A nurse in a provider's office is assessing a patient who has rheumatoid arthritis (RA). Which of the following findings is a late manifestation of this condition?

Choice A rationale

Administering an antiemetic is the most appropriate initial action to address the client's reported nausea and vomiting, which are common side effects of morphine sulfate, an opioid analgesic administered via a PCA pump. An antiemetic medication can help alleviate these symptoms and improve the client's comfort.

Choice B rationale

Auscultating bowel sounds is important for assessing gastrointestinal function, but it does not directly address the client's immediate complaint of nausea and vomiting. While opioid-induced constipation and decreased bowel motility are potential side effects, the immediate priority is to relieve the distressing symptoms.

Choice C rationale

Encouraging the use of the incentive spirometer is crucial for preventing postoperative pulmonary complications such as atelectasis, especially after surgery involving anesthesia and pain medication. However, it does not directly address the client's current nausea and vomiting.

Choice D rationale

Inserting a nasogastric tube is a more invasive intervention and is typically reserved for situations involving severe, persistent vomiting, abdominal distension, or concerns about bowel obstruction. It is not the first-line treatment for nausea and vomiting related to opioid use after surgery.

Choice A rationale

Pediculosis refers to an infestation of lice, which typically presents with intense itching and the presence of nits (lice eggs) attached to hair shafts. While there may be redness and irritation from scratching, oozing lesions are not a primary characteristic of pediculosis.

Choice B rationale

Contact dermatitis is an inflammatory skin condition caused by direct contact with an allergen or irritant. It often manifests as pruritus (itching), redness (erythema), and oozing lesions (vesiculation and weeping) at the site of contact. The client's report of pruritus and reddened, oozing lesions on her lower leg is consistent with contact dermatitis.

Choice C rationale

Alopecia refers to hair loss, which can be localized or widespread. It does not typically involve pruritus or oozing lesions on the skin.

Choice D rationale

Tinea pedis, also known as athlete's foot, is a fungal infection of the feet. It commonly presents with scaling, itching, redness, and sometimes blistering, but oozing lesions are less typical unless there is a secondary bacterial infection. The location on the lower leg is also less common for tinea pedis, which primarily affects the feet. .