The nurse is preparing a client for discharge who was hospitalized with a flare of symptoms from rheumatoid arthritis. Which instruction is most important for the nurse to include?

Decrease daily intake of sodium in diet.

Use a walker when weakness occurs.

Avoid extreme environmental temperatures.

Take prescribed cortisone accurately.

Answer and Explanation

The Correct Answer is D

Rationale:
A. Decrease daily intake of sodium in diet: Limiting sodium may help reduce fluid retention, especially if taking corticosteroids, but it does not directly control rheumatoid arthritis symptoms or prevent disease flares. It is a secondary consideration.

B. Use a walker when weakness occurs: Using assistive devices helps prevent falls during periods of joint weakness, but it does not address the underlying inflammatory process or medication adherence. Safety measures are supportive rather than primary.

C. Avoid extreme environmental temperatures: Temperature extremes can exacerbate joint stiffness or discomfort, but avoidance alone will not prevent flares or disease progression. This is an adjunct measure rather than the priority.

D. Take prescribed cortisone accurately: Adherence to prescribed corticosteroid therapy is essential to control inflammation, reduce pain, and prevent disease flares in rheumatoid arthritis. Proper medication administration directly impacts disease management and overall outcomes, making it the most important instruction for discharge education.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is B

Explanation

Rationale:
A. "I am happy that you are getting better and will be able to go home.": This response shifts focus away from the client’s expressed feelings and does not address the dichotomous thinking or validate the client’s perception, missing an opportunity for therapeutic exploration.

B. "What did the night nurse do that makes you think the nurse is aloof?": This response encourages the client to explore specific behaviors rather than labeling people as “all bad” or “all good,” helping the client identify reality-based observations. It addresses dichotomous thinking in a supportive, therapeutic manner.

C. "Tomorrow I will talk to that nurse about how you were treated last night.": Promising action on the client’s behalf may reinforce dependency and splitting behaviors. The nurse should encourage the client to verbalize feelings rather than taking responsibility for resolving interpersonal conflicts.

D. "I am glad you like me. Which nurse was acting aloof to you?": While partially addressing the situation, this response blends validation with potential judgment, which may reinforce splitting rather than guiding the client to examine perceptions objectively.

A. Gram-negative and gram-positive bacteria on blood cultures. B. Third spacing of fluid into the vascular space. C. Jugular venous distention (JVD). D. Decrease in systolic blood pressure during inspiration. E. Hyperactive deep tendon reflexes (DTR).

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

Explanation

Rationale:
A. Gram-negative and gram-positive bacteria on blood cultures: The presence of bacteria indicates sepsis, which is associated with distributive shock, not obstructive shock. This finding does not reflect mechanical or obstructive circulatory compromise.

B. Third spacing of fluid into the vascular space: Third spacing (fluid shift into interstitial or nonfunctional spaces) occurs in hypovolemic or distributive shock but is not characteristic of obstructive shock, which involves a physical barrier to blood flow.

C. Jugular venous distention (JVD): JVD is a classic sign of obstructive shock caused by impaired venous return to the heart, such as in cardiac tamponade, tension pneumothorax, or massive pulmonary embolism. Elevated central venous pressure reflects backflow from the obstruction.

D. Decrease in systolic blood pressure during inspiration: Pulsus paradoxus, a drop in systolic blood pressure >10 mmHg during inspiration, is indicative of obstructive shock, often seen in cardiac tamponade or severe tension pneumothorax. This reflects impaired ventricular filling.

E. Hyperactive deep tendon reflexes (DTR): Hyperactive DTRs are associated with neurologic conditions or electrolyte imbalances, not obstructive shock. They do not provide information about circulatory obstruction or hemodynamic compromise.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

The nurse is preparing a client for discharge who was hospitalized with a flare of symptoms from rheumatoid arthritis. Which instruction is most important for the nurse to include?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

The nurse is caring for a client in the intensive care unit (ICU) that has multisystem alterations following abdominal surgery. Which finding(s) indicate that the client is experiencing obstructive shock? Select all that apply.

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

Explanation

A male client informs the nurse he has suddenly stopped taking the glucocorticoid medication without consulting the healthcare provider. The nurse should recognize the client is at risk for developing which condition?

The nurse is planning care for a client who has a fourth degree midline laceration that occurred during vaginal delivery of an 8-pound 10-ounce (3674 grams) infant. Which intervention has the highest priority for this client?

When preparing to administer an intravenous medication through a client's triple lumen central venous catheter, the nurse observes that there are no continuous intravenous fluids infusing. Which action should the nurse take?

The nurse working in a critical care unit (CCU) is assigned the care of two clients, one with pneumonia who is being mechanically ventilated, and the other who had a thoracotomy yesterday and is reporting incisional pain. Which action(s) should the nurse perform first?

A client reports to the nurse about feeling upset because no family or friends have visited in two days. The client then begins to shout and toss small objects toward the nurse. Which defense mechanism should the nurse recognize the client is displaying?

For each assessment finding click to indicate whether these nursing interventions are appropriate or not appropriate. Each column must have at least one response option selected.

Patient Data The client is seen for a 1 week follow up appointment. The nurse is evaluating the response to the treatment for cellulitis. Select the 3 findings consistent with a therapeutic response to interventions.