which intervention is most important for a client with rheumatoid arthritis

ATI LPN

ATI PN Comprehensive Predictor 2023 with NGN

1. Which intervention is most important for a client with rheumatoid arthritis?

A. Massage inflamed joints with creams and oils
B. Provide support to flexed joints with pillows and pads
C. Position the client on their abdomen several times a day
D. Assist with heat application and range of motion exercises

Correct answer: D

Rationale: The most important intervention for a client with rheumatoid arthritis is to assist with heat application and range of motion exercises. Heat application helps reduce stiffness and improve joint flexibility, while range of motion exercises help maintain mobility and prevent contractures. Massaging inflamed joints with creams and oils may provide temporary relief but does not address the root cause of stiffness and limited mobility in rheumatoid arthritis. Providing support to flexed joints with pillows and pads can be helpful for comfort but does not actively promote mobility. Positioning the client on their abdomen several times a day is not a standard intervention for managing rheumatoid arthritis.

2. What intervention is key when managing a client with delirium?

A. Administer antipsychotic medication to calm the client
B. Identify any reversible causes of delirium
C. Provide a low-stimulation environment
D. Increase environmental stimulation

Correct answer: B

Rationale: The correct intervention when managing a client with delirium is to identify any reversible causes. Delirium can be caused by various factors such as infections, medications, dehydration, or metabolic imbalances. Administering antipsychotic medications (Choice A) may worsen delirium and should be avoided unless necessary for specific indications. Providing a low-stimulation environment (Choice C) is beneficial as it can help reduce agitation and confusion in individuals with delirium. Increasing environmental stimulation (Choice D) is contraindicated as it can exacerbate symptoms in delirious patients. Therefore, the priority should be on identifying and addressing reversible causes to effectively manage delirium.

3. A nurse is planning care for a client who is receiving hemodialysis via an AV fistula. Which of the following interventions should the nurse include in the plan of care?

A. Avoid taking blood pressures on the arm with the AV fistula.
B. Check the fistula site daily for pallor.
C. Place a warm compress over the fistula site every 4 hours.
D. Keep the client's arm elevated on two pillows.

Correct answer: A

Rationale: The correct intervention is to avoid taking blood pressures on the arm with the AV fistula. This is crucial to prevent complications such as damage to the fistula. Checking the fistula site for pallor is not as important as avoiding blood pressures on the affected arm. Placing warm compresses over the fistula site is not recommended as it can increase the risk of infection. Keeping the client's arm elevated on two pillows is not necessary for the care of an AV fistula.

4. The nurse is performing triage on a group of clients in the emergency department. Which of the following clients should the nurse see first?

A. A 12-year-old oozing blood from a laceration on the left thumb due to a cut from a rusty metal can
B. A 19-year-old with a fever of 103.8°F who is able to identify her sister but not the place and time
C. A 49-year-old with a compound fracture of the right leg who is complaining of severe pain
D. A 65-year-old with a flushed face, dry mucous membranes, and a blood sugar of 470 mg/dL

Correct answer: B

Rationale: The correct answer is B. A 19-year-old with a fever of 103.8°F who is confused and unable to orient to place and time likely has a severe infection or a serious medical condition affecting the central nervous system. This client needs immediate attention as altered mental status combined with a high fever can indicate a life-threatening situation. Choices A, C, and D present important conditions that require medical care, but they are not as urgent as the 19-year-old with a high fever and confusion. The 12-year-old with a laceration may require treatment for bleeding and a tetanus shot, the 49-year-old with a compound fracture needs urgent orthopedic intervention, and the 65-year-old with a high blood sugar is concerning for hyperglycemia but can wait momentarily compared to the client with a fever and altered mental status.

5. What are the differences between Type 1 and Type 2 diabetes in terms of treatment?

A. Type 1: Insulin therapy; Type 2: Lifestyle modifications and oral agents
B. Type 1: Oral agents; Type 2: Insulin therapy
C. Type 1: Insulin resistance; Type 2: Insulin deficiency
D. Type 1: Exercise and diet; Type 2: Insulin only

Correct answer: A

Rationale: The correct answer is A because Type 1 diabetes necessitates insulin therapy, whereas Type 2 diabetes is managed with lifestyle modifications and oral agents. Choice B is incorrect because Type 1 diabetes does not use oral agents as a primary treatment. Choice C is incorrect as it describes the pathophysiology of diabetes types rather than their treatments. Choice D is incorrect because Type 2 diabetes management involves more than just insulin and includes lifestyle changes and oral medications.