Adult HELLth Exam 2

A

A nurse is performing an admission health history and physical assessment for a client who has severe rheumatoid arthritis. When assessing the client's hands, the nurse identifies that they are similar to the hand in the illustration. What should the nurse document in the medical record when describing this typical physiologic change associated with rheumatoid arthritis? A. Ulnar drift B. Hallux valgus C. Swan-neck deformity D. Boutonnière deformity

ACD

A client is admitted with full-blown anaphylactic shock that developed due to a type 1 latex allergic reaction. Which findings will the nurse observe upon assessment? *Select all that apply.* A. Stridor B. Fissuring C. Hypotension D. Dyspnea E. Cracking of the skin

A

A nurse plans care to prevent deformities in a client with rheumatoid arthritis. Which intervention should be alternated with periods of rest? A. Active exercises B. Passive massage C. Bracing of joints D. Isometric exercises

AD

A primary healthcare provider schedules a bone scan for a client with osteoporosis. Which nursing actions are beneficial for the client *Select all that apply.* A. Placing the client in the supine position B. Verifying if the client has a shellfish allergy C. Ensuring that the client has no metal on the clothing D. Instructing the client to empty the bladder before the scan E. Informing the client that the postprocedure headache resolves in 2 days

C

A client admitted to the hospital with an acute episode of rheumatoid arthritis (RA) asks why physical therapy has not been prescribed. What is the most appropriate nursing response? A. "Your primary healthcare provider must have forgotten to prescribe it." B. "Your condition is not severe enough to have physical therapy approved." C. "Your joints are still inflamed, and physical therapy can be harmful." D. "Physical therapy is not helpful for persons who suffer from RA."

BE

A client with a fracture is found to have compartment syndrome. Which interventions will be contraindicated? *Select all that apply.* A. Splitting the cast in half B. Applying cold compresses C. Reducing the traction weight D. Loosening the client's bandage E. Elevating the extremity above heart level

D

A client with rheumatoid arthritis asks the nurse about ways to decrease morning stiffness. What should the nurse suggest? A. Wearing loose but warm clothing B. Planning a short rest break periodically C. Avoiding excessive physical stress and fatigue D. Taking a hot tub bath or shower in the morning

A

A client with rheumatoid arthritis has been taking a steroid medication for the past year. For which complication of prolonged use of this medication should the nurse assess the client? A. Decreased white blood cells B. Increased C-reactive protein C. Increased sedimentation rate D. Decreased serum glucose levels

A

A client with rheumatoid arthritis is to begin taking ibuprofen 800 mg by mouth three times a day. The nurse provides education about the medication's side effects. The nurse concludes that the teaching was effective when the client makes which statement? A. "I need to have my blood work checked periodically." B. "I need to balance exercise with rest." C. "I need to change positions slowly." D. "I need to take the medication between meals."

D

A nurse is taking the health history of a client who is to have surgery in one week. The nurse identifies that the client is taking ibuprofen for discomfort associated with osteoarthritis and notifies the healthcare provider. Which drug does the nurse expect will most likely be prescribed instead of the ibuprofen? A. Naproxen B. Aspirin C. Ketorolac D. Acetaminophen

A

A student nurse is teaching a client about preventive measures for Lyme disease. Which instruction given by the student nurse indicates a need for correction? A. "Wear dark colored dresses." B. "Wear closed shoes or boots." C. "Tuck your shirt into your pants." D. "Bathe immediately after being in an infested area."

CDE

After providing epinephrine to a client experiencing an anaphylactic reaction, which second-line drugs should the nurse prepare to provide? *Select all that apply.* A. Dopamine B. Norepinephrine C. Dexamethasone D. Diphenhydramine hydrochloride E. Hydrocortisone sodium succinate

D

After treatment for Lyme disease, a child expresses fear of going camping again because of the ticks. What is the best response by the nurse? A. "Tell me more about your fears about camping." B. "Just think of all the fun you'll be missing if you don't go to camp." C. "It's hard to believe you're afraid to go camping just because of a tick." D. "I understand you are afraid. Frequently checking for ticks can help prevent re-infection."

A

The nurse considers that a 70-year-old female client can best limit further progression of osteoporosis by doing what? A. Taking supplemental calcium and vitamin D B. Increasing the consumption of eggs and cheese C. Taking supplemental magnesium and vitamin E D. Increasing the consumption of milk and milk products

CD

The nurse is assessing a client with severe nodule-forming rheumatoid arthritis for possible Felty syndrome. Which assessment findings are consistent with Felty syndrome? *Select all that apply.* A. Itchy eyes B. Dry mouth C. Leukopenia D. Spenomegaly E. Photosensitivity

B

The nurse is preparing an individualized teaching plan for a client with osteoarthritis. The nurse recognizes which abnormality specific to osteoarthritis? A. Ulnar drift B. Heberden nodes C. Swan-neck deformity D. Boutonnière deformity

A

The nurse is providing education to a client with systemic lupus erythematosus. Which education will the nurse consider as high priority? A. Instructing about ways to protect the skin B. Helping the client to identify coping strategies C. Teaching methods to monitor body temperature D. Teaching about the effects of the disease on lifestyle

BCD

Which symptoms are observed in a client with Sjögren's syndrome? *Select all that apply.* A. Angioedema B. Tooth decay C. Corneal ulcers D. Vaginal dryness E. Pulmonary hemorrhage

B

A client is experiencing an exacerbation of systemic lupus erythematosus. To reduce the frequency of exacerbations, what would be important for the nurse to include in the client's teaching plan? A. Basic principles of hygiene B. Techniques to reduce stress C. Measures to improve nutrition D. Signs of an impending exacerbation

D

A client reports redness, itching, burning, and pain in the palms and elbows. On assessing, the nurse finds demarcated, silvery, scaling plaques in the area. Which drug does the nurse expect in the client's prescription? A. Oral famcyclovir B. Intravenous ceftriaxone C. Topical benzoyl peroxide D. Intralesional injection of corticosteroids

B

A client experiences an acute episode of rheumatoid arthritis. The nurse observes that the client's finger joints are swollen. The nurse concludes that this swelling most likely is related to which factor? A. Urate crystals in the synovial tissue B. Inflammation in the joint's synovial lining C. Formation of bony spurs on the joint surfaces D. Deterioration and loss of articular cartilage joints

BCD

A client is admitted to the emergency department with joint pain and swelling. Upon assessment the nurse suspects rheumatoid arthritis. Which findings support the nurse's conclusion? *Select all that apply.* A. Obesity B. Antinuclear antibodies C. Inflammatory disease pattern D. Disease in the bilateral symmetric joints E. Disease in the distal intrapharyngeal joints F. Disease in the weight-bearing joints and hands

B

A client suffered an injury to the leg as a result of a fall. X-ray films indicate an intertrochanteric fracture of the femur. The client will be placed in Buck traction until surgery is performed. When considering the client's plan of care, the nurse recalls that the primary purpose of Buck traction is to do what? A. Reduce the fracture. B. Immobilize the fracture. C. Maintain abduction of the leg. D. Eliminate rotation of the femur.

C

An older adult fell at home and fractured the left hip. Which response should the emergency department nurse identify as a typical clinical indicator associated with a fractured hip? A. Affected hip is ecchymotic. B. Left extremity is internally rotated. C. Left leg is noticeably shorter than the right. D. Affected hip is tender when touched.

A

What does the nurse suspect from the image? A. Rash due to tick bite B. Rash due to bee sting C. Rash due to bedbug bites D. Rash due to body lice bites

C

What type of hypersensitivity reaction is the cause of systemic lupus erythematosus? A. Type I B. Type II C. Type III D. Type IV

AB

Which are examples of a type IV hypersensitivity reaction? *Select all that apply.* A. Poison ivy allergic reaction B. Sarcoidosis C. Myasthenia gravis D. Rheumatoid arthritis E. Systemic lupus erythematosus

AB

Which conditions may result from immunoglobulin IgE antibodies on mast cells reacting with antigens *Select all that apply.* A. Asthma B. Hay fever C. Sarcoidosis D. Myasthenia gravis E. Rheumatoid arthritis

BCD

Which emergency care actions are priority for a hospitalized client who develops an anaphylactic reaction after receiving a medication? *Select all that apply.* A. Raise the feet and legs. B. Assess the respiratory status. C. Call the Rapid Response Team. D. Discontinue the intravenous drug. E. Keep the head of the bed elevated to 10 degrees.

B

Which nursing intervention is most appropriate for a client in skeletal traction? A. Add and remove weights as the client desires. B. Assess the pin sites at least every shift and as needed. C. Ensure that the knots in the rope are tied to the pulley. D. Perform range of motion to joints proximal and distal to the fracture at least once a day.