Which of the following nonpharmacological methods cannot be used to manage the chronic pain of a client with rheumatoid arthritis?

Correct Answer: D

Rationale: In managing chronic pain in clients with rheumatoid arthritis, it is essential to employ evidence-based nonpharmacological methods. The correct answer, option D, "Ice for 2 hours at a time," is not recommended for managing rheumatoid arthritis pain. Ice application for such an extended period can potentially lead to skin damage, worsen joint stiffness, and exacerbate pain in individuals with arthritis. On the other hand, options A, B, and C are appropriate nonpharmacological methods for managing chronic pain in rheumatoid arthritis. Adequate rest helps in reducing inflammation and promoting healing. Heat application for 20-30 minutes can help to relax muscles, improve circulation, and reduce pain. Hot showers can also provide similar benefits in terms of muscle relaxation and pain relief. Educationally, it is crucial for healthcare providers to understand the appropriate use of nonpharmacological pain management strategies in rheumatoid arthritis to optimize patient outcomes. By avoiding practices that can potentially harm the patient, like prolonged ice application, healthcare professionals can ensure safe and effective pain management for individuals with rheumatoid arthritis.

Correct Answer: D

Rationale: The correct answer to the question is D) Stage 4. At 7 weeks post-fracture, the bone healing process enters Stage 4, known as the "remodeling stage." During this phase, the callus formed at the fracture site is gradually replaced by mature bone tissue through the action of osteoclasts and osteoblasts. This transformation strengthens the bone and restores its original shape and structure. Option A) Stage 3 is incorrect because Stage 3 is the "callus formation stage," which occurs immediately after the fracture and involves the formation of a soft callus made of fibrous tissue and cartilage. Option B) Stage 5 is incorrect because there are typically only four stages in the bone healing process, so Stage 5 is not a valid stage in this context. Option C) Stage 1 is incorrect because Stage 1 is the "hematoma formation stage," which is the initial response to the fracture where blood clotting and inflammation occur. Understanding the stages of bone healing is crucial for healthcare professionals involved in the care of patients with fractures. Knowing the timeline and processes involved in bone healing helps in assessing the progress of healing, determining appropriate interventions, and managing complications that may arise during the recovery process.

Correct Answer: D

Rationale: In the context of improving communication with a hearing-impaired client, option D, "Speak slowly and clearly while facing the client," is the best nursing intervention. This approach enhances communication by allowing the client to lip-read and observe facial expressions, aiding in understanding. Speaking slowly and clearly helps the client to catch more words and reduces the chances of miscommunication. Option A, talking in a regular voice in the good ear, is not the best choice as it may still pose challenges for the client to fully grasp the conversation. Option B, talking loudly in the impaired ear, can be uncomfortable and ineffective as it may distort sound and not necessarily improve comprehension. Option C, writing down the message, although useful in some situations, may not always be feasible or practical, especially in spontaneous interactions where immediate communication is needed. In an educational context, understanding the most effective interventions for communicating with hearing-impaired clients is crucial for healthcare professionals, especially nurses. By selecting the appropriate communication strategies, nurses can ensure effective patient-centered care, promote understanding, and build trust with clients who have hearing impairments. This knowledge enhances the overall quality of care provided and supports the principles of patient advocacy and effective communication in healthcare settings.

Correct Answer: C

Rationale: In this scenario, the correct answer is option C) Gown. When caring for a client with MRSA in an abdominal wound, it is crucial for the nurse to wear a gown to prevent the transmission of the bacteria to themselves or other patients. A gown provides a barrier between the nurse's clothing and the infectious wound, reducing the risk of contamination. Option A) PAPR mask is not necessary in this situation unless there is a risk of airborne transmission, which is not typically associated with MRSA in a wound. Option B) Sterile gloves would be important when directly handling the wound or performing wound care, but for checking the pulse, regular gloves would suffice. Option D) Surgical mask is not adequate protection against MRSA, as it does not cover the nurse's body and clothing, leaving them vulnerable to exposure. Educationally, understanding the appropriate use of personal protective equipment is crucial for nurses to prevent the spread of infections in healthcare settings. By knowing when to use specific PPE items, nurses can protect themselves, their patients, and prevent the spread of harmful pathogens.

Correct Answer: D

Rationale: In the context of systemic sclerosis (Scleroderma) with Raynaud's phenomenon, the correct assessment finding the nurse would anticipate is D) Cold and purple nailbeds. Raynaud's phenomenon is characterized by vasospasm of small arteries in response to cold or stress, leading to reduced blood flow to the extremities. This can result in the fingers or toes turning white, then blue/purple, and finally red as circulation improves. Cold and purple nailbeds are indicative of this vascular dysfunction associated with Raynaud's. Option A) Excessive heartburn is not typically associated with Raynaud's phenomenon or systemic sclerosis. Heartburn may be more commonly linked to gastroesophageal reflux disease (GERD) in these patients. Option B) Cyanosis of the lips is a sign of inadequate oxygenation and is not a specific finding related to Raynaud's phenomenon. Cyanosis may occur in conditions such as respiratory distress or heart failure. Option C) Excess wrinkled skin is not a typical assessment finding associated with Raynaud's phenomenon or systemic sclerosis. Skin changes in systemic sclerosis often include skin thickening, tightness, and loss of skin elasticity rather than excess wrinkling. In an educational context, it is crucial for nurses to understand the manifestations of systemic sclerosis and its complications like Raynaud's phenomenon. Recognizing the signs and symptoms of Raynaud's can help nurses provide appropriate care, educate patients on symptom management, and collaborate with the healthcare team to optimize treatment strategies for these complex conditions.