which intervention is most important for a client with rheumatoid arthritis

ATI LPN

ATI PN Comprehensive Predictor 2023 with NGN

1. Which intervention is most important for a client with rheumatoid arthritis?

A. Massage inflamed joints with creams and oils
B. Provide support to flexed joints with pillows and pads
C. Position the client on their abdomen several times a day
D. Assist with heat application and range of motion exercises

Correct answer: D

Rationale: The most important intervention for a client with rheumatoid arthritis is to assist with heat application and range of motion exercises. Heat application helps reduce stiffness and improve joint flexibility, while range of motion exercises help maintain mobility and prevent contractures. Massaging inflamed joints with creams and oils may provide temporary relief but does not address the root cause of stiffness and limited mobility in rheumatoid arthritis. Providing support to flexed joints with pillows and pads can be helpful for comfort but does not actively promote mobility. Positioning the client on their abdomen several times a day is not a standard intervention for managing rheumatoid arthritis.

2. What are the key differences between hypoglycemia and hyperglycemia?

A. Hypoglycemia: Sweating, trembling; Hyperglycemia: Frequent urination, thirst
B. Hypoglycemia: Increased thirst; Hyperglycemia: Sweating, confusion
C. Hypoglycemia: Increased appetite; Hyperglycemia: Blurred vision
D. Hypoglycemia: Dizziness; Hyperglycemia: Low blood pressure

Correct answer: A

Rationale: Hypoglycemia typically presents with sweating and trembling, while hyperglycemia is characterized by frequent urination and thirst. Therefore, the correct key differences between hypoglycemia and hyperglycemia are that hypoglycemia includes symptoms like sweating and trembling, while hyperglycemia involves symptoms such as frequent urination and thirst. Choices B, C, and D are incorrect because they do not accurately represent the characteristic symptoms of hypoglycemia and hyperglycemia, as stated in the question.

3. A nurse is reinforcing home safety instructions with the parent of a newborn. Which of the following statements should the nurse include in the instructions?

A. Place your baby's crib away from heat vents
B. Place the crib close to a heater
C. Place the crib near a window
D. Place soft toys in the crib

Correct answer: A

Rationale: The correct answer is A: 'Place your baby's crib away from heat vents.' Placing the crib away from heat vents is essential to prevent the baby from becoming overheated and to reduce the risk of Sudden Infant Death Syndrome (SIDS). Choice B is incorrect because placing the crib close to a heater increases the risk of overheating and poses a fire hazard. Choice C is incorrect as placing the crib near a window exposes the baby to drafts and temperature fluctuations. Choice D is incorrect as soft toys in the crib can pose a suffocation risk to the newborn.

4. While performing assessments on newborns in the nursery, which finding should the nurse report to the provider?

A. A two-day old newborn with a respiratory rate of 70.
B. A 16-hour old newborn who has not passed meconium yet.
C. A two-day old newborn with a small amount of blood-tinged vaginal discharge.
D. A 16-hour old newborn with a blood glucose of 45 mg/dL.

Correct answer: A

Rationale: A respiratory rate of 70 in a two-day old newborn is above the normal range and should be reported to the provider. This finding may indicate respiratory distress or another underlying issue that needs prompt attention. Choices B, C, and D are within normal limits for newborns and do not require immediate reporting to the provider.

5. What is the priority when managing a client with a chest tube postoperatively?

A. Clamp the chest tube for 30 minutes every 4 hours
B. Check for air leaks and proper functioning of the chest tube
C. Encourage deep breathing and coughing every 2 hours
D. Encourage frequent coughing to clear secretions

Correct answer: B

Rationale: The priority when managing a client with a chest tube postoperatively is to check for air leaks and ensure the proper functioning of the chest tube. This is crucial to prevent complications such as pneumothorax or hemothorax. Clamping the chest tube intermittently can lead to a buildup of pressure in the pleural space and should not be done without a specific medical indication. Encouraging deep breathing and coughing helps with lung expansion but is not the priority over ensuring the chest tube's proper function. Encouraging frequent coughing may increase the risk of dislodging the chest tube or causing complications.