HESI Case Study – Rheumatoid Arthritis with Joint Arthroplasty – Flashcards
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Which nursing intervention related to the scheduled bone scan is most important to implement?
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D) Instruct Terry to increase fluid intake after the test
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Which etiologic factor is related to the onset of rheumatoid arthritis?
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B) Genetic Predisposition
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In addition to the bilateral swollen tender joints, weight loss, and fatigue, what additional manifestation(s) of RA might Terry exhibit?
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B) Joint deformities D) Fever E) Stiffness
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Which assessment findings may indicate aspirin toxicity?
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D) Ringing in the ears and confusion E) Heartburn, bloating, and nausea
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Which adverse effect of methotrexate places Terry at the highest risk for infection?
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A) Neutropenia
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Which information should be included when teaching Terry how to manager her chronic pain?
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B) Apply warm packs to affected joints E) Topical analgesics
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Which nursing intervention is best to implement for this nursing diagnosis?
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D) Instruct Terry regarding the use of joint splints
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Which nursing intervention will promote improved coping for Terry?
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D) Help Terry practice problem-solving techniques
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What is the nurse's best response?
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A) You seem very overwhelmed right now
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What is the nurse's best response to this remark?
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B) Have you considered the possibility of surgical joint replacement?
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What is the best definition of arthroplasty?
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B) Surgical joint replacement
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Which postoperative intervention should the nurse expect to implement?
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D) Empty drainage from the suction device and record the output
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Which assessment finding should be reported to the healthcare provider?
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B) Presence of paresthesia bilaterally
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Which instruction should the nurse include when teaching Terry about the PCA pump?
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B) The pump is set to prevent you from receiving an overdose
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Which intervention should the nurse implement first?
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B) Assess Terry and rule out any possible complications
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Which tasks can be delegated to the UAP?
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B) Empty Terry's catheter drainage bag and record her urinary output E) Obtain and record vital signs
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Which professionals have prescriptive authority that can provide a prescription for a different analgesic?
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A) Nurse practitioner D) Physician's assistant
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What is the best nursing action in response to this prescription?
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C) Contact the PA for clarification of this incomplete prescription
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Which intervention should the nurse implement first?
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C) Assess Terry's vital signs, including her temperature
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Which intervention should the nurse prepare to implement?
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A) Obtain wound and blood cultures
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Which manifestations may indicate the onset of septic shock?
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B) Increased pulse rate C) Restlessness
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The prescription for gentamicin (Garamycin) is in a 50 mL piggyback bag of 0.9% normal saline. How many mL/hour would the nurse set the infusion pump on to deliver the IV gentamicin (Garamycin) over 30 minutes? (Enter numerical value only. If rounding is necessary, round to the whole number.)
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100 rationalle: 50 mL/30 minutes = X mL/60 minutes 300 = 30X X = 100 mL hour
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Which outcome is most important for this portion of the teaching plan?
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D) Terry demonstrates the correct use of crutches for ambulation and transfers
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Which positioning indicates that the crutches are sized correctly?
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B) Arms flexed 20 degrees, crutch top two finger-widths from axilla
