Nursing Elites

1. The client asks the nurse what nonpharmacological intervention can be used to reduce pain and swelling in her joints affected by rheumatoid arthritis. What is the most appropriate response by the nurse?

• A. "Ice packs can be used to reduce swelling but should be removed after 20 minutes."?
• B. "Heat always makes the swelling go down. You do not need any other interventions."?
• C. "Try high impact exercise exercise like running to loosen up your joints and reduce pain."?
• D. "Apply ice packs. It is generally okay to keep them on for up to one hour at a time."?

Correct answer: A

Rationale:

2. What is the condition called when the client's pupils are different sizes and have been this way since childhood?

• A. Exophthalmos
• B. Anisocoria
• C. Strabismus
• D. Scleral edema

Correct answer: B

Rationale: Anisocoria is the correct answer. Anisocoria is the condition of having pupils of different sizes. Exophthalmos refers to abnormal protrusion of the eyeball, not pupil size difference. Strabismus is a condition where the eyes are not properly aligned with each other. Scleral edema is swelling of the sclera, the white part of the eye, and not related to differing pupil sizes.

3. A nurse is providing teaching to an older client who has osteoarthritis that is affecting the knees. What statement by the client indicates a correct understanding of the teaching?

• A. I can use either heat or ice to help relieve the discomfort
• B. The purpose of drug therapy is to stop the disease progression.'
• C. I will start a daily running program to get more exercise.'
• D. I should avoid physical activity to prevent further injury.'

Correct answer: A

Rationale:

4. The client has been asked to perform weight-bearing exercises three times a week. The client admits to not doing the recommended exercises. What is the most appropriate response by the nurse?

• A. I walk 3 miles every day. Would you like to join me?
• B. Tell me more about your experience with these exercises.
• C. My dad never exercised. He fell and broke his hip. Is that your goal?
• D. You should be doing these exercises.

Correct answer: B

Rationale: The most appropriate response by the nurse is to ask the client to elaborate on their experience with the exercises. By doing so, the nurse can gain insight into any barriers the client may be facing and work together to find solutions to improve adherence. Choice A is not appropriate as it doesn't address the client's situation. Choice C is not relevant and may induce fear in the client. Choice D is directive and does not promote open communication or understanding of the client's perspective.

5. A client has sustained an open fracture. How can the nurse best prevent osteomyelitis in this client?

• A. Administer pain medication
• B. Use proper hand hygiene and strict infection control
• C. Delegate all client personal care to specific unlicensed assistive personnel
• D. Plate the client in contact precautions

Correct answer: B

Rationale:

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