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Exhibits

The nurse evaluates the client and the flow sheet.

Click to highlight the findings that indicate the client is progressing as expected.

The client presents to the office for reevaluation of rheumatoid arthritis after methotrexate 25 mg PO weekly was started at the last visit. The client reports she has been balancing periods of activity with rest. She recently attended a large family wedding and became fatigued quickly. She has continued to garden, and read, but crocheting is too painful. She is tolerating weekly medication without side effects. She describes pain as 1 to 2 on a 0 to 10 pain scale in bilateral hands. She has noticed "heartburn" about an hour after using ibuprofen for pain relief. The client is pleased with the improvements.

The client reports she has been balancing periods of activity with rest

She recently attended a large family wedding and became fatigued quickly

She has continued to garden, and read, but crocheting is too painful

She is tolerating weekly medication without side effects

She describes pain as 1 to 2 on a 0 to 10 pain scale in bilateral hands

She has noticed "heartburn" about an hour after using ibuprofen for pain relief

The client is pleased with the improvements

Answer and Explanation

The Correct Answer is ["A","D","E","G"]

Rationale for Correct Findings:

Balancing periods of activity with rest: This indicates effective self-management and understanding of a key principle in managing rheumatoid arthritis. Maintaining this balance helps prevent overexertion and joint flares while preserving mobility and function.
Client reports pain as 1 to 2 on a 0 to 10 pain scale in bilateral hands: The reduction in pain from a previous score of 3 to 1-2 indicates a positive response to treatment. Pain reduction is a key marker of progress in managing rheumatoid arthritis, especially with the initiation of methotrexate.
She is tolerating weekly medication without side effects: Tolerating methotrexate without side effects is a positive outcome. Methotrexate is a cornerstone treatment for rheumatoid arthritis, and its ability to be well-tolerated suggests good disease control.
The client is pleased with the improvements: The client’s satisfaction with her treatment and the improvements in her condition demonstrate effective management of her rheumatoid arthritis and a positive response to the prescribed interventions.

Rationale for Incorrect Findings:

She has continued to garden, but crocheting is too painful: The client’s inability to crochet due to pain suggests that joint function is still limited in certain fine motor activities. This shows that while some improvement has been made, the disease still affects specific functions.
She recently attended a large family wedding and became fatigued quickly: Fatigue is common in RA and suggests that the client’s energy levels still need better management. Overexertion could indicate a need for better pacing between rest and activity to avoid exacerbating symptoms.
She has noticed "heartburn" about an hour after using ibuprofen for pain relief: Heartburn is a common side effect of NSAIDs like ibuprofen, which could lead to gastrointestinal irritation. This issue requires attention, as it could progress to more serious gastrointestinal complications.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Free Nursing Study Resources

Correct Answer is A

Explanation

A. Urinate at a specified time, discard this urine, and collect all subsequent urine during the next 24 hours: Discarding the first void ensures the collection begins with an empty bladder, and all urine afterward is included for accurate measurement.

B. Urinate immediately into a urinal, and the lab will collect the specimen every 6 hours, for the next 24 hours: This describes timed urine sampling, not a continuous 24-hour collection required for creatinine clearance.

C. For the next 24 hours, notify nurse when the bladder is full, and the nurse will collect catheterized specimens: Routine creatinine clearance testing does not require catheterization unless the client is already catheterized.

D. Cleanse around the meatus, discard first portion of voiding, and collect the rest in a sterile bottle: This describes a midstream or clean-catch technique, typically used for urine cultures, not 24-hour collections.

A. Contagious until symptoms subside. B. Sandpaper-like rash. C. Peeling and flaking skin in a week. D. Darkening of skin under arms. E. Fever lasting for 7 to 10 days.

Correct Answer is ["B","C"]

Explanation

A. Contagious until symptoms subside: Streptococcal pharyngitis is contagious until 24 hours after starting antibiotics, not until all symptoms are gone. This is important for limiting transmission to others in the household or school setting.

B. Sandpaper-like rash: A sandpaper-textured rash is a hallmark sign of scarlet fever, which is a complication of strep throat. It usually begins on the neck or chest and spreads, often feeling coarse to the touch.

C. Peeling and flaking skin in a week: Desquamation, or skin peeling, is common several days after a strep rash subsides, particularly on the hands and feet. This symptom signals the healing phase of scarlet fever.

D. Darkening of skin under arms: Darkened underarm skin is typically linked to acanthosis nigricans, associated with insulin resistance or obesity. It is not seen with streptococcal infections or fever-related conditions.

E. Fever lasting for 7 to 10 days: Fever from strep throat usually resolves quickly within 24–48 hours of initiating antibiotic therapy. Prolonged fever would be atypical and requires further evaluation for complications.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse plans to collect a 24 hour urine specimen for a creatinine clearance test. Which instruction should the nurse provide to the adult male client?

Correct Answer is A

Explanation

Correct Answer is ["B","C"]

Explanation

A parent brings their child, who has a history of asthma, to the emergency room. The child is wheezing and speaking one word between each breath. The child is anxious, tachycardic, and has labored respirations. Which assessment is most important for the nurse to obtain?

Which laboratory values are critical for the nurse to monitor for a client who is experiencing a thyrotoxic crisis?

The nurse is demonstrating correct transfer procedures to the unlicensed assistive personnel (UAP) working on a rehabilitation unit. The UAP asks the nurse how to safely move a physically disabled client from the wheelchair to a bed. Which action should the nurse recommend?

The nurse is caring for a client who receives a prescription for parenteral lidocaine. Prior to administering the medication, the nurse should review the medical record for which condition?

Exhibits The nurse reviews the intake information prior to seeing the client. What finding(s) should the nurse recognize as signs of dehydration that require immediate follow up? Select all that apply.