A client sustains an injury to his heel while the unlicensed assistive personnel and the nurse are moving him in bed. What force caused the injury?

Choice A reason: This is an unrealistic and unattainable goal for a client with rheumatoid arthritis. Rheumatoid arthritis is a chronic and progressive inflammatory disease that causes joint pain, stiffness, swelling, and deformity. It is not possible to eliminate pain completely with this condition. The nurse should help the client set realistic and individualized goals for pain management.

Choice B reason: This is a vague and subjective goal for pain control. Pain is a personal and multidimensional experience that varies from person to person. The nurse should use a valid and reliable pain assessment tool, such as the numeric rating scale, to measure the client's pain intensity and quality. The nurse should also ask the client about their acceptable level of pain and how it affects their daily activities and quality of life.

Choice C reason: This is a good goal for general health and wellness, but it is not specific to pain control. Eating healthy meals and staying hydrated can help the client maintain their nutritional status and hydration, which are important for overall health. However, they do not directly address the pain caused by rheumatoid arthritis. The nurse should also consider other factors that can influence pain, such as stress, mood, sleep, and coping strategies.

Choice D reason: This is the best goal for pain control in a client with rheumatoid arthritis. It is realistic, measurable, and individualized. It acknowledges that some pain is inevitable with this condition, but it aims to reduce it to a tolerable level that allows the client to function and enjoy life. It also uses a numeric rating scale to quantify the pain and monitor the effectiveness of interventions.

Choice A reason: Allowing the client to sleep to build up stamina is not the priority intervention, because it does not address the psychosocial needs of the client. Sleeping is a physiological need, not a psychosocial need. Sleeping may help the client recover physically, but it does not help the client cope emotionally or socially with the isolation.

Choice B reason: Maintaining a sixfoot distance from the client is not the priority intervention, because it does not enhance the psychosocial needs of the client. Maintaining a sixfoot distance from the client is a safety measure, not a psychosocial intervention. Maintaining a sixfoot distance from the client may help prevent the transmission of infection, but it does not help the client feel less lonely or isolated.

Choice C reason: Providing a timeframe for the isolation is not the priority intervention, because it does not enhance the psychosocial needs of the client. Providing a timeframe for the isolation is an informational intervention, not a psychosocial intervention. Providing a timeframe for the isolation may help the client understand the rationale and duration of the precautions, but it does not help the client feel more engaged or supported.

Choice D reason: Providing the client with diversional activities is the priority intervention, because it enhances the psychosocial needs of the client. Providing the client with diversional activities is a psychosocial intervention, not a physiological, safety, or informational intervention. Providing the client with diversional activities may help the client feel more entertained, stimulated, and connected with others, which can reduce the negative effects of isolation.