The nurse establishes a nursing problem of "Fatigue related to inability to rest comfortably secondary to rheumatoid arthritis." Which nursing intervention should the nurse include in the plan of care for this client?

Assist the client with learning how to set priorities and pace activities.

Instruct the client about the importance of maintaining bedrest.

Consult the discharge planner about transferring the client to an assisted living center.

Offer assurance that the fatigue inducing stage of the disease does not last.

Answer and Explanation

The Correct Answer is A

A.   RA often causes joint pain and stiffness, which can make it challenging to complete daily activities. Teaching the client how to set priorities and pace their activities helps them balance exertion with rest, thus reducing fatigue and improving overall function. This approach supports effective management of their condition by preventing overexertion and allowing time for recovery.
B.   While rest is important for managing fatigue, strict bedrest is generally not recommended for RA patients. Prolonged bedrest can lead to muscle weakness, joint stiffness, and decreased mobility. Active management through appropriate rest and activity is usually more beneficial than complete bedrest.
C.   Transferring to an assisted living center may be appropriate for some clients, but this intervention is not necessarily related to managing fatigue due to rheumatoid arthritis in the current context. This
decision would typically depend on the overall level of care needed and the client’s living situation.
D.   While providing reassurance is part of supportive care, it’s important to address the specific needs and management strategies for fatigue. Simply offering assurance without practical interventions may not effectively address the client’s current symptoms or help them manage their condition in the long
term.

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Correct Answer is A

Explanation

A. This is the most likely intervention to avert cardiomegaly and improve myocardial contractility. By reducing blood pressure, the heart doesn't have to work as hard to pump blood, which can help prevent the heart from enlarging (cardiomegaly) and improve its ability to contract effectively.
B. While rest and oxygen can help manage symptoms of heart failure, they do not directly address the underlying issue of increased cardiac workload and hypertrophy.
C. Monitoring heart rate and rhythm is important for assessing the patient's condition, but it does not prevent cardiomegaly or improve contractility.
D. Nitroglycerin is used to treat acute symptoms of heart failure, such as chest pain, but it is not a long- term solution for preventing cardiomegaly or improving contractility.

A. Palpate all peripheral pulses in the extremities. B. Encourage cough and deep breathing exercises. C. Complete a focused assessment of the abdomen. D. Initiate measurement of fluid intake and output.

Correct Answer is C

Explanation

A. While assessing peripheral pulses is important, it's not the priority in this situation. The primary concern is the rectal bleeding.
B. These exercises are important to prevent postoperative complications like pneumonia, but they are not the immediate priority when a patient is experiencing rectal bleeding.
C. Assessing the abdomen will help determine the severity of the bleeding, identify any signs of abdominal distention or tenderness, and provide crucial information for further interventions.
D. Monitoring fluid intake and output is important for any patient, but it's not the initial priority when a patient is actively bleeding.

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The nurse establishes a nursing problem of "Fatigue related to inability to rest comfortably secondary to rheumatoid arthritis." Which nursing intervention should the nurse include in the plan of care for this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is admitted with heart failure (HF) and left ventricular hypertrophy. Which intervention is most likely to avert development of cardiomegaly and improve myocardial contractility?

Correct Answer is A

Explanation

An adult client is admitted to the medical unit due to rectal bleeding after a colonoscopy in which a polyp was biopsied and cauterized. Which Intervention should the nurse do first?

Correct Answer is C

Explanation

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