The joints most commonly involved with rheumatoid arthritis include the

Correct Answer: C

Rationale: In rheumatoid arthritis, the correct answer is C) Small joints of hands and feet. This is because rheumatoid arthritis is a systemic autoimmune disorder that primarily affects the synovial joints, leading to inflammation, pain, and joint deformity. The small joints of the hands and feet are commonly involved due to their complex structure and high degree of mobility, making them more susceptible to the inflammatory process seen in rheumatoid arthritis. Option A) Spine, from the sacrum to the cervical spine, is incorrect because rheumatoid arthritis typically does not primarily affect the spine. Option B) Symmetrical involvement of major joints is incorrect as rheumatoid arthritis tends to affect joints bilaterally, but it is not limited to major joints only. Option D) Slightly movable joints of the axial skeleton is incorrect as rheumatoid arthritis predominantly affects synovial joints rather than the less movable joints of the axial skeleton. Educationally, understanding the specific joints commonly involved in rheumatoid arthritis is crucial for healthcare professionals to accurately assess, diagnose, and provide appropriate care for patients with this condition. Recognizing the characteristic joint involvement patterns can aid in early detection and intervention, ultimately improving patient outcomes and quality of life.

Correct Answer: D

Rationale: In the context of surgery-related stress, the physiological response often includes sodium and water retention, making option D the correct answer. When the body undergoes stress, such as during surgery, the release of stress hormones like cortisol can lead to increased sodium and water retention by the kidneys. This response helps to maintain blood pressure and fluid balance in the body during times of stress. Option A, bronchial constriction, is not typically associated with surgery-related stress. Bronchial constriction is more commonly seen in conditions like asthma or allergic reactions. Decreased cortisol levels, as mentioned in option B, would be an atypical response to surgery-related stress. During stress, cortisol levels usually rise to help the body cope with the increased demands. Peripheral vasodilation, as in option C, is not a typical response to surgery-related stress. In fact, vasoconstriction is more commonly seen in response to stress to help redirect blood flow to vital organs. Understanding the physiological responses to stress in the context of surgery is crucial for nurses and healthcare professionals. Being able to identify these responses helps in providing appropriate care and monitoring post-operative patients for any complications related to the stress response.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) a process analysis. Conducting an audit of nursing records to assess compliance with a hospital policy regarding pre-administration heart rate assessment before giving digoxin is a form of process analysis. Process analysis involves evaluating the steps and procedures followed in a specific process to identify areas for improvement and ensure adherence to established protocols. In this case, the focus is on the process of assessing and recording a patient's heart rate before administering digoxin. Option B) a quality analysis, is incorrect because quality analysis typically involves assessing the overall quality of care provided, not specifically focusing on adherence to a particular policy or procedure. Option C) a system analysis, is incorrect because system analysis involves evaluating the interaction of components within a system, which is not the primary focus of auditing nursing records for compliance with a specific policy. Option D) an outcome analysis, is incorrect as outcome analysis typically involves evaluating the results or impact of a process or intervention, rather than the process itself. Educationally, understanding the distinction between different types of analyses is crucial for healthcare professionals to effectively assess and improve the quality of care delivery. By conducting process analyses like the one described in the question, healthcare organizations can identify and address gaps in practice to enhance patient safety and outcomes.

Correct Answer: B

Rationale: In the context of a suspected stroke, the next immediate step for the patient's care is to obtain a CT scan of the head without contrast (Option B). This is crucial because a CT scan can quickly identify if the stroke is ischemic or hemorrhagic, guiding subsequent treatment decisions. Administering tissue plasminogen activator (Option A) is a time-sensitive intervention for ischemic strokes, but it should only be done after a CT scan rules out hemorrhagic stroke to prevent potential worsening of bleeding. Obtaining a neurosurgical consultation (Option C) and preparing for carotid Doppler ultrasonography (Option D) may be necessary for further management or to assess risk factors, but they are not the immediate next steps in a suspected stroke scenario. From an educational perspective, understanding the sequence of actions in stroke care is vital for nurses to provide safe and effective patient care. This scenario highlights the importance of timely and appropriate diagnostic assessments to inform treatment decisions in acute neurological emergencies.

Correct Answer: A

Rationale: In caring for a client with trigeminal neuralgia, the nurse should select option A, which is to offer small meals of high-calorie soft food. Trigeminal neuralgia causes severe facial pain triggered by activities such as chewing. Therefore, providing small meals of soft, high-calorie foods helps the client meet their nutritional needs without exacerbating their pain. Option B is incorrect because sitting in a chair for meals does not specifically address the dietary requirements related to trigeminal neuralgia. Option C suggesting additional servings of fruits and raw vegetables may be challenging for a client experiencing facial pain and difficulty chewing. Option D recommending specific protein sources like fish, liver, and chicken may not be appropriate if the client experiences pain while chewing these harder foods. Educationally, this question highlights the importance of understanding how certain health conditions impact a client's ability to meet their nutritional needs. Nurses must adapt their approach to nutrition based on the client's specific condition to ensure optimal care and comfort.