HESI Case Study Rheumatoid Arthritis with Joint Arthroplasty

Which nursing intervention related to the scheduled bone scan is most important to implement? Correct answer- Inform Terry that radioisotope will be administered 2 hours before the procedure. Which etiologic factor is related to the onset of rheumatoid arthritis? Correct answer- Genetic predisposition. The nurse completes an assessment of Terry. In addition to the bilateral swollen tender joints, weight loss, and fatigue, what additional manifestations of RA might Terry exhibit? Correct answer- Joints tender, painful, and warm to the touch. Fever Swan neck deformity of fingers. Bilateral symmetric joint involvement. Which assessment findings may indicate aspirin toxicity? Correct answer- Headache and confusion. Hyperventilation and agitation. Which adverse effect of methotrexate places Terry at the highest risk for infection? Correct answer- Leukopenia. Which information should be included when teaching Terry how to manage her chronic pain? Correct answer- Protect joints from stress. Alternate scheduled rest period with activity throughout the day. Terry is experiencing impaired mobility. Which nursing intervention is best to implement for this nursing diagnosis? Correct answer- Advise Terry to take a hot shower in the morning to prevent morning stiffness. Which nursing intervention will promote improved coping for Terry? Correct answer- Discuss with Terry how to work through problems that can arise while managing her condition. What is the nurse's best response? Correct answer- "You seem very concerned about how this is impacting your family and you." Terry continues, "It is so hard on my husband and children. It seems I have no options in my life." What is the nurse's best response to this remark? Correct answer- "There are surgical options that may help. Would you like to discuss those options?" Which best describes arthroplasty? Correct answer- Surgical reconstruction or replacement of a joint. Which postoperative intervention should the nurse expect to implement? Correct answer- Perform regular neurovascular assessment. The nurse performs neurovascular assessment of Terry's feet every 2 hours. Which assessment finding should be reported to the healthcare provider? Correct answer- Pallor to right foot only. Which instruction should the nurse include when teaching Terry about the PCA pump? Correct answer- "You can request additional pain medication if your pain is not controlled with the pump." Which intervention should the nurse implement first? Correct answer- Perform a neurovascular assessment. Which tasks can be delegated to the UAP? Correct answer- Apply antiembolic hose. Remove the CPM machine while assisting Terry to bathe. Which professional(s) have prescriptive authority that can provide a prescription for a different analgesic? . Correct answer- Nurse practitioner. Physician's assistant. The nurse contacts the surgical physician's assistant (PA), who provides the following verbal prescription: hydrocodone/acetominophen (Lortab) 7.5/500 mg, 2 tabs PO PRN for pain. What is the best nursing action in response to this prescription? Correct answer- Repeat the verbal order back to the PA for clarification and completeness of the order. Which intervention should the nurse implement first? Correct answer- Assess Terry's vital signs and check the surgical dressings.. Which intervention should the nurse prepare to implement? Correct answer- Obtain cold packs or a cooling blanket. Which manifestations may indicate the onset of septic shock? Correct answer- Decreased urinary output. Altered mental status. The nurse notifies the healthcare provider and obtains wound and blood cultures. Terry is started on levofloxacin 750 mg every 24 hours, a primary IV of Ringer's Lactate at 125 mL/hour, and a cooling blanket. The prescription for levofloxacin is in a 100 mL piggyback bag of 0.9% normal saline. How many mL/hour would the nurse set the infusion pump on to deliver the IV levofloxacin over 2 hours? (Enter numerical value only. If rounding is necessary, round to the whole number.) Correct answer- 50 Which outcome is most important for this portion of the teaching plan? Correct answer- Terry successfully demonstrates the correct use of crutches for ambulation and transfers. Which positioning indicates that the crutches are sized correctly? Correct answer- Arms flexed 30 degrees, crutch top 3 finger-widths from axilla.