Question 1

The nurse is planning care for a client with multiple sclerosis. Which intervention would address the nursing diagnosis of Fatigue?

Accepted Answer

A)Interventions to address the diagnosis of Fatigue include assessing the client's level of fatigue, arranging activities to include rest periods between them, and assisting the client in setting priorities regarding activities. Activities should not be grouped together. Increased activity will not help the client with fatigue. Physical therapy three times a day may be too aggressive for this client.
B)Interventions to address the diagnosis of Fatigue include assessing the client's level of fatigue, arranging activities to include rest periods between them, and assisting the client in setting priorities regarding activities. Activities should not be grouped together. Increased activity will not help the client with fatigue. Physical therapy three times a day may be too aggressive for this client.
C)Interventions to address the diagnosis of Fatigue include assessing the client's level of fatigue, arranging activities to include rest periods between them, and assisting the client in setting priorities regarding activities. Activities should not be grouped together. Increased activity will not help the client with fatigue. Physical therapy three times a day may be too aggressive for this client.
D)Interventions to address the diagnosis of Fatigue include assessing the client's level of fatigue, arranging activities to include rest periods between them, and assisting the client in setting priorities regarding activities. Activities should not be grouped together. Increased activity will not help the client with fatigue. Physical therapy three times a day may be too aggressive for this client.

Question 2

The nurse is caring for a client with osteoarthritis. Which factor in the client's history and physical assessment would the nurse recognize as a risk factor for developing this condition?

Accepted Answer

A)Obesity increases the risk of developing osteoarthritis (OA), because the added weight increases stress on weight-bearing joints, causing the joints to wear down more quickly. This client has a body mass index of 36.5, which is considered obese. Moderate recreational exercise (such as tennis three times per week)has been shown to decrease the chance of developing OA and slow the progression of manifestations when OA is present. Esophageal reflux is not associated with OA. Blood pressure is not a known risk factor for the development of OA.
B)Obesity increases the risk of developing osteoarthritis (OA), because the added weight increases stress on weight-bearing joints, causing the joints to wear down more quickly. This client has a body mass index of 36.5, which is considered obese. Moderate recreational exercise (such as tennis three times per week)has been shown to decrease the chance of developing OA and slow the progression of manifestations when OA is present. Esophageal reflux is not associated with OA. Blood pressure is not a known risk factor for the development of OA.
C)Obesity increases the risk of developing osteoarthritis (OA), because the added weight increases stress on weight-bearing joints, causing the joints to wear down more quickly. This client has a body mass index of 36.5, which is considered obese. Moderate recreational exercise (such as tennis three times per week)has been shown to decrease the chance of developing OA and slow the progression of manifestations when OA is present. Esophageal reflux is not associated with OA. Blood pressure is not a known risk factor for the development of OA.
D)Obesity increases the risk of developing osteoarthritis (OA), because the added weight increases stress on weight-bearing joints, causing the joints to wear down more quickly. This client has a body mass index of 36.5, which is considered obese. Moderate recreational exercise (such as tennis three times per week)has been shown to decrease the chance of developing OA and slow the progression of manifestations when OA is present. Esophageal reflux is not associated with OA. Blood pressure is not a known risk factor for the development of OA.

Question 3

Which category of multiple sclerosis (MS)is characterized by a slow but nearly continuous worsening of the disease from the time of onset with no distinct remissions?

Accepted Answer

A)There are four classifications of multiple sclerosis (MS). Relapsing-remitting MS is characterized by clearly defined flare-ups with worsening neurological function followed by periods of partial or complete remission with few or no symptoms. Primary-progressive MS involves slow but nearly continuous worsening of the disease from the time of onset with no distinct remissions. Secondary-progressive MS begins as relapsing-remitting but becomes worse between exacerbations. Progressive-relapsing MS involves a steady worsening of disease with acute relapses.
B)There are four classifications of multiple sclerosis (MS). Relapsing-remitting MS is characterized by clearly defined flare-ups with worsening neurological function followed by periods of partial or complete remission with few or no symptoms. Primary-progressive MS involves slow but nearly continuous worsening of the disease from the time of onset with no distinct remissions. Secondary-progressive MS begins as relapsing-remitting but becomes worse between exacerbations. Progressive-relapsing MS involves a steady worsening of disease with acute relapses.
C)There are four classifications of multiple sclerosis (MS). Relapsing-remitting MS is characterized by clearly defined flare-ups with worsening neurological function followed by periods of partial or complete remission with few or no symptoms. Primary-progressive MS involves slow but nearly continuous worsening of the disease from the time of onset with no distinct remissions. Secondary-progressive MS begins as relapsing-remitting but becomes worse between exacerbations. Progressive-relapsing MS involves a steady worsening of disease with acute relapses.
D)There are four classifications of multiple sclerosis (MS). Relapsing-remitting MS is characterized by clearly defined flare-ups with worsening neurological function followed by periods of partial or complete remission with few or no symptoms. Primary-progressive MS involves slow but nearly continuous worsening of the disease from the time of onset with no distinct remissions. Secondary-progressive MS begins as relapsing-remitting but becomes worse between exacerbations. Progressive-relapsing MS involves a steady worsening of disease with acute relapses.

Question 4

A client with osteoarthritis (OA)of the knees and hips returns for a 3-month follow-up visit with the provider. The nurse calculates that the client's body mass index (BMI)is now 22. The client reports starting a water aerobics and running program three times per week. The client is also using hot packs for edema for 20 minutes and cold packs for pain for 40 minutes daily. After evaluating the client's actions, which follow-up interventions should the nurse plan? Select all that apply.

Accepted Answer

A)The nurse should congratulate the client on starting water aerobics because it is a low-impact exercise mode. The nurse should also congratulate the client on the weight loss. Note, however, that a BMI of 22 is ideal, so continued weight loss should not be encouraged. The client should be informed that using cold packs for more than 30 minutes may cause skin injury. The nurse should also reinforce that hot packs are used to decrease pain and ice packs are used for edema (swelling). Finally, the nurse should suggest that the client replace the high impact exercise of running with a lower impact exercise such as walking or biking.
B)The nurse should congratulate the client on starting water aerobics because it is a low-impact exercise mode. The nurse should also congratulate the client on the weight loss. Note, however, that a BMI of 22 is ideal, so continued weight loss should not be encouraged. The client should be informed that using cold packs for more than 30 minutes may cause skin injury. The nurse should also reinforce that hot packs are used to decrease pain and ice packs are used for edema (swelling). Finally, the nurse should suggest that the client replace the high impact exercise of running with a lower impact exercise such as walking or biking.
C)The nurse should congratulate the client on starting water aerobics because it is a low-impact exercise mode. The nurse should also congratulate the client on the weight loss. Note, however, that a BMI of 22 is ideal, so continued weight loss should not be encouraged. The client should be informed that using cold packs for more than 30 minutes may cause skin injury. The nurse should also reinforce that hot packs are used to decrease pain and ice packs are used for edema (swelling). Finally, the nurse should suggest that the client replace the high impact exercise of running with a lower impact exercise such as walking or biking.
D)The nurse should congratulate the client on starting water aerobics because it is a low-impact exercise mode. The nurse should also congratulate the client on the weight loss. Note, however, that a BMI of 22 is ideal, so continued weight loss should not be encouraged. The client should be informed that using cold packs for more than 30 minutes may cause skin injury. The nurse should also reinforce that hot packs are used to decrease pain and ice packs are used for edema (swelling). Finally, the nurse should suggest that the client replace the high impact exercise of running with a lower impact exercise such as walking or biking.
E)The nurse should congratulate the client on starting water aerobics because it is a low-impact exercise mode. The nurse should also congratulate the client on the weight loss. Note, however, that a BMI of 22 is ideal, so continued weight loss should not be encouraged. The client should be informed that using cold packs for more than 30 minutes may cause skin injury. The nurse should also reinforce that hot packs are used to decrease pain and ice packs are used for edema (swelling). Finally, the nurse should suggest that the client replace the high impact exercise of running with a lower impact exercise such as walking or biking.

Question 5

A nurse is teaching the parents of a client who was recently diagnosed with multiple sclerosis (MS)about what to expect as their child's condition progresses. Which statement by the parents indicates the need for further instruction?

Accepted Answer

A)Children with MS often experience seizures related to their diagnosis, and they may suffer from reduced academic performance and difficulty in family and peer relationships. However, MS usually progresses more slowly in children than in adults. Thus, the parents' statement about the speed of disease progression indicates the need for further instruction.
B)Children with MS often experience seizures related to their diagnosis, and they may suffer from reduced academic performance and difficulty in family and peer relationships. However, MS usually progresses more slowly in children than in adults. Thus, the parents' statement about the speed of disease progression indicates the need for further instruction.
C)Children with MS often experience seizures related to their diagnosis, and they may suffer from reduced academic performance and difficulty in family and peer relationships. However, MS usually progresses more slowly in children than in adults. Thus, the parents' statement about the speed of disease progression indicates the need for further instruction.
D)Children with MS often experience seizures related to their diagnosis, and they may suffer from reduced academic performance and difficulty in family and peer relationships. However, MS usually progresses more slowly in children than in adults. Thus, the parents' statement about the speed of disease progression indicates the need for further instruction.

Question 6

An adult client recently diagnosed with multiple sclerosis (MS)reports engaging in vigorous exercise on a regular basis. Which statements contain the correct information to give this client when answering specific questions about lifestyle? Select all that apply.

Accepted Answer

A)Symptoms of MS are exacerbated by increased body temperature. Exercising in a cold room and drinking cold beverages help keep body temperature down. Acupuncture has low risk and may be beneficial for some symptoms of MS. Hyperbaric oxygen therapy carries more risk than benefit. Also, it is unlikely that a newly diagnosed client with MS will be able to tolerate regular vigorous exercise.
B)Symptoms of MS are exacerbated by increased body temperature. Exercising in a cold room and drinking cold beverages help keep body temperature down. Acupuncture has low risk and may be beneficial for some symptoms of MS. Hyperbaric oxygen therapy carries more risk than benefit. Also, it is unlikely that a newly diagnosed client with MS will be able to tolerate regular vigorous exercise.
C)Symptoms of MS are exacerbated by increased body temperature. Exercising in a cold room and drinking cold beverages help keep body temperature down. Acupuncture has low risk and may be beneficial for some symptoms of MS. Hyperbaric oxygen therapy carries more risk than benefit. Also, it is unlikely that a newly diagnosed client with MS will be able to tolerate regular vigorous exercise.
D)Symptoms of MS are exacerbated by increased body temperature. Exercising in a cold room and drinking cold beverages help keep body temperature down. Acupuncture has low risk and may be beneficial for some symptoms of MS. Hyperbaric oxygen therapy carries more risk than benefit. Also, it is unlikely that a newly diagnosed client with MS will be able to tolerate regular vigorous exercise.
E)Symptoms of MS are exacerbated by increased body temperature. Exercising in a cold room and drinking cold beverages help keep body temperature down. Acupuncture has low risk and may be beneficial for some symptoms of MS. Hyperbaric oxygen therapy carries more risk than benefit. Also, it is unlikely that a newly diagnosed client with MS will be able to tolerate regular vigorous exercise.

Question 7

A client with multiple sclerosis (MS)is said to be experiencing an exacerbation when he or she experiences symptoms that:

Accepted Answer

A)Clients with MS who are suffering from an exacerbation may experience one or more symptoms that last from days to months, and symptoms can be different during distinct exacerbations. A true exacerbation must last at least 24 hours and must be separated from the previous attack by at least 30 days.
B)Clients with MS who are suffering from an exacerbation may experience one or more symptoms that last from days to months, and symptoms can be different during distinct exacerbations. A true exacerbation must last at least 24 hours and must be separated from the previous attack by at least 30 days.
C)Clients with MS who are suffering from an exacerbation may experience one or more symptoms that last from days to months, and symptoms can be different during distinct exacerbations. A true exacerbation must last at least 24 hours and must be separated from the previous attack by at least 30 days.
D)Clients with MS who are suffering from an exacerbation may experience one or more symptoms that last from days to months, and symptoms can be different during distinct exacerbations. A true exacerbation must last at least 24 hours and must be separated from the previous attack by at least 30 days.

Question 8

A client with osteoarthritis tells the nurse she has difficulty walking to the bathroom first thing in the morning. Which nursing action would assist this client?

Accepted Answer

A)Assistive devices are items used to maintain, increase, or improve function. The client describes difficulty walking to the bathroom in the morning. The best intervention to help this client would be to consult with physical therapy for an assistive walking device such as a walker or cane. The use of a bedside commode or bedpan may help with the immediate need to use the bathroom, but the client will still have difficulty ambulating in the morning. The option of residing in an assisted-living facility might be premature for this client.
B)Assistive devices are items used to maintain, increase, or improve function. The client describes difficulty walking to the bathroom in the morning. The best intervention to help this client would be to consult with physical therapy for an assistive walking device such as a walker or cane. The use of a bedside commode or bedpan may help with the immediate need to use the bathroom, but the client will still have difficulty ambulating in the morning. The option of residing in an assisted-living facility might be premature for this client.
C)Assistive devices are items used to maintain, increase, or improve function. The client describes difficulty walking to the bathroom in the morning. The best intervention to help this client would be to consult with physical therapy for an assistive walking device such as a walker or cane. The use of a bedside commode or bedpan may help with the immediate need to use the bathroom, but the client will still have difficulty ambulating in the morning. The option of residing in an assisted-living facility might be premature for this client.
D)Assistive devices are items used to maintain, increase, or improve function. The client describes difficulty walking to the bathroom in the morning. The best intervention to help this client would be to consult with physical therapy for an assistive walking device such as a walker or cane. The use of a bedside commode or bedpan may help with the immediate need to use the bathroom, but the client will still have difficulty ambulating in the morning. The option of residing in an assisted-living facility might be premature for this client.

Question 9

During an outpatient clinic follow-up appointment, a client with multiple sclerosis (MS)has lab tests completed. The results show elevated levels of aspartate aminotransferase (AST), serum glutamic-oxaloacetic transaminase (SGOT), alanine aminotransferase (ALT), serum glutamic-pyruvic transaminase (SGPT), and alkaline phosphatase (ALP). The nurse recognizes that these elevated enzyme levels are a potential adverse effect of which medications? Select all that apply.

Accepted Answer

A)AST, SGOT, ALT, SGPT, and ALP are liver enzymes that are monitored to detect adverse responses to the medications interferon beta-1a (Avonex)and teriflunomide (Aubagio). Glatiramer acetate (Copaxone), mitoxantrone (Novantrone), and fingolimod (Gilenya)are used to treat MS but do not typically cause liver damage.
B)AST, SGOT, ALT, SGPT, and ALP are liver enzymes that are monitored to detect adverse responses to the medications interferon beta-1a (Avonex)and teriflunomide (Aubagio). Glatiramer acetate (Copaxone), mitoxantrone (Novantrone), and fingolimod (Gilenya)are used to treat MS but do not typically cause liver damage.
C)AST, SGOT, ALT, SGPT, and ALP are liver enzymes that are monitored to detect adverse responses to the medications interferon beta-1a (Avonex)and teriflunomide (Aubagio). Glatiramer acetate (Copaxone), mitoxantrone (Novantrone), and fingolimod (Gilenya)are used to treat MS but do not typically cause liver damage.
D)AST, SGOT, ALT, SGPT, and ALP are liver enzymes that are monitored to detect adverse responses to the medications interferon beta-1a (Avonex)and teriflunomide (Aubagio). Glatiramer acetate (Copaxone), mitoxantrone (Novantrone), and fingolimod (Gilenya)are used to treat MS but do not typically cause liver damage.
E)AST, SGOT, ALT, SGPT, and ALP are liver enzymes that are monitored to detect adverse responses to the medications interferon beta-1a (Avonex)and teriflunomide (Aubagio). Glatiramer acetate (Copaxone), mitoxantrone (Novantrone), and fingolimod (Gilenya)are used to treat MS but do not typically cause liver damage.

Question 10

The nurse is providing teaching to the client recently diagnosed with osteoarthritis. Which statement by the nurse is correct?

Accepted Answer

A)Osteoarthritis is characterized by progressive erosion of the cartilage within joints. It is not a metabolic bone disease; examples of such diseases include osteoporosis, osteomalacia, and Paget disease. Thin, small-built female clients are at increased risk for osteoporosis, not osteoarthritis. In fact, osteoarthritis is more commonly associated with obesity than with slight build. Finally, joint inflammation is a characteristic of rheumatoid arthritis, not osteoarthritis.
B)Osteoarthritis is characterized by progressive erosion of the cartilage within joints. It is not a metabolic bone disease; examples of such diseases include osteoporosis, osteomalacia, and Paget disease. Thin, small-built female clients are at increased risk for osteoporosis, not osteoarthritis. In fact, osteoarthritis is more commonly associated with obesity than with slight build. Finally, joint inflammation is a characteristic of rheumatoid arthritis, not osteoarthritis.
C)Osteoarthritis is characterized by progressive erosion of the cartilage within joints. It is not a metabolic bone disease; examples of such diseases include osteoporosis, osteomalacia, and Paget disease. Thin, small-built female clients are at increased risk for osteoporosis, not osteoarthritis. In fact, osteoarthritis is more commonly associated with obesity than with slight build. Finally, joint inflammation is a characteristic of rheumatoid arthritis, not osteoarthritis.
D)Osteoarthritis is characterized by progressive erosion of the cartilage within joints. It is not a metabolic bone disease; examples of such diseases include osteoporosis, osteomalacia, and Paget disease. Thin, small-built female clients are at increased risk for osteoporosis, not osteoarthritis. In fact, osteoarthritis is more commonly associated with obesity than with slight build. Finally, joint inflammation is a characteristic of rheumatoid arthritis, not osteoarthritis.

Question 11

Which of the following would be classified as a secondary symptom of multiple sclerosis (MS)?

Accepted Answer

A)Secondary symptoms of MS result from chronic primary symptoms of the disease. Because pressure sores result from primary symptoms such as muscle weakness and inability to ambulate, they would be considered a secondary symptom. In comparison, both urinary retention and unsteady gait are primary symptoms of MS, whereas depression is a tertiary symptom (because it involves a psychosocial problem).
B)Secondary symptoms of MS result from chronic primary symptoms of the disease. Because pressure sores result from primary symptoms such as muscle weakness and inability to ambulate, they would be considered a secondary symptom. In comparison, both urinary retention and unsteady gait are primary symptoms of MS, whereas depression is a tertiary symptom (because it involves a psychosocial problem).
C)Secondary symptoms of MS result from chronic primary symptoms of the disease. Because pressure sores result from primary symptoms such as muscle weakness and inability to ambulate, they would be considered a secondary symptom. In comparison, both urinary retention and unsteady gait are primary symptoms of MS, whereas depression is a tertiary symptom (because it involves a psychosocial problem).
D)Secondary symptoms of MS result from chronic primary symptoms of the disease. Because pressure sores result from primary symptoms such as muscle weakness and inability to ambulate, they would be considered a secondary symptom. In comparison, both urinary retention and unsteady gait are primary symptoms of MS, whereas depression is a tertiary symptom (because it involves a psychosocial problem).

Question 12

A client seeking treatment for severe knee pain has worked in a factory for 30 years in a position requiring repetitive lifting and carrying of 20- to 40-pound boxes. Based on the client's history, the nurse should anticipate which initial recommendation from the multidisciplinary healthcare team?

Accepted Answer

A)Of these options, pharmacologic therapy would be the most likely initial intervention. Acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), and joint injections are all possible options. Joint replacement should be delayed as long as possible because artificial joints often require replacement within 15-20 years. There is not enough information to determine whether applying for disability is appropriate at this time. A cane is not indicated at this time.
B)Of these options, pharmacologic therapy would be the most likely initial intervention. Acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), and joint injections are all possible options. Joint replacement should be delayed as long as possible because artificial joints often require replacement within 15-20 years. There is not enough information to determine whether applying for disability is appropriate at this time. A cane is not indicated at this time.
C)Of these options, pharmacologic therapy would be the most likely initial intervention. Acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), and joint injections are all possible options. Joint replacement should be delayed as long as possible because artificial joints often require replacement within 15-20 years. There is not enough information to determine whether applying for disability is appropriate at this time. A cane is not indicated at this time.
D)Of these options, pharmacologic therapy would be the most likely initial intervention. Acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), and joint injections are all possible options. Joint replacement should be delayed as long as possible because artificial joints often require replacement within 15-20 years. There is not enough information to determine whether applying for disability is appropriate at this time. A cane is not indicated at this time.

Question 13

A client with chronic hip pain is diagnosed with osteoarthritis. Which instruction regarding home safety is most appropriate for the nurse to provide to this client?

Accepted Answer

A)The client should be encouraged to install grab bars in the bathroom near the commode and in the shower. The client should be instructed not to overuse the affected joints with excessive stair climbing. Scatter rugs are a hazard to mobility and should be avoided. The client should also be instructed to sit in a straight-back chair, avoid slumping, and avoid use of a recliner.
B)The client should be encouraged to install grab bars in the bathroom near the commode and in the shower. The client should be instructed not to overuse the affected joints with excessive stair climbing. Scatter rugs are a hazard to mobility and should be avoided. The client should also be instructed to sit in a straight-back chair, avoid slumping, and avoid use of a recliner.
C)The client should be encouraged to install grab bars in the bathroom near the commode and in the shower. The client should be instructed not to overuse the affected joints with excessive stair climbing. Scatter rugs are a hazard to mobility and should be avoided. The client should also be instructed to sit in a straight-back chair, avoid slumping, and avoid use of a recliner.
D)The client should be encouraged to install grab bars in the bathroom near the commode and in the shower. The client should be instructed not to overuse the affected joints with excessive stair climbing. Scatter rugs are a hazard to mobility and should be avoided. The client should also be instructed to sit in a straight-back chair, avoid slumping, and avoid use of a recliner.

Question 14

The nurse is planning care for a client with osteoarthritis. Which nursing diagnosis would have the highest priority?

Accepted Answer

A)When providing care to a client diagnosed with osteoarthritis, priority diagnoses would include Chronic Pain, Impaired Physical Mobility, and Self-Care Deficit. Thus, of the diagnoses identified for this client, Chronic Pain would be the highest priority. Once this diagnosis has been addressed, the nurse and client can focus on the lower priority diagnoses of Fatigue, Ineffective Coping, and Disturbed Body Image.
B)When providing care to a client diagnosed with osteoarthritis, priority diagnoses would include Chronic Pain, Impaired Physical Mobility, and Self-Care Deficit. Thus, of the diagnoses identified for this client, Chronic Pain would be the highest priority. Once this diagnosis has been addressed, the nurse and client can focus on the lower priority diagnoses of Fatigue, Ineffective Coping, and Disturbed Body Image.
C)When providing care to a client diagnosed with osteoarthritis, priority diagnoses would include Chronic Pain, Impaired Physical Mobility, and Self-Care Deficit. Thus, of the diagnoses identified for this client, Chronic Pain would be the highest priority. Once this diagnosis has been addressed, the nurse and client can focus on the lower priority diagnoses of Fatigue, Ineffective Coping, and Disturbed Body Image.
D)When providing care to a client diagnosed with osteoarthritis, priority diagnoses would include Chronic Pain, Impaired Physical Mobility, and Self-Care Deficit. Thus, of the diagnoses identified for this client, Chronic Pain would be the highest priority. Once this diagnosis has been addressed, the nurse and client can focus on the lower priority diagnoses of Fatigue, Ineffective Coping, and Disturbed Body Image.

Question 15

Lab results are back for a client who has limiting joint pain. Synovial fluid analysis shows no uric acid crystals or bacteria. The client asks what the test results mean. How should the nurse respond?

Accepted Answer

A)Gout is caused by the collection of uric acid crystals in a joint. The absence of uric acid crystals in the synovial fluid (joint fluid)makes gout unlikely. Septic arthritis is caused by infection, so the absence of bacteria makes sepsis unlikely. However, this test does not rule out osteoarthritis or rheumatoid arthritis, so these are still possible diagnoses. Although the nurse may provide information related to which conditions have been ruled out, providing a medical diagnosis is outside the nurse's scope of practice.
B)Gout is caused by the collection of uric acid crystals in a joint. The absence of uric acid crystals in the synovial fluid (joint fluid)makes gout unlikely. Septic arthritis is caused by infection, so the absence of bacteria makes sepsis unlikely. However, this test does not rule out osteoarthritis or rheumatoid arthritis, so these are still possible diagnoses. Although the nurse may provide information related to which conditions have been ruled out, providing a medical diagnosis is outside the nurse's scope of practice.
C)Gout is caused by the collection of uric acid crystals in a joint. The absence of uric acid crystals in the synovial fluid (joint fluid)makes gout unlikely. Septic arthritis is caused by infection, so the absence of bacteria makes sepsis unlikely. However, this test does not rule out osteoarthritis or rheumatoid arthritis, so these are still possible diagnoses. Although the nurse may provide information related to which conditions have been ruled out, providing a medical diagnosis is outside the nurse's scope of practice.
D)Gout is caused by the collection of uric acid crystals in a joint. The absence of uric acid crystals in the synovial fluid (joint fluid)makes gout unlikely. Septic arthritis is caused by infection, so the absence of bacteria makes sepsis unlikely. However, this test does not rule out osteoarthritis or rheumatoid arthritis, so these are still possible diagnoses. Although the nurse may provide information related to which conditions have been ruled out, providing a medical diagnosis is outside the nurse's scope of practice.

Question 16

Which of the following medications is used to treat tertiary symptoms of multiple sclerosis (MS)?

Accepted Answer

A)Tertiary symptoms of MS relate to psychosocial problems, such as relationship difficulties, loss of a job because of decreased performance, or hopelessness. Of the medications listed here, only bupropion (an antidepressant)would be used to treat a tertiary symptom (depression). Copaxone would be used to treat the primary symptoms of MS, whereas ciprofloxacin (an antibiotic)and magnesium hydroxide (a laxative)would be used to treat the secondary symptoms of infection and constipation, respectively.
B)Tertiary symptoms of MS relate to psychosocial problems, such as relationship difficulties, loss of a job because of decreased performance, or hopelessness. Of the medications listed here, only bupropion (an antidepressant)would be used to treat a tertiary symptom (depression). Copaxone would be used to treat the primary symptoms of MS, whereas ciprofloxacin (an antibiotic)and magnesium hydroxide (a laxative)would be used to treat the secondary symptoms of infection and constipation, respectively.
C)Tertiary symptoms of MS relate to psychosocial problems, such as relationship difficulties, loss of a job because of decreased performance, or hopelessness. Of the medications listed here, only bupropion (an antidepressant)would be used to treat a tertiary symptom (depression). Copaxone would be used to treat the primary symptoms of MS, whereas ciprofloxacin (an antibiotic)and magnesium hydroxide (a laxative)would be used to treat the secondary symptoms of infection and constipation, respectively.
D)Tertiary symptoms of MS relate to psychosocial problems, such as relationship difficulties, loss of a job because of decreased performance, or hopelessness. Of the medications listed here, only bupropion (an antidepressant)would be used to treat a tertiary symptom (depression). Copaxone would be used to treat the primary symptoms of MS, whereas ciprofloxacin (an antibiotic)and magnesium hydroxide (a laxative)would be used to treat the secondary symptoms of infection and constipation, respectively.

Question 17

The nurse is planning care for a client with osteoarthritis of the hip. Which intervention would be appropriate for this client?

Accepted Answer

A)Interventions appropriate for a client with osteoarthritis (OA)include NSAIDs, moist heat, active range-of-motion exercises, proper posture and body mechanics, and assistive devices to safely maintain independence with activities of daily living. Opioid medication is not typically prescribed for the treatment of OA. NSAIDs are most effective if taken before the pain is severe. The client should be encouraged to be mobile, not on strict bedrest.
B)Interventions appropriate for a client with osteoarthritis (OA)include NSAIDs, moist heat, active range-of-motion exercises, proper posture and body mechanics, and assistive devices to safely maintain independence with activities of daily living. Opioid medication is not typically prescribed for the treatment of OA. NSAIDs are most effective if taken before the pain is severe. The client should be encouraged to be mobile, not on strict bedrest.
C)Interventions appropriate for a client with osteoarthritis (OA)include NSAIDs, moist heat, active range-of-motion exercises, proper posture and body mechanics, and assistive devices to safely maintain independence with activities of daily living. Opioid medication is not typically prescribed for the treatment of OA. NSAIDs are most effective if taken before the pain is severe. The client should be encouraged to be mobile, not on strict bedrest.
D)Interventions appropriate for a client with osteoarthritis (OA)include NSAIDs, moist heat, active range-of-motion exercises, proper posture and body mechanics, and assistive devices to safely maintain independence with activities of daily living. Opioid medication is not typically prescribed for the treatment of OA. NSAIDs are most effective if taken before the pain is severe. The client should be encouraged to be mobile, not on strict bedrest.

Question 18

The nurse is evaluating care provided to a client with osteoarthritis (OA). Which client statement indicates to the nurse that interventions for OA have been successful?

Accepted Answer

A)Expected outcomes for the care of a client with OA include independence with activities of daily living, minimal lifestyle impact because of OA, and controlled pain that allows for rest and sleep. Of the client statements provided, only the one about improved sleep and pain not interfering with work indicates achievement of these outcomes. A client who changes work hours and has a nursing assistant for bathing is experiencing a reduction in activities of daily living and a significant impact in lifestyle. A client who is moving in with a daughter is experiencing significant lifestyle impact. A client who retires early and stays at home all day is also experiencing a significant impact in lifestyle.
B)Expected outcomes for the care of a client with OA include independence with activities of daily living, minimal lifestyle impact because of OA, and controlled pain that allows for rest and sleep. Of the client statements provided, only the one about improved sleep and pain not interfering with work indicates achievement of these outcomes. A client who changes work hours and has a nursing assistant for bathing is experiencing a reduction in activities of daily living and a significant impact in lifestyle. A client who is moving in with a daughter is experiencing significant lifestyle impact. A client who retires early and stays at home all day is also experiencing a significant impact in lifestyle.
C)Expected outcomes for the care of a client with OA include independence with activities of daily living, minimal lifestyle impact because of OA, and controlled pain that allows for rest and sleep. Of the client statements provided, only the one about improved sleep and pain not interfering with work indicates achievement of these outcomes. A client who changes work hours and has a nursing assistant for bathing is experiencing a reduction in activities of daily living and a significant impact in lifestyle. A client who is moving in with a daughter is experiencing significant lifestyle impact. A client who retires early and stays at home all day is also experiencing a significant impact in lifestyle.
D)Expected outcomes for the care of a client with OA include independence with activities of daily living, minimal lifestyle impact because of OA, and controlled pain that allows for rest and sleep. Of the client statements provided, only the one about improved sleep and pain not interfering with work indicates achievement of these outcomes. A client who changes work hours and has a nursing assistant for bathing is experiencing a reduction in activities of daily living and a significant impact in lifestyle. A client who is moving in with a daughter is experiencing significant lifestyle impact. A client who retires early and stays at home all day is also experiencing a significant impact in lifestyle.

Question 19

An older adult client with bilateral osteoarthritis of the knees tells the nurse, "I know I need to lose weight, but exercising makes my knees ache." What instruction should the nurse provide to this client?

Accepted Answer

A)Encouraging exercise is an important aspect of nursing care for clients with osteoarthritis (OA). Exercise can increase flexibility, improve blood flow, and help clients lose weight. Over time, these factors can help protect the joints against further deterioration and pain. The nurse should not counsel the client to follow a reduced-calorie eating plan for several months before attempting exercise. The client may or may not want to have knee replacement surgery. Stretching is just one type of exercise that will benefit clients with OA. The other components, strengthening and aerobic exercise, can be obtained through walking, swimming, and isometric, isotonic, and resistive exercises.
B)Encouraging exercise is an important aspect of nursing care for clients with osteoarthritis (OA). Exercise can increase flexibility, improve blood flow, and help clients lose weight. Over time, these factors can help protect the joints against further deterioration and pain. The nurse should not counsel the client to follow a reduced-calorie eating plan for several months before attempting exercise. The client may or may not want to have knee replacement surgery. Stretching is just one type of exercise that will benefit clients with OA. The other components, strengthening and aerobic exercise, can be obtained through walking, swimming, and isometric, isotonic, and resistive exercises.
C)Encouraging exercise is an important aspect of nursing care for clients with osteoarthritis (OA). Exercise can increase flexibility, improve blood flow, and help clients lose weight. Over time, these factors can help protect the joints against further deterioration and pain. The nurse should not counsel the client to follow a reduced-calorie eating plan for several months before attempting exercise. The client may or may not want to have knee replacement surgery. Stretching is just one type of exercise that will benefit clients with OA. The other components, strengthening and aerobic exercise, can be obtained through walking, swimming, and isometric, isotonic, and resistive exercises.
D)Encouraging exercise is an important aspect of nursing care for clients with osteoarthritis (OA). Exercise can increase flexibility, improve blood flow, and help clients lose weight. Over time, these factors can help protect the joints against further deterioration and pain. The nurse should not counsel the client to follow a reduced-calorie eating plan for several months before attempting exercise. The client may or may not want to have knee replacement surgery. Stretching is just one type of exercise that will benefit clients with OA. The other components, strengthening and aerobic exercise, can be obtained through walking, swimming, and isometric, isotonic, and resistive exercises.

Question 20

The nurse is caring for several clients from various cultural backgrounds. Which client would the nurse assess as having the highest risk for multiple sclerosis?

Accepted Answer

A)The Northern Canadian woman who smokes has three risk factors for MS: female gender, living farthest from the equator, and smoking. Factors that lower the risk of MS include living closer to the equator (as is the case for the Brazilian and Hispanic clients), having a lowered immune response (as is the case for the client with chronic parasitic infestation), and being male.
B)The Northern Canadian woman who smokes has three risk factors for MS: female gender, living farthest from the equator, and smoking. Factors that lower the risk of MS include living closer to the equator (as is the case for the Brazilian and Hispanic clients), having a lowered immune response (as is the case for the client with chronic parasitic infestation), and being male.
C)The Northern Canadian woman who smokes has three risk factors for MS: female gender, living farthest from the equator, and smoking. Factors that lower the risk of MS include living closer to the equator (as is the case for the Brazilian and Hispanic clients), having a lowered immune response (as is the case for the client with chronic parasitic infestation), and being male.
D)The Northern Canadian woman who smokes has three risk factors for MS: female gender, living farthest from the equator, and smoking. Factors that lower the risk of MS include living closer to the equator (as is the case for the Brazilian and Hispanic clients), having a lowered immune response (as is the case for the client with chronic parasitic infestation), and being male.

Quiz 13: Mobility

The nurse is planning care for a client with multiple sclerosis. Which intervention would address the nursing diagnosis of Fatigue?

The nurse is caring for a client with osteoarthritis. Which factor in the client's history and physical assessment would the nurse recognize as a risk factor for developing this condition?

Which category of multiple sclerosis (MS) is characterized by a slow but nearly continuous worsening of the disease from the time of onset with no distinct remissions?

A nurse is teaching the parents of a client who was recently diagnosed with multiple sclerosis (MS) about what to expect as their child's condition progresses. Which statement by the parents indicates the need for further instruction?

An adult client recently diagnosed with multiple sclerosis (MS) reports engaging in vigorous exercise on a regular basis. Which statements contain the correct information to give this client when answering specific questions about lifestyle? Select all that apply.

A client with multiple sclerosis (MS) is said to be experiencing an exacerbation when he or she experiences symptoms that: