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Exhibits

The nurse evaluates the client and the flow sheet.

Click to highlight the findings that indicate the client is progressing as expected.

The client presents to the office for reevaluation of rheumatoid arthritis after methotrexate 25 mg PO weekly was started at the last visit. The client reports she has been balancing periods of activity with rest. She recently attended a large family wedding and became fatigued quickly. She has continued to garden, and read, but crocheting is too painful. She is tolerating weekly medication without side effects. She describes pain as 1 to 2 on a 0 to 10 pain scale in bilateral hands. She has noticed "heartburn" about an hour after using ibuprofen for pain relief. The client is pleased with the improvements.

The client reports she has been balancing periods of activity with rest

She recently attended a large family wedding and became fatigued quickly

She has continued to garden, and read, but crocheting is too painful

She is tolerating weekly medication without side effects

She describes pain as 1 to 2 on a 0 to 10 pain scale in bilateral hands

She has noticed "heartburn" about an hour after using ibuprofen for pain relief

The client is pleased with the improvements

Answer and Explanation

The Correct Answer is ["A","D","E","G"]

Rationale for Correct Findings:

Balancing periods of activity with rest: This indicates effective self-management and understanding of a key principle in managing rheumatoid arthritis. Maintaining this balance helps prevent overexertion and joint flares while preserving mobility and function.
Client reports pain as 1 to 2 on a 0 to 10 pain scale in bilateral hands: The reduction in pain from a previous score of 3 to 1-2 indicates a positive response to treatment. Pain reduction is a key marker of progress in managing rheumatoid arthritis, especially with the initiation of methotrexate.
She is tolerating weekly medication without side effects: Tolerating methotrexate without side effects is a positive outcome. Methotrexate is a cornerstone treatment for rheumatoid arthritis, and its ability to be well-tolerated suggests good disease control.
The client is pleased with the improvements: The client’s satisfaction with her treatment and the improvements in her condition demonstrate effective management of her rheumatoid arthritis and a positive response to the prescribed interventions.

Rationale for Incorrect Findings:

She has continued to garden, but crocheting is too painful: The client’s inability to crochet due to pain suggests that joint function is still limited in certain fine motor activities. This shows that while some improvement has been made, the disease still affects specific functions.
She recently attended a large family wedding and became fatigued quickly: Fatigue is common in RA and suggests that the client’s energy levels still need better management. Overexertion could indicate a need for better pacing between rest and activity to avoid exacerbating symptoms.
She has noticed "heartburn" about an hour after using ibuprofen for pain relief: Heartburn is a common side effect of NSAIDs like ibuprofen, which could lead to gastrointestinal irritation. This issue requires attention, as it could progress to more serious gastrointestinal complications.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

A. Frequency that the child uses a rescue inhaler during the week: While it is important to know how often the child uses a rescue inhaler, it does not provide immediate, critical information to assess the severity of the current asthma attack.

B. Type of inhaler the child typically uses on a regular basis: While knowing the type of inhaler the child uses regularly can provide insight into their asthma management, it is not the most critical information at this moment, the current treatment is he most urgent.

C. Type of allergen exposure or trigger for the current episode: Understanding the trigger for the current asthma episode is helpful for long-term management but is not as urgent in the immediate assessment of the child’s condition during an acute exacerbation.

D. Last dose and type of rescue inhaler used by the child: This information helps assess whether the child has received appropriate treatment and whether additional or different interventions are needed immediately to address the asthma exacerbation, helps guide further treatment decisions.

A. Electromyography. B. Skin biopsy. C. Complete blood count. D. Allergy test.

Correct Answer is C

Explanation

A. Electromyography: Electromyography assesses electrical activity in muscles and is used to diagnose neuromuscular disorders. It is not relevant to evaluating bleeding tendencies or pinpoint skin spots, which suggest a hematologic issue like thrombocytopenia.

B. Skin biopsy: A skin biopsy might help diagnose dermatologic conditions, but it is invasive and not the initial step when systemic drug side effects like petechiae are suspected. The presence of red spots suggests a possible blood disorder requiring laboratory confirmation first.

C. Complete blood count: A CBC is essential to evaluate for thrombocytopenia, a known adverse effect of zidovudine. Pinpoint red spots, or petechiae, are often linked to low platelet counts, which require prompt detection and management to prevent serious complications.

D. Allergy test: Allergy testing identifies hypersensitivity reactions, typically associated with rashes or itching. Petechiae are not commonly caused by allergic reactions but are more indicative of blood abnormalities, making this test less immediately relevant.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A parent brings their child, who has a history of asthma, to the emergency room. The child is wheezing and speaking one word between each breath. The child is anxious, tachycardic, and has labored respirations. Which assessment is most important for the nurse to obtain?

Correct Answer is D

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?

Correct Answer is C

Explanation

The nurse completes percussion of the abdomen on an older adult client. Which finding is considered normal for this client?

An older adult client with a history of heart failure is admitted with influenza and requests assistance to sit up in bed to eat lunch. The nurse observes the unlicensed assistive personnel (UAP) wearing a gown and gloves to assist the client. Which action should the nurse take?

Exhibits After the obstetrician leaves, the client appears confused and asks the nurse, "How will I know if I have high blood sugar?" Which are the nurse's best responses? Select all that apply.

The nurse is caring for a client with chronic kidney disease (CKD). Which meal selection should the nurse recommend to the client?

The nurse notes that a client with depression has been more withdrawn and noncommunicative during the past two weeks. Which intervention is most important to include in the updated plan of care for this client?

The nurse is reviewing the plan of care for a newly admitted client who is intoxicated on admission. Which findings should the nurse include as indicators to begin implementing the detoxification medication protocol?