A nurse is teaching a patient who has osteoarthritis.
Which of the following instructions should the nurse include in the teaching?
"Take acetaminophen as the primary medication to treat the pain.”.
"Decrease foods high in purines.”.
"Elevate the affected joint on large pillows.”.
"Apply a heat pack at a temperature below your body temperature.”.
The Correct Answer is A
Choice A rationale
Acetaminophen is often recommended as a first-line analgesic for managing mild to moderate pain associated with osteoarthritis. It acts centrally to inhibit prostaglandin synthesis in the central nervous system and block pain impulses peripherally. Unlike nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen lacks significant anti-inflammatory properties and does not typically cause gastrointestinal irritation or bleeding, making it a safer initial option for chronic pain management in many individuals.
Choice B rationale
Decreasing foods high in purines is a dietary recommendation for patients with gout, a type of inflammatory arthritis caused by the accumulation of uric acid crystals in the joints. Osteoarthritis, however, is a degenerative joint disease resulting from cartilage breakdown and is not directly linked to purine metabolism or uric acid levels. Therefore, this dietary modification is not relevant to managing osteoarthritis.
Choice C rationale
While elevating an affected joint can help reduce swelling and discomfort, it is generally recommended for acute inflammation or injury rather than the chronic pain of osteoarthritis. Large pillows under the knee or hip for extended periods can actually promote joint flexion contractures and should be avoided. Proper positioning usually involves maintaining joint alignment and avoiding prolonged static positions.
Choice D rationale
Applying heat can provide pain relief and muscle relaxation for osteoarthritis by increasing blood flow to the area and reducing stiffness. However, the temperature should be comfortably warm, not below body temperature, to achieve these therapeutic effects. Heat application typically ranges from 104°F to 113°F (40°C to 45°C) for optimal benefit without causing burns.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Basal cell carcinoma typically presents as a pearly or waxy bump, often with telangiectasia (small blood vessels) and a rolled border. While it can grow, it is less likely to exhibit irregular shape and significant color variation.
Choice B rationale
Malignant melanoma is characterized by the "ABCDE" criteria: asymmetry (irregular shape), border irregularity (notched, scalloped, or blurred), color variation (multiple shades of brown, black, red, white, or blue), diameter (usually larger than 6 mm), and evolving (change in size, shape, color, or elevation). The patient's report of an increased size and an irregularly shaped lesion with varying colors strongly suggests malignant melanoma, a serious form of skin cancer arising from melanocytes.
Choice C rationale
Squamous cell carcinoma often appears as a firm, red nodule or a scaly, crusty patch. While it can be irregular in shape and may grow, the description of varied colors is less typical of squamous cell carcinoma compared to melanoma.
Choice D rationale
Kaposi's sarcoma presents as red, purple, or brown blotches or nodules on the skin. It is associated with human herpesvirus 8 (HHV-8) and is more common in individuals with weakened immune systems. The description of an increasing, irregularly shaped, and multicolored lesion is not typical of Kaposi's sarcoma.
Correct Answer is B
Explanation
Choice A rationale
While weight loss is generally healthy for obese individuals, this statement dismisses a potential link between obesity and reflux, which may not be entirely accurate. Increased intra-abdominal pressure due to excess weight is a known contributing factor to gastroesophageal reflux.
Choice B rationale
Excess abdominal adipose tissue increases pressure on the stomach. This elevated pressure can overcome the lower esophageal sphincter's (LES) barrier function, allowing stomach acid and contents to reflux into the esophagus, causing the symptoms of gastroesophageal reflux disease (GERD).
Choice C rationale
While a high-fat diet can contribute to reflux by delaying gastric emptying and relaxing the LES, this statement generalizes that all obese people eat more high-fat food. Obesity itself, regardless of dietary habits, can increase intra-abdominal pressure.
Choice D rationale
This statement is a generalization about the eating habits of obese individuals and does not directly explain the physiological mechanism by which obesity can cause reflux. While larger or more frequent meals can increase stomach distension and potentially reflux, the primary link related to obesity is the increased abdominal pressure.
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