A nurse is performing the health history and physical assessment of a client diagnosed with rheumatoid arthritis (RA). What assessment is most consistent with the clinical presentation of RA?

Visible atrophy of the knee and shoulder joints.

Joint stiffness, especially in the morning

Signs of systemic infection

Cool joints with a decreased range of motion

Answer and Explanation

The Correct Answer is B

Rationale:
A. Visible atrophy may occur in advanced disease due to disuse, but it is not a hallmark early finding of RA.
B. Morning joint stiffness lasting more than 30 minutes is a classic symptom of rheumatoid arthritis, often improving with activity. This distinguishes it from osteoarthritis, where stiffness is typically brief.
C. While RA is a systemic inflammatory disease, it does not typically present with signs of acute infection (e.g., fever, chills) unless there’s a secondary complication.
D. RA-affected joints are usually warm, swollen, and tender, not cool. Decreased range of motion can occur but is not the most specific early indicator.

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Correct Answer is A

Explanation

Rationale:
A. Administering broad-spectrum antibiotics promptly is the priority because PID is a serious infection that can cause complications if not treated urgently.
B. Encouraging hydration is important but secondary to initiating antibiotic therapy.
C. Sexual abstinence is part of education but not the immediate priority in acute care.
D. Laparoscopy may be used for diagnosis but is not the first step in management.

A. I will put a heating pad on my ankle at bedtime tonight" B. I will rewrap my ankle starting from the knee down." C. I will bear weight on my ankle for 10 minutes every hour." D. 'I will apply ice to my ankle today and tomorrow."

Correct Answer is D

Explanation

Rationale:
A. Applying heat in the first 24–48 hours after a sprain can increase swelling and is not recommended. Cold therapy (ice) is preferred initially to reduce inflammation.
B. Wrapping should start from the toes and move upward toward the knee to promote venous return and proper compression, not from the knee down.
C. Bearing weight too soon can worsen the injury; rest and limited movement are advised initially.
D. Applying ice during the first 24–48 hours helps reduce swelling and pain, and is an appropriate self-care measure for a recent ankle sprain, indicating proper understanding of discharge instructions.

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A nurse is performing the health history and physical assessment of a client diagnosed with rheumatoid arthritis (RA). What assessment is most consistent with the clinical presentation of RA?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A 28-year-old female client presents to the clinic with lower abdominal pain, fever, and vaginal discharge. Upon assessment, the nurse suspects Pelvic Inflammatory Disease (PID). Which of the following actions should the nurse prioritize when caring for this client?

Correct Answer is A

Explanation

A nurse is discharging a client who came to the outpatient clinic with an ankle sprain. Which of the following statements should the nurse identify as an indication that the client understands the discharge instructions?

Correct Answer is D

Explanation

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