A nurse is teaching a client who has osteoarthritis about joint protection strategies.
Which of the following instructions should the nurse include?
Sit in chairs with low, soft backs.
Use both hands to hold objects.
Push up from the bed with your fingers.
Turn doorknobs clockwise.
The Correct Answer is B
Choice A rationale
Sitting in chairs with low, soft backs can worsen osteoarthritis symptoms and increase joint stress. Low chairs require more force from the hips and knees to stand up, which can strain these joints. Soft backs provide inadequate support, leading to poor posture and increased stress on the spine and other joints. Proper joint protection involves maintaining good posture and minimizing strain on affected joints.
Choice B rationale
Using both hands to hold objects distributes the weight and stress evenly across multiple joints, such as those in both wrists and hands, thereby reducing the workload on any single joint. This technique minimizes the risk of joint deformation and pain associated with osteoarthritis by preventing excessive force from being applied to a single joint, a key principle of joint protection.
Choice C rationale
Pushing up from a bed with fingers puts a concentrated, high-impact force on the small joints of the fingers, which are often affected by osteoarthritis. This action can lead to pain, inflammation, and potential deformity over time. Instead, individuals should use their palms or forearms to push up, distributing the force over a larger, stronger surface area.
Choice D rationale
Turning doorknobs clockwise or in any specific direction with a forceful grip can exacerbate joint pain and strain in the fingers and wrist. This motion places significant torque on the affected joints. To protect joints, clients should be advised to use lever-style doorknobs or adaptive devices that require less grip strength and a different motion. *.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Giving a new sibling plenty of "alone time" with a preschooler is a misconception and can cause increased feelings of resentment and jealousy. A preschool-age child may not understand why they are being left alone with the new baby, and it can be a source of stress. It is more effective to involve the older child in the care of the baby and to ensure the older child receives dedicated one-on-one time with a parent to feel valued and loved.
Choice B rationale
A common strategy to help a preschooler adjust to a new sibling is to give them a gift from the new baby. This gesture helps the older child associate the new baby with a positive experience rather than a negative one. It makes the older child feel special and included, reducing feelings of displacement or jealousy. It is a simple way to foster a sense of connection and warmth between the siblings.
Choice C rationale
Holding the new baby when the older child first meets them can cause the older child to feel excluded and jealous. This action may inadvertently create a sense of competition for the parent's attention. A better approach is for one parent to hold the baby while the other parent holds the older child, or for the baby to be in a bassinet or held by another family member, allowing the preschooler to have uninterrupted attention from the parent.
Choice D rationale
While meeting a new sibling at home can be beneficial, the most crucial factor is how the meeting is structured, not just the location. The location is less important than ensuring the older child feels included and not replaced. The nurse's suggestion should focus on strategies to manage the preschooler's feelings of jealousy and displacement, such as giving them a gift, rather than on the meeting's location, which is a secondary consideration
Correct Answer is C
Explanation
Choice A rationale
Looping the tubing so it is lower than the collection bag creates a dependent loop, which can cause urine to pool and create a backflow into the bladder. This stasis of urine provides a fertile environment for bacteria to multiply and ascend the urinary tract, significantly increasing the client's risk for a urinary tract infection. The bag should always be below the bladder.
Choice B rationale
Keeping the urinary bag at bladder level or higher when ambulating is a significant risk factor for urinary tract infections. This positioning allows for the backflow of urine from the collection bag into the bladder. The retrograde flow of urine can transport bacteria into the sterile bladder, leading to bacterial colonization and a subsequent infection.
Choice C rationale
Securing the catheter to the client's thigh is a crucial intervention for minimizing the risk of a UTI. It prevents movement and traction on the catheter at the urethral meatus. This minimizes urethral tissue irritation and micro-trauma, which can serve as entry points for bacteria. It also reduces tension on the catheter, preventing accidental dislodgement.
Choice D rationale
Disconnecting the tubing connections to obtain a urinary sample is a high-risk action for introducing microorganisms. Each disconnection breaks the closed, sterile system, allowing airborne bacteria or contaminants from the external environment to enter the catheter and tubing. This breach of sterility can lead to bacterial ascension into the bladder, causing a urinary tract infection. *.
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