Which of the following is a common complication associated with long-term corticosteroid use in patients with rheumatoid arthritis?

Correct Answer: A

Rationale: Long-term corticosteroid use in patients with rheumatoid arthritis can lead to osteoporosis, which is a common complication. Osteoporosis causes weakening of the bones, increasing the risk of fractures, particularly in weight-bearing bones such as the hip, spine, and wrist. Osteoporotic fractures are a significant concern in patients on long-term corticosteroid therapy, highlighting the importance of monitoring bone health and considering preventive measures such as calcium, Vitamin D supplementation, and regular bone density testing. While osteonecrosis of the femoral head and avascular necrosis of the talus can also occur as complications of corticosteroid use, osteoporotic fractures are more commonly associated with this type of therapy in patients with rheumatoid arthritis. Septic arthritis, on the other hand, is not directly related to corticosteroid use but can occur due to other factors such as joint infections.

Correct Answer: A

Rationale: The Family Coping Index is a tool designed to assess the strategies that a family uses to deal with stressful situations. It focuses on how families manage and cope with stress and challenges, rather than solely on their interactions, health management, or health habits. By identifying the family's coping strategies, healthcare professionals can better understand the family dynamics and provide targeted support and interventions to help them navigate difficult circumstances.

Correct Answer: A

Rationale: The death of Lory is the precipitating factor for Ella's feeling of wanting to die. Losing someone close to us can lead to feelings of profound sadness, grief, and hopelessness, which may trigger thoughts of wanting to die. The impact of losing a loved one can be devastating and overwhelming, often leading individuals to question the meaning of life and their own mortality. In Ella's case, the death of Lory has likely caused a significant emotional upheaval, contributing to her desire to end her own life. It is essential to address these feelings of loss and provide support and intervention to help Ella cope with her grief and prevent any self-harm.

Correct Answer: B

Rationale: Option B, "Maintaining professional boundaries helps protect both patients and nurses," indicates an understanding of the importance of professional boundaries in nursing practice. Professional boundaries define the limits of the nurse-patient relationship and help ensure that interactions are safe, therapeutic, and based on the patient's best interest. By maintaining these boundaries, nurses can uphold ethical standards, prevent harm, and maintain trust with patients. It also helps prevent issues such as transference, countertransference, and breaches of confidentiality. Overall, understanding and respecting professional boundaries are essential for promoting the well-being of both patients and healthcare providers.

Correct Answer: C

Rationale: The most appropriate nursing action in this situation is to notify the healthcare provider immediately. The symptoms the postpartum client is experiencing - persistent, severe abdominal pain, distention, and absent bowel sounds - are concerning and could indicate a serious underlying issue such as bowel obstruction or other complications. Prompt communication with the healthcare provider is crucial to ensure the client receives the necessary assessment, intervention, and treatment. Encouraging ambulation, providing a heating pad, or administering a laxative are not appropriate actions in this case without first consulting with the healthcare provider due to the severity and potential complexity of the client's symptoms.

Correct Answer: C

Rationale: The appropriate and recommended site for insulin injection to help avoid hypoglycemia is the abdominal wall subcutaneously. This site offers a consistent and reliable rate of absorption of insulin into the bloodstream. By injecting insulin into the abdominal wall subcutaneously, it allows for better control of blood sugar levels and reduces the risk of hypoglycemia. Additionally, it is important to rotate injection sites within the chosen area to prevent the development of lipohypertrophy (thickened, rubbery areas under the skin), which can affect insulin absorption.

Correct Answer: C

Rationale: The best approach in dealing with a nurse who is resistant to change and not actively participating is to communicate and encourage verbalizing feelings about the change. By talking with the nurse and allowing them to express their concerns and feelings, you can address any underlying issues that may be causing the resistance. This approach can help build trust, improve communication, and ultimately increase the nurse's engagement in the change process. Coercion (Choice A) can create negative feelings and resistance, while ignoring the nurse's resistance (Choice D) will not resolve the issue. Providing positive rewards (Choice B) may be helpful but may not address the underlying reasons for resistance. Communication is key in addressing resistance to change and fostering a positive, open environment for all involved.

Correct Answer: C

Rationale: The most effective plan would be for the nurse to educate the entire family at the same time about the disease and medications to treat it (Option C). This approach ensures that each family member receives the same information and understanding about obsessive compulsive disorder (OCD) and its treatment. By educating the entire family simultaneously, it creates a supportive environment where everyone is on the same page and can provide understanding and assistance to the individual with OCD, in this case, Mrs. Juan. It also allows for open communication and collaboration within the family unit, leading to better management and support for Mrs. Juan in dealing with her illness.

Correct Answer: D

Rationale: Informed consent is a critical ethical requirement in research involving human participants. In this study scenario, it is crucial that both the participants and their parents provide consent. The involvement of the parents is important, especially when the participants are minors or vulnerable individuals who may not fully understand the study's implications or risks. By obtaining consent from both the participants and their parents, researchers can ensure that everyone involved is aware of what participation in the study entails, including any potential risks or benefits. This approach upholds the principles of autonomy, respect for individuals, and ethical research conduct.