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

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.

Instruct the client about the importance of maintaining bedrest.

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

Answer and Explanation

The Correct Answer is D

Rationale:
A. Consult the discharge planner about transferring the client to an assisted living center: While discharge planning may be appropriate for clients with functional limitations, it does not directly address fatigue management or help the client cope with daily activities related to rheumatoid arthritis.

B. Offer assurance that the fatigue inducing stage of the disease does not last: Providing reassurance alone does not equip the client with practical strategies to manage fatigue or improve energy levels, making it an insufficient intervention.

C. Instruct the client about the importance of maintaining bedrest: Prolonged bedrest can worsen fatigue, reduce joint mobility, and increase the risk of deconditioning in rheumatoid arthritis. Encouraging bedrest is not an appropriate intervention for managing fatigue here.

D. Assist the client with learning how to set priorities and pace activities: Teaching the client to prioritize tasks and pace activities helps conserve energy and manage fatigue effectively. This intervention directly addresses the nursing problem by promoting functional independence and improving quality of life.

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

Explanation

Rationale for Correct Choices:

Pain assessment: The client reports severe pain (8/10) that has persisted for 9 days without relief. Acute, uncontrolled pain can indicate a worsening gout flare or possible complication, requiring immediate nursing intervention to manage pain and prevent functional impairment.
Temperature: The client’s oral temperature is 100.5°F (38.1°C), indicating a low-grade fever. Fever in the context of acute joint pain raises concern for infection, which requires prompt assessment and possible laboratory workup.
Blood pressure: The client’s blood pressure is elevated at 151/87 mm Hg. While not immediately life-threatening, hypertension in combination with acute pain and fever increases cardiovascular risk and can exacerbate comorbidities. Prompt monitoring and intervention are necessary to prevent complications.

Rationale for Incorrect Choices:

Oxygen saturation: At 95% on room air, the client’s oxygenation is within acceptable limits and does not indicate an immediate threat to tissue perfusion.
Edema: Mild (1+) bilateral lower extremity edema is chronic and consistent with underlying comorbidities, such as hypertension or possible venous insufficiency. It does not require immediate intervention in this acute scenario.

A. The need to switch to e-cigarettes instead of smoking tobacco cigarettes B. Importance of eating a balanced diet C. Need for influenza and pneumonia vaccination D. Regular exercise E. Supplemental oxygen instructions F. Smoking cessation G. Use of albuterol prior to exercise H. How to use a continuous positive airway pressure (CPAP) device at night

Correct Answer is ["B","C","D","E","F","G"]

Explanation

Rationale for Correct Choices

Importance of eating a balanced diet: Clients with COPD require adequate nutrition to maintain energy and prevent muscle wasting, which can worsen respiratory function. Balanced meals support overall health and lung function.
Need for influenza and pneumonia vaccination: Vaccinations reduce the risk of respiratory infections, which can exacerbate COPD and lead to hospitalization. Preventive immunizations are essential for long-term disease management.
Regular exercise: Exercise improves cardiovascular fitness, strengthens respiratory muscles, and enhances overall endurance, helping clients tolerate daily activities despite airflow limitations.
Supplemental oxygen instructions: If prescribed, clients need to know proper oxygen use, flow rates, and safety precautions to maintain adequate oxygen saturation and prevent hypoxemia.
Smoking cessation: Quitting smoking is the single most effective intervention to slow the progression of COPD and reduce exacerbations. Education on cessation strategies and resources is critical.
Use of albuterol prior to exercise: Pre-exercise use of short-acting bronchodilators can reduce exercise-induced bronchospasm, improving tolerance to activity and preventing acute shortness of breath episodes.

Rationale for Incorrect Choices:

The need to switch to e-cigarettes instead of smoking tobacco cigarettes: E-cigarettes are not considered a safe alternative and can still harm the lungs. Advising switching does not reduce COPD progression.
How to use a continuous positive airway pressure (CPAP) device at night: CPAP is used for obstructive sleep apnea, not standard COPD management unless the client has coexisting sleep apnea. It is not routinely included in COPD education.

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

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Patient Data Exhibits Which assessment factors require immediate nursing intervention based on the nurse’s assessment? Select all that apply)

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

Explanation

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Correct Answer is ["B","C","D","E","F","G"]

Explanation

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