys may not produce enough erythropoietin, leading to anemia. Epoetin is a synthetic form of erythropoietin that stimulates red blood cell production and is commonly used to treat anemia in these clients.
B. Transfusion of red blood cells (RBCs): While transfusion of RBCs may be necessary in severe cases of anemia or acute blood loss, it is not the first-line treatment for anemia related to chronic renal disease. Erythropoietin-stimulating agents are preferred to stimulate endogenous RBC production.
C. Weekly monitoring of complete blood count (CBC): Monitoring of CBC is important to assess the response to treatment and adjust therapy as needed but does not represent a specific treatment for anemia in chronic renal disease.
D. An order for iron replacement medication: Iron replacement may be indicated if iron deficiency is contributing to the anemia, but it is not the primary treatment for anemia in chronic renal disease. Erythropoietin-stimulating agents are typically used first to address the underlying cause of anemia.
Correct Answer is C
Explanation
A. Joint contractures: Joint contractures are a common manifestation of systemic scleroderma, but they are not directly related to altered tissue perfusion. They are more related to skin and tissue fibrosis.
B. Peripheral arterial dilation: Peripheral arterial dilation is not typically associated with systemic scleroderma. Instead, peripheral vasoconstriction, such as in Raynaud's phenomenon, is more common.
C. Raynaud's phenomenon: Raynaud's phenomenon, characterized by episodic vasospasm of small arteries in response to cold or stress, can lead to impaired tissue perfusion, especially in the extremities.
D. Pulmonary fibrosis: Pulmonary fibrosis is a complication of systemic scleroderma that affects lung tissue, but it is not directly related to altered tissue perfusion. It may lead to impaired gas exchange rather than altered perfusion.
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