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Exhibits

The client has received a medical diagnosis of rheumatoid arthritis (RA). The client should receive education about living and managing her condition and how to minimize disease complications.
Which education should be given to the client by the nurse? Select all that apply.

Perform aggressive weight bearing exercises.

Anticipate dry eyes and mouth; no intervention is needed.

Take hot showers to help relieve stiffness.

Observe skin for any lesions.

Watch for gastrointestinal upset with medication administration.

Discuss body image feelings with a trusted friend or therapist.

Avoid fluids, to decrease trips to the bathroom.

Prioritize rest, with short periods of activity.

Answer and Explanation

Correct Answer : C,D,E,F,H

A. Perform aggressive weight bearing exercises: Aggressive weight-bearing exercises may place too much strain on the joints, especially for someone with RA. Low-impact activities, such as swimming or walking, are generally recommended to avoid exacerbating joint damage or pain.

B. Anticipate dry eyes and mouth; no intervention is needed: While dry eyes and mouth can occur in autoimmune diseases like RA, particularly if the client has secondary Sjögren's syndrome, they should not be ignored. The nurse should advise the client to seek treatment for these symptoms, as interventions can provide relief.

C. Take hot showers to help relieve stiffness: Warm showers or baths can help reduce the stiffness and pain associated with rheumatoid arthritis (RA) by relaxing muscles and improving circulation. This can be an effective method to manage the morning stiffness that the client experiences.

D. Observe skin for any lesions: Skin lesions can be a result of certain medications or the disease process itself. RA treatment, particularly with medications like methotrexate or biologics, can increase the risk of skin issues, and regular monitoring is important for early identification.

E. Watch for gastrointestinal upset with medication administration: NSAIDs like ibuprofen, which the client is taking for pain, can cause gastrointestinal issues such as ulcers or irritation. Monitoring for these symptoms is important to avoid complications related to the medication.

F. Discuss body image feelings with a trusted friend or therapist: The chronic nature of RA, along with potential joint deformities and limitations, can impact body image. Discussing these feelings with a trusted person or therapist can help the client manage the psychological aspects of living with a chronic condition.

G. Avoid fluids, to decrease trips to the bathroom: Reducing fluid intake could lead to dehydration, which may cause other complications. The client should be encouraged to drink adequate fluids, despite more frequent trips to the bathroom, to stay properly hydrated.

H. Prioritize rest, with short periods of activity: RA can cause joint fatigue and pain. It’s important to balance periods of rest with light, non-strenuous activities to reduce stress on the joints while maintaining some level of mobility. This can help manage energy levels and minimize joint strain.

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Correct Answer is B

Explanation

A. Report any increase in the white blood cell count: While monitoring for signs of infection is important, an increase in WBC count alone does not address the risk of MRSA recurrence in the wound. Early intervention with infection control measures is more important.

B. Change the surgical dressing readily when soiled: A soiled dressing acts as a wick, pulling moisture and bacteria toward the incision. In a postoperative client with a history of MRSA, any drainage or moisture trapped against the skin provides a medium for the staphylococcus bacteria to multiply and invade the surgical site. Changing the dressing readily when soiled ensures that the wound environment remains unfavorable for bacterial growth, directly reducing the risk of a localized recurrence or surgical site infection (SSI).

C. Instruct the family to adhere to contact precautions: Instructing the family on contact precautions is essential for preventing the spread of MRSA to others (the nurse, other patients, or the family members themselves), but it does not directly reduce the risk of the client's own MRSA recurring in their new surgical wound.

D. Wear a face mask while performing wound care: Wearing a face mask is not necessary for preventing MRSA transmission in the wound care setting. Contact precautions, including proper hand hygiene and wearing gloves, are more effective for MRSA prevention.

A. Demonstrate to the PN how to position the client more effectively for the procedure. B. Arrange for unlicensed assistive personnel to assist the PN during the procedure. C. Acknowledge that the PN has positioned the client safely and correctly. D. Assume care of the client and assign the PN to the care of a different client.

Correct Answer is A

Explanation

A. Demonstrate to the PN how to position the client more effectively for the procedure:
The correct position for a sigmoidoscopy is the left lateral or Sims' position to allow easier access to the sigmoid colon. Demonstrating the correct position supports patient safety and provides teaching for the PN.

B. Arrange for unlicensed assistive personnel to assist the PN during the procedure: Assistance is not the issue in this scenario; the problem lies in incorrect positioning. Assigning additional help does not address the need to correct the client's position.

C. Acknowledge that the PN has positioned the client safely and correctly: The flat prone position is not appropriate for a sigmoidoscopy. Acknowledging incorrect positioning would be unsafe and potentially delay the procedure or increase the risk of injury.

D. Assume care of the client and assign the PN to the care of a different client: This is an excessive response that undermines the PN’s role. The more constructive approach is to guide and support the PN through demonstration rather than reassignment.

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Exhibits The client has received a medical diagnosis of rheumatoid arthritis (RA). The client should receive education about living and managing her condition and how to minimize disease complications. Which education should be given to the client by the nurse? Select all that apply.

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Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

The nurse is setting up the equipment to assist with a sigmoidoscopy while the practical nurse (PN) positions the client in a flat prone position. Which action should the nurse implement?

Correct Answer is A

Explanation

A client who is receiving zidovudine reports the appearance of pinpoint, red, round spots on the skin. Which result should the nurse report to the healthcare provider?

Exhibits The nurse reviews the intake information prior to seeing the client. What finding(s) should the nurse recognize as signs of dehydration that require immediate follow up? Select all that apply.

A client who had bariatric surgery 2 months ago is admitted because of vomiting and inability to tolerate food and liquids. The client is pain free. Which intervention should the nurse include in the client's plan of care?

The nurse is reviewing the recommended preventative care for clients with asthma, chronic bronchitis, and emphysema. Which health care measure is most important for the nurse to recommend to these clients?

The nurse is planning a class about blood glucose monitoring for a group of clients with diabetes mellitus. Which timing of glucose testing would apply for any client regardless of the client's age or type of diabetes?

The nurse is assisting the healthcare provider with a thoracentesis for a client who has emphysema. Which equipment should the nurse have at the bedside in the event the procedure is ineffective?

Exhibits

The client has received a medical diagnosis of rheumatoid arthritis (RA). The client should receive education about living and managing her condition and how to minimize disease complications.
Which education should be given to the client by the nurse? Select all that apply.