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.

Answer and Explanation

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. *.

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Correct Answer is C

Explanation

Choice A rationale

A nonstress test (NST) does not require the client to fast. The client can eat and drink normally, and sometimes a sugary beverage is even encouraged to stimulate fetal movement, as the test aims to record fetal heart rate accelerations in response to these movements.

Choice B rationale

The nonstress test is a screening tool used to assess fetal well-being by measuring the fetal heart rate's response to fetal movement. It does not provide information about genetic problems, which are typically identified through genetic testing or prenatal diagnostic procedures such as amniocentesis.

Choice C rationale

A key component of the nonstress test involves the mother noting fetal movements. The client is given a marker, often a button, to press each time she feels the baby move. This action correlates the mother's perception of movement with the fetal heart rate accelerations recorded on the monitor.

Choice D rationale

Oxytocin is not administered during a nonstress test. The purpose of this test is to assess the baby's baseline heart rate and accelerations without external stimulation. Oxytocin is used in a contraction stress test, which is a different procedure to evaluate how the baby handles uterine contractions. *.

A. Potassium. B. Calcium. C. Iron. D. Magnesium.

Correct Answer is A

Explanation

Choice A rationale

Spironolactone is a potassium-sparing diuretic. Its mechanism of action involves blocking aldosterone receptors in the kidney's distal convoluted tubule and collecting duct, leading to increased sodium and water excretion while retaining potassium. Consequently, taking a potassium supplement concurrently would dangerously increase the risk of hyperkalemia, a condition characterized by high blood potassium levels (normal range is 3.5-5.0 mEq/L), which can cause life-threatening cardiac dysrhythmias.

Choice B rationale

Spironolactone's primary effect is on sodium and potassium balance, not calcium. Calcium supplements do not typically interact with spironolactone in a way that would cause a significant, adverse change in calcium levels. The nurse should instruct the client to avoid supplements that directly alter the electrolytes affected by the medication's mechanism of action.

Choice C rationale

Spironolactone does not significantly impact iron metabolism. Therefore, a client taking an iron supplement would not be at increased risk of an adverse interaction. Iron supplements are generally well-tolerated with spironolactone, and there is no contraindication for their concurrent use. The focus of client teaching should be on electrolytes directly affected by the medication.

Choice D rationale

Spironolactone does not have a direct or clinically significant interaction with magnesium supplements. While diuretics can sometimes affect magnesium levels, spironolactone's primary action is on potassium and sodium. Therefore, there is no major contraindication for the use of magnesium supplements, unlike the life-threatening risk associated with potassium supplementation. *.

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A nurse is teaching a client who has osteoarthritis about joint protection strategies. Which of the following instructions should the nurse include?

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A nurse is teaching a client who has osteoarthritis about joint protection strategies.

Which of the following instructions should the nurse include?