Exam 5 Review

The primary health care provider prescribes methotrexate (MTX) for a client with a new diagnosis of rheumatoid arthritis. The nurse provides health teaching about the drug. What statement by the nurse is appropriate to include about methotrexate?

• "The drug can increase your risk for infection, so you should avoid crowds."

• "It's OK for you to drink about 2 to 3 glasses of wine each week while taking the drug."

• "It will take at least 1 to 2 weeks for the drug to help relieve your symptoms."

• "The drug is very expensive but there are pharmacy plans to help pay for it."

The nurse assesses a client after a total hip arthroplasty. The client's surgical leg is visibly shorter than the other one and the client reports extreme pain. While a co-worker calls the surgeon, what action by the nurse is appropriate?

• Elevate the surgical leg and apply ice.

• Assess neurovascular status in both legs.

• Try to place the surgical leg in abduction.

• Prepare to administer pain medication.

A client has a metastatic bone tumor in the left leg. What action by the nurse is appropriate?

• Teach the client about amputation care.

• Elevate the extremity and apply moist heat.

• Place the client on protective precautions.

• Administer pain medication as prescribed.

A client had a bunionectomy with osteotomy. The client asks why healing may take up to 3 months. What explanation by the nurse is best?

• "The bones in your feet are hard to operate on."

• "The surrounding bones and tissue are damaged."

• "Your feet bear weight so they never really heal."

• "Your feet have less blood flow, so healing is slower."

When assessing gait, what feature(s) would the nurse inspect? (Select all that apply.)

• Ease of Stride

• Length of Stride

• Balance

• Steadiness

• Goniometer Readings

The nurse is caring for an older client who has kyphosis and a widened gait. For which health problems is the client at risk?

• Osteoporosis

• Osteopenia

• Falls

• Contracture

The nurse is assessing a client diagnosed with trigeminal neuralgia affecting cranial nerve V. What assessment findings will the nurse expect for this client?

• Slurred Speech

• Severe facial pain

• Ptosis (Eyelid Dropping)

• Expressive Aphasia

The nurse reads on a chart that a client has lichenification. What assessment finding confirms this description?

• Purple skin patches

• Increased skin thickness

• Excessive facial hair

• Tightly stretched skin

A nurse assesses an older adult's skin. Which findings require immediate referral? (Select all that apply.)

• Presence of toenail fungus

• Excessive moisture under axilla

• Asymmetric 6mm dark lesion on forehead

• Spider veins on legs

• Lesions with various colors

A nurse performs an assessment of pain discrimination on an older adult. The client correctly identifies, with eyes closed, a sharp sensation on the right hand when touched with a pin. Which action would the nurse take next?

• Ask the client about current and past medications.

• Contact the primary health care provider with the assessment results.

• Touch the pin on the same area of the left hand.

• Continue the assessment on the client's feet and legs.