Exhibits

The nurse is preparing the client's plan of care. A major component of the clients at home care is pain management.
Select the 3 most important interventions the nurse can educate the client with rheumatoid arthritis (RA) about to help with pain management.

Consult a dietitian to support nutrition and weight loss.

Perform fine motor activities for the client to decrease pain.

Avoid movement, as it will increase pain.

Eat a diet high in refined carbohydrates.

Apply ice packs to inflamed joints.

Facilitate paraffin wax dips to help soothe joints.

Answer and Explanation

Correct Answer : A,E,F

A. Consult a dietitian to support nutrition and weight loss: Excess weight puts added stress on joints, particularly weight-bearing joints. A dietitian can help create a balanced, anti-inflammatory diet and assist with weight loss to reduce strain on the joints and control inflammation.

B. Perform fine motor activities for the client to decrease pain: Fine motor activities may increase joint strain and discomfort in RA patients, particularly if done in excess or without adequate rest. Focus should be on rest and controlled activity.

C. Avoid movement, as it will increase pain: Complete immobilization of joints can lead to stiffness and further deterioration. While rest is important during flare-ups, gentle movement and exercises, such as range-of-motion exercises, are essential to prevent joint stiffness and preserve function.

D. Eat a diet high in refined carbohydrates: A diet high in refined carbohydrates is not beneficial for RA patients. Refined carbohydrates can increase inflammation and contribute to weight gain, which may worsen the symptoms of RA. A well-balanced, anti-inflammatory diet is recommended instead.

E. Apply ice packs to inflamed joints: Applying ice packs to inflamed joints can reduce swelling and provide relief from acute pain and inflammation. Cold therapy can help to numb the area, providing short-term relief and decreasing inflammation in affected joints for pain management in RA.

F. Facilitate paraffin wax dips to help soothe joints: Paraffin wax dips used to relieve pain and stiffness in joints affected by rheumatoid arthritis. The warm wax helps to relax muscles, increase blood flow, and reduce stiffness in the hands and wrists, providing comfort and improving joint mobility.

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Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B"}

Explanation

Rationale:

Respirations: After administering morphine, it is crucial to monitor the client's respirations because opioids can cause respiratory depression, which may be more pronounced in elderly patients or those who are in pain and immobile.
Deep breathing techniques: The nurse should encourage deep breathing techniques. This helps improve lung expansion and reduces the risk of respiratory complications such as pneumonia and atelectasis, especially in a client with decreased mobility due to pain and injury.

Rationale for Incorrect Options:

Heart rate: While heart rate monitoring is important, it is not the primary concern immediately after morphine administration. The client's respiratory status takes precedence, especially considering the risk of opioid-induced respiratory depression.
Blood pressure: While blood pressure monitoring is essential, morphine administration primarily affects the respiratory system, not the circulatory system. The nurse should prioritize respiratory monitoring over blood pressure unless the patient exhibits signs of hypotension.
Range of motion exercises: Range of motion exercises are important for mobility and rehabilitation, but they are not a priority immediately following the trauma and morphine administration. The client should be assessed and stabilized before beginning exercises.
Joint protection techniques: Joint protection techniques are beneficial in long-term rehabilitation, but in the acute phase, the priority is to manage the fracture, pain, and prevent further complications.

A. Monitor collection container and replace when full. B. Encourage frequent use of the incentive spirometer. C. Assess area around chest tube for subcutaneous emphysema. D. Keep tubing loosely coiled below the level of the chest. E. Verify air bubbling present in the water seal chamber.

Correct Answer is ["A","B","C","D"]

Explanation

A. Monitor collection container and replace when full: The nurse should monitor the collection container to ensure it doesn't become full, as this could cause backflow into the pleural cavity. Replacing it when full is essential to maintain proper drainage.

B. Encourage frequent use of the incentive spirometer: Using the incentive spirometer helps prevent atelectasis and pneumonia by promoting lung expansion. It is important for postoperative recovery to maintain good respiratory function.

C. Assess area around chest tube for subcutaneous emphysema: Subcutaneous emphysema can occur if air leaks into the tissues around the chest tube. The nurse should check for this condition as it could indicate complications like an air leak or pneumothorax.

D. Keep tubing loosely coiled below the level of the chest: The tubing should be positioned below the chest to facilitate gravity drainage. Keeping it loosely coiled ensures that fluid and air drain efficiently without backflow.

E. Verify air bubbling present in the water seal chamber: Continuous bubbling in the water seal chamber is not expected and may indicate an air leak. Intermittent bubbling may be normal if the lung is still re-expanding, but ongoing bubbling should be reported, not simply verified.

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Exhibits The nurse is preparing the client's plan of care. A major component of the clients at home care is pain management. Select the 3 most important interventions the nurse can educate the client with rheumatoid arthritis (RA) about to help with pain management.

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Naxlex Comprehensive Predictor Exams

Exhibits Choose the most likely options for the information missing from the statements by selecting from the lists of options provided. The nurse monitors the client's dropdownafter administering the morphine. The nurse should include dropdownto reduce complications of the client's injury.

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B"}

Explanation

The nurse is caring for a client who underwent a right lobectomy for lung cancer 24 hours ago and has a single chest tube on the right side. Which intervention(s) should the nurse plan to implement? Select all that apply.

Correct Answer is ["A","B","C","D"]

Explanation

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Exhibits

The nurse is preparing the client's plan of care. A major component of the clients at home care is pain management.
Select the 3 most important interventions the nurse can educate the client with rheumatoid arthritis (RA) about to help with pain management.