The healthcare provider prescribes naproxen (Naprosyn) 500 mg PO twice a day for a client with osteoarthritis. During a follow-up visit one month later, the client tells the nurse, 'The pills don't seem to be working. They are not helping the pain at all.' Which factor should influence the nurse's response?

Correct Answer: D

Rationale: Step 1: NSAID response is variable - Different individuals respond differently to NSAIDs like naproxen due to genetic and physiological differences. Step 2: Trying another NSAID may be more effective - If the current NSAID is not effective, switching to a different one with a different mechanism of action may provide better pain relief. Step 3: Individualized approach - Tailoring the treatment to the individual's response is key in managing osteoarthritis pain effectively. Summary: Choice D is correct as it acknowledges the variability in NSAID response and suggests trying another NSAID if the current one is ineffective. Choices A, B, and C are incorrect as they do not address the variable response to NSAIDs and do not provide a solution to address the lack of pain relief.

Correct Answer: B

Rationale: The correct answer is B: Assess pulses, paresthesia, and paralysis distal to the right knee. This is the appropriate action because the client presents with warm, edematous right knee and calf, indicating a potential vascular issue like deep vein thrombosis (DVT). Assessing pulses, paresthesia, and paralysis distal to the right knee helps evaluate circulation and nerve function, crucial in identifying complications of DVT. Glasgow Coma Scale (A) is used to assess consciousness, not relevant in this case. Assessing proximal pulses, paresthesia, and paralysis (C) may not provide accurate information about circulation distal to the knee. Evaluating the optic nerve (D) using an ophthalmoscope is unrelated to the client's presenting symptoms and medical history.

Correct Answer: D

Rationale: The correct answer is D: Teach them to limit sugar and caffeine intake. Rationale: 1. Sugar and caffeine intake can exacerbate anxiety and interfere with sleep due to their stimulant effects. 2. Limiting these substances can help regulate the body's energy levels and reduce anxiety symptoms. 3. By teaching the client to limit sugar and caffeine intake, the nurse is addressing the root causes of the client's sleeplessness and anxiety. Summary: A: Encouraging daily rituals may provide structure but does not directly address the physiological effects of sugar and caffeine on anxiety. B: Reinforcing the reality of the financial situation may increase anxiety rather than alleviate it. C: Drinking red wine at bedtime is not a recommended solution for managing anxiety and sleeplessness.

Correct Answer: C

Rationale: The correct answer is C: Pulse rate of 56 BPM. A normal finding for a primigravida client 12 hours postpartum would be a lower pulse rate as the body is recovering from childbirth. A pulse rate of 56 BPM is within the normal range for an adult. A: Soft, spongy fundus would be a concerning finding as it could indicate uterine atony. B: Saturating two perineal pads per hour would be excessive bleeding and could indicate postpartum hemorrhage. D: Unilateral lower leg pain could be a sign of deep vein thrombosis, which is a potential complication postpartum.

Correct Answer: B

Rationale: The correct answer is B: "The medication will help you think more clearly." This is the most appropriate statement to educate the client about clozapine. Clozapine is an antipsychotic medication used to treat schizophrenia and helps with cognitive symptoms such as disorganized thinking. Choice A is too vague and doesn't specify the medication's intended effect. Choice C is too general and doesn't focus on cognitive improvement. Choice D is incorrect as clozapine does not specifically target grooming and hygiene but rather cognitive symptoms.