unit 3
A nurse is assessing a client who has systemic lupus erythematosus (SLE). Which of the following findings is the highest priority for the nurse to report to the provider?
Presence of peripheral edema.
What is glaucoma characterized by?
Ocular nerve damage
A nurse in a provider's office is assessing a client who has rheumatoid arthritis. Which of the following findings is a late manifestation of this condition?
knuckle deformity
A nurse is teaching a group of clients about osteoarthritis. Which of the following recommendations should the nurse include in the teaching?
maintain a recommenced body weight
A nurse is assessing a client who has systemic lupus erythematosus. Which of the following findings is the highest priority for the nurse to report to the provider?
presence of peripheral edema
A nurse is teaching a client who has rheumatoid arthritis about self-care strategies for managing the diseases. Which of the following activities should the nurse include in the teaching?
press water from a sponge rather than wringing it
What is the most common medication used for treating glaucoma? A) Diuretics B) Stimulants C) Antipyrine D) Timolol
D
A nurse is providing teaching to a client who has gout and a new prescription for allopurinol. Which of the following statements by the client indicates an understanding of the teaching? -"If I get a rash from this medication, I will take my usual antihistamine." -"I need to increase my fluid intake while taking this medication." -"I should take this medicine on an empty stomach." -"If I get a fever while taking this medication, I will take some aspirin
"I need to increase my fluid intake while taking this medication.
A nurse is teaching a client how to follow a low-purine diet as prescribed by the provider for the management of gout. Which of the following statements indicates the client understands the teaching?
"I should avoid eating liver and other organ meats."
A nurse is reviewing the cause of gout with a group of nurses. Which of the following statements should the nurse make?
"The intra-articular deposition of urate crystals causes inflammation."
A nurse is planning care for a client who has a detached retina and is pre-operative for a surgical repair. The nurse should prepare to administer which of the following medications? A)Phenylephrine B) latanoprost C) pocarpine D) timolol
A
A nurse is providing education for a client who has glaucoma. Which of the following statements should the nurse in clued in the teaching? A) without treatment glaucoma can cause blindness B) double vision is a common sign of glaucoma C) glaucoma is caused by inadequate production of fluid within the eye D) use of eyedrops will improve vision overtime
A
The nurse is developing a plan of care for a client who is postoperative following a pneumatic retinopexy to repair a detached retina. Which of the following intervention should the nurse include in the plan? A) position the client prone B) encourage the client to cough and deep breathe C) keep both eyes bandage D) provide a magazine for the client to read during recovery
A
The nurse is teaching a group of older adults about basic eye examinations. What would the nurse recommend about the frequency for eye examinations for most people over 65 years of age? a. Every 1 to 2 years b. Every 2 to 4 years c. Every 3 to 5 years d. When the primary health care provider recommends
A
What are the 4 major symptoms of glaucoma? A) Scotoma, loss of peripheral vision, blurred vision, difficulty adjusting to low lighting B) Scotoma, loss of peripheral vision, blurred vision, difficulty adjusting to bright rooms C) Scotoma, peripheral vision improves, blurred vision increases, difficulty adjusting to low lighting B) Scotoma, loss of peripheral vision, sees floaters, difficulty adjusting to bright rooms
A
A clinic nurse is performing a physical assessment on a client who has systemic lupus erythematosus (SLE). Which of the following findings should the nurse expect?
A dry, red rash across the bridge of the nose and on the cheeks.
What are some symptoms of retinal detachment? (Select all that apply) A) bright flashes of lights B) increased amounts of floaters C) nausea D) cobwebs E) shade of a curtain coming over the eye
A) bright flashes of lights B) increased amounts of floaters D) cobwebs E) shade of a curtain coming over the eye
What can the nurse teach to avoid increased IOP (select all that apply) A) squeezing eyes tightly B) staring with eyes open C) rolling eyes D) reading E) blinking
A) squeezing eyes tightly B) rolling eyes E) blinking
SATA the nurse is caring for a client being treated for hodgkin lymphoma. for which side effect of treatment will the nurse assess? a. severe nausea and vomiting b. low platelet count c. skin irritation at radiation site d. low RBC e. high WBC
A,B,C,D
The nurse is assessing a client for signs and symptoms of systemic lupus erythematosus (SLE). Which of the following would be consistent with this disorder? (Select all that apply.) a. Discoid rash on skin exposed to sunlight b. Urinalysis positive for casts and protein c. Painful, deformed small joints d. Pain on inspiration e. Thrombocytosis f. Serum positive for antinuclear antibodies (ANA)
A,B,D,F
A nurse caring for clients with systemic lupus erythematosus (SLE) plans care understanding the most common causes of death for these clients is which of the following? (Select all that apply.) a. Infection b. Cardiovascular impairment c. Vasculitis d. Chronic kidney disease e. Liver failure f. Blood dyscrasias
B and D
A client is about to start taking celecoxib(Celebrex) to treat osteoarthritis symptoms. The nurse should instruct the client to watch for and report which of the following possible indications of a serious reaction to this drug? A. Bone pain B .Dry mouth C. Polyuria D. Black,tarry stools
D
A client is taking timolol eyedrops . The nurse assess the clients's pulse at 48 beats/min. What action by the nurse is the priority? a. Ask the client about excessive salivation b. Take the client's blood pressure and temperature c. Giv ethe drops using punctual occlusion d. Hold the eyedrops and notify the primary health care provider
D
A nurse is caring for a client who has developed gout. Which of the following medications should the nurse prepare to administer? -Zolpidem -Alprazolam -Spironolactone -Allopurinol
D
A nurse is teaching the client with systemic lupus erythematosus about prednisone. What information is the priority? a. Might make the client feel jittery or nervous. b. Can cause sodium and fluid retention. c. Long-term effects include fat redistribution. d. Never stop prednisone abruptly.
D
The nurse assesses a client for factors that place the client at risk for cataracts. Which factor places the client at the highest risk for cataract development? a. Heart disease b. Glaucoma c. Diabetes mellitus d. Advanced age
D
nurse is caring for an older adult client who has rheumatoid arthritis and is taking aspirin 650 mg every 4 hrs. Which of the following diagnostic tests should the nurse monitor to evaluate the effectiveness of this medication?
ESR
A nurse is teaching a client who has a new diagnosis of gout about managing the disorder. Which of the following instructions should the nurse include in the teaching?
Eat less liver, sardines, and shrimp.
A nurse is providing teaching a client who has rheumatoid arthritis and a new prescription for methotrexate. Which of the following instructions should the nurse include? Expect to feel the medication's effects immediately. Do not drink alcoholic beverages while taking this medication. Report unexplained bruising to the provider. Avoid people who have infections. Take NSAIDS to help minimize the adverse effects of the medication.
Expect to feel the medication's effects immediately is incorrect. It may take 3 to 6 weeks to achieve the medication's therapeutic effects. Do not drink alcoholic beverages while taking this medication is correct. Report unexplained bruising to the provider is correct. Avoid people who have infections is correct. Take NSAIDs to help minimize the adverse effects of the medication is incorrect. NSAIDs interact with methotrexate and should be avoided. Providers sometimes prescribe folic acid to help minimize the side effects of methotrexate.
A nurse is caring for a female client who has rheumatoid arthritis and a new prescription for methotrexate. The client tells the nurse she is planning a pregnancy. Which of the following instructions should the nurse give the client?
The medication should be discontinued 3 months prior to a planned pregnancy.
A nurse is performing discharge teaching for a client who has systemic lupus erythematosus (SLE). Which of the following instructions should the nurse include?
Use a sun-blocking agent with a sun protection factor of at least 15."
A nurse is reviewing laboratory values for a client who has systemic lupus erythematosus (SLE). Which of the following values should give the nurse the best indication of the client's renal function?
serum creatinine
A nurse is providing discharge teaching to a client who has systemic lupus erythematosus (SLE). Which of the following instructions should the nurse include?
wash the hair with a mild protein shampoo
A nurse is providing teaching to a client who has a new prescription for hydroxychloroquine to treat mild manifestations of rheumatoid arthritis. Which of the following information should the nurse include in the teaching?
wear sunglasses when out in bright light
A nurse is teaching a client who has a new prescription for aspirin to treat rheumatoid arthritis. The nurse should include to monitor for which of the following adverse effects of this medication? -Constipation -Bleeding -Blurred vision -Insomnia
bleeding
A nurse is assessing a client who has systemic lupus erythematosus an dis taking hydroxychloroquine. The nurse should report which of the following adverse effects to the provider immediately?
blurred vision
A nurse is assessing a client who has systemic lupus erythematosus and is taking hydroxychloroquine. The nurse should report which of the following adverse effects to the provider immediately?
blurred vision
The nurse is teaching a client about cataract surgery. Which statement would the nurse include as part of preoperative preparation? a. "You will receive general anesthesia for the surgical procedure." b. "You will be in the hospital for only 1 to 2 days if everything goes as expected." c. "You will need to put several types of eyedrops in your eyes before and after surgery." d. "You will be on bedrest for about a week after the surgical procedure.
c
what is the nurses's priority when caring for a client who just complete a bone marrow aspiration and biopsy? a. teach the client to avoid activity for 24 to 48 hours to prevent infection b. administer a NSAID to promote comfort c. check the pressure dressing frequently for signs of excessive or active bleeding d. report the lab results to the primary health care provider
c
A nurse is caring for a client who has a new diagnosis of systemic lupus erythematosus and asks where this disease originates within the body. The nurse should tell the client that SLE originates in which of the following locations in the body
connective tissue
A nurse is caring for a client who has cancer and is receiving palliative care. Which of the following statements by the client indicates they understand this type of treatment?
i am hoping this will limit my discomfort
A nurse in a medical clinic is providing teaching to an older adult client who has osteoarthritis that is affecting her knees. Which of the following client statements indicates an understanding of the teaching?
i can use either heat or ice to help relieve the discomfort
A nurse is reviewing discharge instructions with a client who has rheumatoid arthritis and a new prescription for prednisone. Which of the following statements by the client indicates an understanding of the teaching?
i should eat more bananas while taking this medication
A nurse is completing discharge instructions with a client following an acute onset of gout. Which of the following client statements indicates an understanding of the treatment regimen?
i will limit my alcohol intake
A nurse is teaching a client who has a new prescription for colchicine to treat gout. Which of the following instructions should the nurse include?
monitor for muscle pain
A nurse is completing a physical assessment of a client who has early osteoarthritis. Which of the following manifestations should the nurse expect?
pain worsens with activity
A nurse is teaching a client who has rheumatoid arthritis about increasing physical rest as part of her treatment plan. Which of the following outcomes of this intervention should the nurse document as a goal for this client?
reduced joint stress
A client has been prescribed brinzolamide for glaucoma. What assessment by the nurse requires communication with the primary health care provider? a.Allergy to eggs b. Allergy to sulfonamides c. Use of contact lenses d. Use of beta blockers
B
A home health nurse is assessing an older adult client in the home who has decreased vision due to a history of glaucoma. Which of the following findings should the nurse identify as a safety risk? A) electrical cords that are placed along the walls B) scattered rugs that are present in the kitchen C) handrails are present in the kitchen D) a microwave for cooking
B
A nurse is teaching a client who has rheumatoid arthritis about taking methotrexate. Which of the following information should the nurse include? -Take an antiemetic 1 hr following administration. -Drink 2 to 3 L of water per day. -Take the medication with an NSAID. -Rinse mouth 2 times per day with an alcohol based mouthwash.
B
the client is taking celecoxib for osteoarthritis, he knows to watch for and report which of the following possible indications of an adverse reaction to celecoxib? a. tinnitus b. weight gain c. anxiety d. tremor
B
the nurse is assessing a client who has probable lymphoma. what is the most common early assessment finding for clients with this disorder? a. weight gain b. enlarged painless lymph nodes c. fever at night d. nausea and vomiting
B
A client has been newly diagnosed with systemic lupus erythematosus and is reviewing self-care measures with the nurse. Which statement by the client indicates a need to review the material? a. "I will avoid direct sunlight as much as possible." b. "Baby powder is good for the constant sweating." c. "Grouping errands will help prevent fatigue." d. "Rest time will have to become a priority."
B
A nurse is providing teaching a client who has rheumatoid arthritis and a new prescription for methotrexate. Which of the following instructions should the nurse include? (Select all that apply.) A.Expect to feel the medication's effects immediately. B.Do not drink alcoholic beverages while taking this medication. C.Report unexplained bruising to the provider. D.Avoid people who have infections. -E.take NSAIDS to help minimize the adverse effects of the medication.
B,C,D
A client with a family history of glaucoma asks the nurse how to prevent glaucoma? What statement by the nurse is appropriate? a. "You should check with your primary health care provider about eye examination." b. "You should have genetic testing to determine your risk for glaucoma." c. "You should have your intraocular pressure measured once or twice a year." d. "You should check with your primary health care provider about preventive drug therapy.
C
A client's intraocular pressure (IOP) is 28 mm Hg. What action would the nurse anticipate? a. Educate the client on corneal transplantation. b. Facilitate scheduling the eye surgery c. Teach about drugs for glaucoma. d. Refer the patient to local Braille classes.
C
A nurse at an Ophthalmic G clinic is providing teaching to a client who has an open angle glaucoma and a new prescription for timolol eye drops. Which of the following instruction should the nurse provide? A) the medication is to be applied when the client is expressing our pain B) the medication will be used into the client in ocular pressure return to normal C) the medication should be applied on a regular schedule for the rest of the clients life D) the medication is to be used for approximately 10 days following a gradual tapering off
C
A nurse is at an ophthalmology clinic is providing teaching to a client who has an open angle glaucoma and a new treatment regimen of Timolol and pilocarpine eye drops. Which of the following instruction should the nurse provide? A) administer the medication by touching the tip of the dropper to the square of the I B) hold pressure on the conjunctiva sac for two minutes following the application drop C) administer the medication five minutes apart D) it is not necessary to remove contact lenses before administering
C
The nurse is administering timolol Eyedrops to a client who has glaucoma. Which of the following actions should the nurse take? A) apply pressure to the bridge of the nose after administering B) wipe the eye from the outer campus to the inner canthus before installation C) drop the prescribed amount of medication into the conjunctiva sac D) protect the distal portion of the eyedropper using clean technique
C
A nurse is teaching a client who is to begin long-term therapy with prednisone to treat rheumatoid arthritis. The nurse should instruct the client to take which of the following supplements while taking this medication?
Calcium and vitamin D
The nurse is teaching about signs and symptoms of cataracts. Which change would the nurse emphasize as possibly indicating beginning cataract formation? a. Diplopia b. Cloudy pupil c. Loss of peripheral vision d. Blurred vision
D
which statement by a client with leukemia indicates a need for further teaching by the nurse? a. i will use a soft-bristled toothbrush and avoid flossing b. i will not take aspirin or any aspirin product c. i will use an electric shaver instead of my manual one d. i will take a daily laxative to prevent constipation
D
A nurse is planning care for a client one day postoperative following a detached retina repair. Which of the following instruction should the nurse include in the plan? A) encourage coughing and deep breathing B)allow the client ambulate C) remove the eyepatch during the day D) avoid reading and writing
D) avoid reading and writing
A nurse is caring for a female client who has rheumatoid arthritis and asks the nurse if it is safe for her to take aspirin. The nurse should recognize which of the following findings in the client's history is a contraindication to this medication? -Report of recent migraine headaches -History of gastric ulcers -Current diagnosis of glaucoma -Prior reports of amenorrhea
History of gastric ulcers
A nurse is caring for a client who is taking naproxen following an exacerbation of rheumatoid arthritis. Which of the following statements by the client requires further discussion by the nurse?
I've been taking an antacid to help with indigestion."
A nurse in a clinic is talking with a client who has a new diagnosis of osteoarthritis. The nurse should anticipate that the client will require teaching about which of the following medications?
acetaminophen
A nurse is teaching a client about risk factors for osteoarthritis. Which of the following factors should the nurse include in the teaching? (Select all that apply.)
aging, obesity and smoking
an CNA is caring for a client with leukemia and asks why the client is still at risk for infection when the WBC count is high. what response by the nurse is correct? a. if the WBCs are high, there already is an infection present b. the client is in a blast crisis and has too many WBC c. there must be a mistake; the WBC should be very low d. those WBC are abnormal and dont provide protection
d
A nurse is teaching a client who has a new prescription for prednisone to treat rheumatoid arthritis. The nurse should inform the client that which of the following is a therapeutic effect of this medication? -Reduces risk of infection -Decreases inflammation -Improves peripheral blood flow -Increases bone density
decrease inflammation
A nurse is teaching a female client who has a new diagnosis of systemic lupus erythematosus (SLE). The nurse should recognize the need for further teaching when the client identifies which of the following as a factor that can exacerbate SLE?
exercise
A nurse is assessing a client for early manifestations of rheumatoid arthritis. Which of the following changes is an early manifestation of RA? FatigueFatigue, weakness, and anorexia are early manifestations of RA.
fatigue
