A nurse is reinforcing discharge teaching with a client who has osteoarthritis. Which of the following statements by the client indicates an understanding of the teaching?
Osteoarthritis is caused by inflammation that affects both joints and other body tissues.
Osteoarthritis occurs due to the aging process and results in disintegration of cartilage in a joint.
Osteoarthritis is due to loss of calcium in the bones, which can lead to increased risk for bone fractures.
Osteoarthritis happens in several phases when deposits of crystals develop in joints and soft tissues.
The Correct Answer is B
Choice A rationale
Osteoarthritis is caused by inflammation that affects both joints and other body tissues is incorrect. This description is more characteristic of rheumatoid arthritis, which is an autoimmune disease that causes systemic inflammation.
Choice B rationale
Osteoarthritis occurs due to the aging process and results in disintegration of cartilage in a joint is correct. Osteoarthritis is a degenerative joint disease that primarily affects the cartilage, leading to its breakdown over time.
Choice C rationale
Osteoarthritis is due to loss of calcium in the bones, which can lead to increased risk for bone fractures is incorrect. This description is more characteristic of osteoporosis, a condition that weakens bones and makes them more prone to fractures.
Choice D rationale
Osteoarthritis happens in several phases when deposits of crystals develop in joints and soft tissues is incorrect. This description is more characteristic of gout, a type of arthritis caused by the deposition of urate crystals in the joints.
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Correct Answer is A
Explanation
Choice A rationale
Regular insulin is correct because it is a short-acting insulin that can be used to treat diabetic ketoacidosis (DKA). The client’s symptoms of confusion, flushed appearance, and acetone odor on the breath suggest DKA, which requires prompt treatment with insulin to lower blood glucose levels and correct metabolic acidosis. Regular insulin has a rapid onset of action and can be administered intravenously to achieve quick results.
Choice B rationale
NPH insulin is incorrect because it is an intermediate-acting insulin that is not suitable for the immediate treatment of DKA. NPH insulin has a slower onset of action and is typically used for basal insulin coverage rather than for acute management of hyperglycemia. In cases of DKA, rapid-acting or short-acting insulin is preferred to achieve quick glucose control.
Choice C rationale
Glargine insulin is incorrect because it is a long-acting insulin that provides basal insulin coverage over 24 hours. It is not suitable for the immediate treatment of DKA, as it does not have a rapid onset of action. Glargine insulin is typically used for maintaining stable blood glucose levels over a prolonged period rather than for acute management of hyperglycemia.
Choice D rationale
Detemir insulin is incorrect because it is a long-acting insulin similar to glargine. It provides basal insulin coverage and is not suitable for the immediate treatment of DKA. Detemir insulin has a slower onset of action and is used for maintaining stable blood glucose levels rather than for rapid correction of hyperglycemia in acute situations.
Correct Answer is A
Explanation
Choice A rationale
Determining the patency of the tubing is the first action the nurse should take. If there is no urinary output, it is important to check for any kinks or blockages in the tubing that may be preventing the flow of urine. Ensuring the patency of the tubing can help resolve the issue without the need for further intervention.
Choice B rationale
Notifying the provider is not the first action the nurse should take. The nurse should first assess the situation and determine if there is a simple solution, such as checking the patency of the tubing, before escalating the issue to the provider.
Choice C rationale
Administering a prescribed analgesic is not the first action the nurse should take. While pain management is important, it is crucial to address the lack of urinary output first to prevent complications such as bladder distention or damage.
Choice D rationale
Offering oral fluids is not the first action the nurse should take. While maintaining hydration is important, the immediate concern is to determine why there is no urinary output and address any potential blockages in the tubing.