A nurse is teaching a client who has osteoarthritis about joint protection strategies.
Which of the following instructions should the nurse include?
Sit in chairs with low, soft backs.
Use both hands to hold objects.
Push up from the bed with your fingers.
Turn doorknobs clockwise.
The Correct Answer is B
Choice A rationale
Sitting in chairs with low, soft backs can worsen osteoarthritis symptoms and increase joint stress. Low chairs require more force from the hips and knees to stand up, which can strain these joints. Soft backs provide inadequate support, leading to poor posture and increased stress on the spine and other joints. Proper joint protection involves maintaining good posture and minimizing strain on affected joints.
Choice B rationale
Using both hands to hold objects distributes the weight and stress evenly across multiple joints, such as those in both wrists and hands, thereby reducing the workload on any single joint. This technique minimizes the risk of joint deformation and pain associated with osteoarthritis by preventing excessive force from being applied to a single joint, a key principle of joint protection.
Choice C rationale
Pushing up from a bed with fingers puts a concentrated, high-impact force on the small joints of the fingers, which are often affected by osteoarthritis. This action can lead to pain, inflammation, and potential deformity over time. Instead, individuals should use their palms or forearms to push up, distributing the force over a larger, stronger surface area.
Choice D rationale
Turning doorknobs clockwise or in any specific direction with a forceful grip can exacerbate joint pain and strain in the fingers and wrist. This motion places significant torque on the affected joints. To protect joints, clients should be advised to use lever-style doorknobs or adaptive devices that require less grip strength and a different motion. *.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
The first step in inserting an indwelling urinary catheter, after gathering supplies and preparing the client, is to lubricate the tip. The application of a generous amount of water-soluble gel to the catheter tip reduces friction as it passes through the urethra. This is crucial for minimizing trauma to the urethral mucosa and decreasing client discomfort during insertion.
Choice B rationale
Positioning the sterile drape is a later step in the procedure, after the catheter has been prepared for insertion. The drape is used to create a sterile field and isolate the perineum. This helps prevent contamination of the sterile catheter and gloves from surrounding non-sterile areas, which is essential for maintaining sterility and preventing infection.
Choice C rationale
Cleansing the meatus with an antiseptic solution is a critical step, but it is performed after the catheter is lubricated and the sterile field is established. This action mechanically and chemically removes microorganisms from the perineal area, reducing the risk of introducing bacteria into the urinary tract during catheter insertion.
Choice D rationale
Attaching a prefilled syringe to the inflation hub is done after the catheter is fully inserted into the bladder and urine flow is established. This step is necessary to inflate the balloon, which secures the catheter in place and prevents it from being expelled. Doing this prematurely could cause urethral damage. *.
Correct Answer is A
Explanation
Choice A rationale
Chills are a systemic manifestation of an infectious process and are commonly associated with endometritis. Endometritis is an infection of the uterine lining, which can cause a systemic inflammatory response. This response often includes fever and chills, as the body's immune system fights the invading pathogens, causing a thermoregulatory cascade. A temperature of 100.4°F (38°C) or higher is typical.
Choice B rationale
Back pain can occur with various postpartum conditions, but it is not a primary or specific finding for endometritis. While uterine cramping and pelvic pain are characteristic due to the uterine inflammation, back pain is not as specific. More classic signs are fever, lower abdominal pain, uterine tenderness, and foul-smelling lochia due to the presence of bacteria.
Choice C rationale
Tachycardia, not bradycardia, is an expected finding in a client with endometritis. Tachycardia is a physiological response to fever, infection, and the systemic inflammatory process. The heart rate increases to compensate for increased metabolic demand and to circulate immune cells more efficiently. Bradycardia would be an unusual and unexpected finding.
Choice D rationale
Agitation is not a primary or typical finding of endometritis. Endometritis is a physical infection of the uterine lining. While discomfort and fever may cause irritability, agitation is not a specific expected symptom. This finding is more associated with neurological or psychiatric conditions, or severe complications like septic shock, which is a more advanced state. *.
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