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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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Free Nursing Study Resources

Correct Answer is ["B","C","E"]

Explanation

A. Explain expected side effects of postoperative chemotherapy: Chemotherapy and its side effects are typically discussed after surgery when the treatment plan is clearer. The focus before surgery should be on preparing the child and family for the surgery itself.

B. Monitor blood pressure every 2 hours for hypertension: Wilm's tumor can be associated with hypertension due to renin production from the tumor, so monitoring the child's blood pressure closely is essential to detect any signs of hypertension early.

C. Provide parents with simple explanations and repeat often: Simplified, repeated explanations are key to helping parents understand the diagnosis and surgical procedure. This approach supports emotional comfort and ensures informed decision-making.

D. Attend all healthcare provider and parent conferences: While it is important to support the family, the nurse’s role in attending all healthcare provider and parent conferences is not mandatory unless specifically needed for continuity of care.

E. Measure the child's abdominal girth: Measuring abdominal girth is essential preoperatively to monitor for any abdominal changes, such as swelling or distension, which could indicate tumor growth or other complications related to the Wilm's tumor.

A. Tenderness. B. Pain. C. Musical and drumlike. D. Absent sounds.

Correct Answer is C

Explanation

A. Tenderness: Tenderness during percussion could indicate an underlying issue, such as inflammation or infection, and is not a normal finding.

B. Pain: Pain during percussion may suggest problems like organ inflammation or distension and is not considered normal.

C. Musical and drumlike: This finding is normal and is often indicative of the presence of air or gas in the intestines, which is a common finding in older adults, especially those with less efficient digestion.

D. Absent sounds: Absent sounds could indicate bowel obstruction or other serious issues and are not a normal finding. Normal percussive sounds should be heard.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A 3-year-old child is admitted with a Stage II Wilm's tumor. Which preoperative intervention(s) should the nurse implement? Choose all that apply.

Correct Answer is ["B","C","E"]

Explanation

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

Correct Answer is C

Explanation

The wife of a newly diagnosed client with Parkinson's disease asks the nurse if alternative or complimentary medical therapies might cure the disease. Which response should the nurse provide?

A client who sustained an L-1 spinal cord injury six months ago that resulted in paraplegia is now experiencing spastic muscle movements in the lower extremities. Which intervention should the nurse implement?

Exhibits The client has started to wake up more, opening her eyes without stimulation and looking around the room. Which should the nurse do as the client becomes more aware of her surroundings? Select all that apply.

Exhibits Choose the most likely options for the information missing from the statements by selecting from the lists of options provided. Based on the client's condition, the priority need will be to addressdropdown. In addition, he will need interventions to preventdropdown.

A client who is admitted after an episode of status epilepticus is stabilized. Which finding should the nurse use to determine the client's risk for recurrence of seizure activity?

The mental health nurse is leading a group about relaxation and explains the benefits of deep breathing for relaxation. As a female client begins to explain how she uses yoga to relax, another client interrupts and asks, "What's yoga?" Which is the nurse's best response?