A nurse is caring for an older adult client who has rheumatoid arthritis (RA) and is taking aspirin 650 mg every 4 hours.

Which of the following diagnostic tests should the nurse monitor to evaluate the effectiveness of this medication?

Erythrocyte sedimentation rate (ESR).

White blood cell (WBC) Count.

Rheumatoid factor (RF).

Antinuclear antibody (ANA).

Answer and Explanation

The Correct Answer is A

Choice A rationale:
The ESR is a common blood test that measures how quickly red blood cells settle at the bottom of a test tube. Inflammation can cause the cells to settle faster, and this test can be used to monitor the effectiveness of anti-inflammatory treatments like aspirin.
Choice B rationale:
The WBC count is a measure of the body’s immune response and is not directly affected by aspirin.
Choice C rationale:
The RF is a specific marker for rheumatoid arthritis, but it does not change with aspirin treatment.
Choice D rationale:
The ANA is a test used to help diagnose autoimmune disorders, and it is not affected by aspirin.

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Correct Answer is []

Explanation

Condition Most Likely Experiencing:

Delirium

Explanation: The client has acute confusion, disorganized thinking, restlessness, incoherent speech, and altered sleep-wake cycle—all classic signs of delirium. The sudden onset (starting the previous evening) and fever (38.6°C) suggest a potential underlying cause, such as infection or dehydration.

Actions to Take:

Monitor the client's fluid intake and output.

Explanation: The client has severe fluid imbalance (250 mL intake vs. 2,500 mL output), leading to dehydration, which can contribute to delirium. Monitoring intake and output is critical for managing hydration status.

Encourage family members to stay with the client.

Explanation: Familiar faces can help reorient the client and reduce agitation. Delirium often improves with familiar environmental cues and reassurance.

Parameters to Monitor:

Sleep-wake cycle.

Explanation: Disrupted sleep patterns are a key symptom of delirium. Tracking sleep can help assess improvement or worsening of the condition.

Fall risk.

Explanation: The client is attempting to get out of bed without assistance, which puts them at high risk for falls. Close monitoring is essential to prevent injury.

Incorrect Choices and Explanations:

Request a prescription for benzodiazepine.

Why Incorrect? Benzodiazepines can worsen delirium, especially in older adults, by increasing confusion and fall risk.

Assist the client to identify coping skills.

Why Incorrect? Delirium is an acute medical condition, not a psychological disorder. The focus should be on treating the underlying cause, not psychological coping strategies.

Encourage the client to exercise.

Why Incorrect? The client is confused, weak, and at risk of falls. Exercise is not appropriate at this stage.

BUN level.

Why Incorrect? While kidney function (BUN) could be affected by dehydration, monitoring fluid balance directly (intake/output) is more immediate and relevant.

Weight loss.

Why Incorrect? While the client has refused to eat or drink, weight loss occurs over time, whereas the primary concern is acute dehydration and delirium.

Suicidal ideation.

Why Incorrect? There is no indication of suicidal thoughts. The confusion and agitation are more likely due to delirium than depression.

A. "Food preparation is not your responsibility.”. B. "Disinfect equipment contaminated with blood or body fluids for twenty-four hours.”. C. "Prevent the spread of infection with good household cleaning practices.”. D. "Burn soiled dressings.”.

Correct Answer is C

Explanation

Choice A rationale:
While it’s important for someone with AIDS to avoid potential sources of infection, food preparation can be done safely with proper precautions.
Choice B rationale:
Disinfecting equipment for 24 hours is not a standard practice. Standard cleaning procedures with appropriate disinfectants are usually sufficient.
Choice C rationale:
Good household cleaning practices can help prevent the spread of infection, which is crucial for someone with AIDS due to their compromised immune system.
Choice D rationale:
Burning soiled dressings is not a recommended practice. Soiled dressings should be disposed of properly in a biohazard waste bag.

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A nurse is caring for an older adult client who has rheumatoid arthritis (RA) and is taking aspirin 650 mg every 4 hours. Which of the following diagnostic tests should the nurse monitor to evaluate the effectiveness of this medication?

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Correct Answer is []

Explanation

Incorrect Choices and Explanations:

A nurse is preparing a client who has AIDS for discharge. Which of the following statements should the nurse include in the discharge instructions?

Correct Answer is C

Explanation

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A nurse is caring for an older adult client who has rheumatoid arthritis (RA) and is taking aspirin 650 mg every 4 hours.

Which of the following diagnostic tests should the nurse monitor to evaluate the effectiveness of this medication?