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 C
Explanation
Choice A rationale
Tetracycline binds to divalent and trivalent cations such as calcium, magnesium, and aluminum. Milk and dairy products are rich in calcium, so taking tetracycline with milk significantly reduces its absorption from the gastrointestinal tract, rendering the medication less effective. The drug should be taken on an empty stomach with a full glass of water.
Choice B rationale
Taking tetracycline at bedtime is not a recommended practice for this drug. Although some medications are taken at night to avoid side effects or promote sleep, tetracycline can cause gastroesophageal reflux or esophagitis, particularly when a person lies down soon after ingestion. It is important to remain upright for at least 30 minutes after taking the medication.
Choice C rationale
Photosensitivity is a well-documented adverse effect of tetracycline. The drug sensitizes the skin to ultraviolet light, leading to an exaggerated sunburn reaction. This is due to the drug's accumulation in the skin and its ability to absorb light energy. Clients must be advised to use sunscreen, wear protective clothing, and avoid prolonged sun exposure.
Choice D rationale
Tetracycline is known to cause gastrointestinal side effects, but diarrhea is far more common than constipation. This is often due to the disruption of the normal gut flora, which can lead to opportunistic infections like Clostridium difficile. While not exclusively causing diarrhea, constipation is not a typical adverse effect and should not be the primary teaching point. *.
Correct Answer is B
Explanation
Choice A rationale
Visual disturbances are a less common side effect of risperidone and are not typically considered a priority finding. While they can be a nuisance for the client, they do not pose an immediate threat to the client's life. Other side effects require more immediate attention and intervention from the healthcare provider.
Choice B rationale
Risperidone can cause cardiac side effects such as QT prolongation, which can lead to life-threatening arrhythmias like Torsades de pointes. An irregular pulse is a critical finding that could indicate an underlying cardiac issue and requires immediate evaluation. This is a priority finding for the nurse to report to the provider.
Choice C rationale
Constipation is a common side effect of risperidone due to its anticholinergic properties. While it can cause discomfort, it is not an immediate life-threatening condition. The nurse should address this by encouraging fluid and fiber intake and possibly discussing a stool softener with the provider, but it is not the highest priority.
Choice D rationale
Dry mouth is a common and relatively benign side effect of risperidone. While it can cause discomfort and increase the risk of dental caries, it is not an urgent or life-threatening condition. The nurse can advise the client on strategies to manage this symptom, such as using sugar-free candies or chewing gum. *.
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