A client with rheumatoid arthritis taking hydroxychloroquine (Plaquenil) should be taught that, because of this drug therapy, he should

Correct Answer: B

Rationale: The correct answer is B) have an eye examination every 4-6 months. This is essential because hydroxychloroquine can cause retinopathy, a serious eye condition that can lead to vision loss if not detected early. Regular eye examinations are crucial for monitoring any signs of retinal damage and ensuring prompt intervention if needed. Option A is incorrect because hydroxychloroquine may take several weeks to months to start showing its full effects in managing symptoms of rheumatoid arthritis, so immediate relief within 1-2 weeks is not typical. Option C is incorrect as there is no specific requirement to take hydroxychloroquine before bedtime. The key is to take the medication consistently as prescribed. Option D is also incorrect because while being alert for a skin rash is important when taking any medication, it is not the primary concern associated with hydroxychloroquine therapy in rheumatoid arthritis. In an educational context, it is crucial for healthcare providers to educate patients about the potential side effects of medications they are prescribed, like hydroxychloroquine. Emphasizing the need for regular eye examinations can help prevent serious complications and promote patient safety and well-being. Patients should be empowered with knowledge to actively participate in their treatment and monitoring processes for better health outcomes.

Correct Answer: A

Rationale: In this scenario, the nurse suspects that the client is experiencing problems with circulation, which is the correct answer (Option A). Weak pulses, dusky color in the ankles, and significant local edema are indicative of impaired blood flow to the lower extremities. This could be due to conditions such as peripheral vascular disease or deep vein thrombosis, which can lead to serious complications if not addressed promptly. Option B, problems with sensation, is incorrect in this case because the symptoms described are more closely related to circulatory issues rather than sensory deficits. Problems with sensation would typically involve issues such as numbness, tingling, or loss of feeling in the affected area. Option C, problems with mobility, is also incorrect as the symptoms presented do not directly point to issues with the client's ability to move. While impaired circulation can impact mobility in the long term if left untreated, it is not the primary concern based on the symptoms provided. Option D, problems with pain, is not the most likely issue as the symptoms described are more indicative of compromised blood flow rather than pain perception. While the client may eventually experience pain if circulation is severely compromised, the initial symptoms point more towards circulatory issues. From an educational perspective, understanding the signs and symptoms of circulatory problems in the lower extremities is crucial for nurses working in various clinical settings. Recognizing these indicators early can help prevent complications such as tissue damage, ulceration, and even amputation. Nurses should be able to differentiate between circulatory issues, sensory deficits, mobility problems, and pain to provide timely and appropriate care to their patients.

Correct Answer: D

Rationale: In the context of positioning a client with a fracture, it is crucial to ensure that the joints are positioned in an anatomic alignment to prevent damage to the peripheral nerves and blood vessels, making option D the correct answer. When joints are not in proper alignment, there is a risk of compression or injury to the surrounding nerves and blood vessels due to increased pressure or tension on these structures. This can lead to complications such as impaired circulation, numbness, tingling, or even more serious nerve damage. Option A, to prevent deep vein thrombosis, is incorrect in this scenario because deep vein thrombosis is more related to immobility and blood clot formation in the deep veins, rather than joint alignment. Option B, to facilitate lung expansion and prevent pooling of secretions, is not directly related to joint alignment in a client with a fracture. Option C, to prevent the escalation of pain and swelling, is important but not the primary reason for ensuring anatomic alignment of joints. Educationally, understanding the rationale behind proper positioning in clients with fractures is essential for nurses to provide safe and effective care, prevent complications, and promote optimal healing and recovery. It highlights the importance of attention to detail and precision in nursing interventions to promote positive patient outcomes.

Correct Answer: A

Rationale: The correct answer is A) Swelling due to the initial trauma may make the injury seem more severe than it actually is. A more accurate assessment will be made once the swelling goes down. This response is the best because in cases of acute trauma such as an automobile accident, immediate swelling and inflammation can mask the true extent of the injury. It is important to wait until the swelling decreases to assess the patient's condition accurately. Jumping to conclusions or making assumptions based on initial presentation can lead to incorrect diagnoses and inappropriate interventions. Option B is incorrect because it is a simplistic explanation that does not consider the complexity of the situation. It does not provide a comprehensive or accurate assessment of the patient's condition. Option C is incorrect because while rehabilitation centers may be beneficial for some patients, the immediate concern in this situation is assessing the extent of the injury and providing appropriate acute care. Option D is incorrect because it is not relevant to the immediate medical assessment and care needed for the patient's current condition. It is important to focus on the patient's current symptoms and needs rather than placing blame or discussing preventative measures at this moment. In an educational context, this question highlights the importance of thorough assessment and critical thinking in emergency situations. It emphasizes the need to consider factors such as swelling and initial presentation when evaluating a patient's condition. It also underscores the significance of avoiding premature conclusions and ensuring a comprehensive evaluation before determining a course of action.

Correct Answer: C

Rationale: In the context of preparing a patient with carpal tunnel syndrome for surgery, delegating assisting the patient with daily self-care measures such as bathing and eating to the nursing assistant is the most appropriate intervention. This task falls within the scope of the nursing assistant's role and is essential for ensuring the patient's comfort and hygiene during the pre-operative period. Option A, initiating the placement of a splint for immobilization during the day, involves a more specialized skill that should be performed by a licensed healthcare provider, such as a nurse or physician. While assessing the patient's wrist and hand for discoloration and brittle nails (Option B) is important in the overall assessment of carpal tunnel syndrome, it is not directly related to preparing the patient for surgery. Testing the patient for painful tingling in the four digits of the hand (Option D) is a clinical assessment task that requires specialized knowledge and should be performed by a nurse or healthcare provider. Delegating appropriate tasks to the nursing assistant not only optimizes the efficiency of care but also ensures that each team member is working within their scope of practice, promoting safe and effective patient care.