A nurse is teaching an adult client who has been recently diagnosed with rheumatoid arthritis. Which of the following should the nurse include in the teaching?
"When taking leflunomide, expect decreased swelling within 1 week.".
"If acute inflammation is present, apply hot packs directly to the joint for pain relief.".
"Take calcium and vitamin D supplements along with your steroid medication.".
"Make sure your varicella vaccine is up to date.".
The Correct Answer is C
Choice A rationale:
Leflunomide is a disease-modifying antirheumatic drug (DMARD) used for rheumatoid arthritis, but it does not typically result in decreased swelling within one week. It usually takes several weeks or even months for its full effect to be observed.
Choice B rationale:
Applying hot packs directly to the joint for pain relief is not recommended for rheumatoid arthritis, as heat can exacerbate inflammation. Cold packs or other anti-inflammatory measures are more appropriate.
Choice C rationale:
Steroid medications, such as prednisone, can lead to bone density loss and an increased risk of osteoporosis. Taking calcium and vitamin D supplements helps to mitigate this risk.
Choice D rationale:
The Varicella vaccine is not directly related to rheumatoid arthritis. It is important for immune support, but it is not specifically required for rheumatoid arthritis treatment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
The nurse should maintain the client in a semi-Fowler's position to promote comfort and reduce the risk of complications related to appendicitis. This position helps to decrease pressure on the abdomen and may alleviate pain by reducing tension on the abdominal muscles.
Choice B rationale:
Administering an enema 1 hour prior to surgery is not indicated for a client with appendicitis. Enemas are generally not recommended for clients with suspected or confirmed appendicitis as they can potentially worsen inflammation and cause perforation of the inflamed appendix.
Choice C rationale:
Applying a warm pack to the client's lower abdomen is contraindicated in appendicitis. Heat can exacerbate inflammation and should be avoided in such cases.
Choice D rationale:
Placing the client on a clear liquid diet is not appropriate for appendicitis. Clients with appendicitis are typically NPO (nothing by mouth) to avoid stimulating the gastrointestinal tract and reduce the risk of rupture if surgery is needed.
Correct Answer is A
Explanation
Choice A rationale:
The combination of widened QRS, frequent premature ventricular contractions (PVCs), and bradycardia (heart rate of 55/min) on telemetry monitoring suggests hyperkalemia. Elevated potassium levels in the blood can cause delayed repolarization of cardiac cells, leading to widened QRS complexes and PVCs. Bradycardia is another common manifestation of hyperkalemia.
Choice B rationale:
Hypocalcemia, characterized by low calcium levels in the blood, can lead to cardiac arrhythmias, but it typically presents with a prolonged QT interval rather than widened QRS complexes and PVCs.
Choice C rationale:
Hyperglycemia, which is high blood glucose levels, does not directly affect the electrocardiogram (ECG) parameters like QRS width or heart rate. It may have systemic effects, but it is not responsible for the ECG changes described in the scenario.
Choice D rationale:
Hypophosphatemia, or low levels of phosphate in the blood, can cause muscle weakness and may have systemic effects, but it is not associated with the specific ECG changes seen in hyperkalemia, such as widened QRS complexes and PVCs.
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