HESI CASE STUDY RHEUMATOID ARTHRITISWITH
JOINT ARTHROPLASTY EXPECTED QUESTIONS WITH
VERIFIED ANSWERS
Question 1.
Which positioning indicates that the crutches are sized correctly?
ANSWER
Arms flexed 30 degrees, crutch top 3 finger-widths from axilla.
R: Correct positioning includes the arms flexed at no more than 30 degrees, with the tops of
the crutches 2 to 3 finger-widths from the axilla when the crutch tips are at least 6 inches in
front of the foot.
Question 2.
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?
ANSWER
i. "There are surgical options that may help. Would you like to discuss those options?"
ii. R: Making a client-focused suggestion offers Terry an alternative without being
confrontational or belittling.
Question 3.
Terry is experiencing impaired mobility. Which nursing intervention is best to implement for this
nursing diagnosis?
ANSWER
i. Advise Terry to take a hot shower in the morning to prevent morning stiffness.
ii. R: Morning stiffness can be reduced by taking a hot shower in the morning.
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, Question 4.
Which information should be included when teaching Terry how to manage her chronic pain?
ANSWER
Protect joints from stress.
R: While RA is a progressive chronic disease, emphasis needs to be made to help Terry identify
ways to alter her tasks to put less stress on joints.
Alternate scheduled rest period with activity throughout the day.
R: This will help to relieve fatigue and pain.
Question 5.
What is the nurse's best response?
ANSWER
i. "You seem very concerned about how this is impacting your family and you."
ii. R: Clarification of Terry's feelings is a therapeutic technique which will encourage further
communication.
Question 6.
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?
ANSWER
Joints tender, painful, and warm to the touch.
R: In RA, joints are tender, painful, and warm to the touch.
Fever.
R: A persistent low-grade fever is a common early manifestation of this inflammatory disease.
Remember, RA is both a local and systemic inflammatory disease with many generalized
symptoms such as fever, fatigue, and weakness, along with multiple lung, cardiac, and renal
manifestations.
Bilateral symmetric joint involvement.
R: The symptoms usually include bilateral, symmetric joint involvement.
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JOINT ARTHROPLASTY EXPECTED QUESTIONS WITH
VERIFIED ANSWERS
Question 1.
Which positioning indicates that the crutches are sized correctly?
ANSWER
Arms flexed 30 degrees, crutch top 3 finger-widths from axilla.
R: Correct positioning includes the arms flexed at no more than 30 degrees, with the tops of
the crutches 2 to 3 finger-widths from the axilla when the crutch tips are at least 6 inches in
front of the foot.
Question 2.
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?
ANSWER
i. "There are surgical options that may help. Would you like to discuss those options?"
ii. R: Making a client-focused suggestion offers Terry an alternative without being
confrontational or belittling.
Question 3.
Terry is experiencing impaired mobility. Which nursing intervention is best to implement for this
nursing diagnosis?
ANSWER
i. Advise Terry to take a hot shower in the morning to prevent morning stiffness.
ii. R: Morning stiffness can be reduced by taking a hot shower in the morning.
1/7
, Question 4.
Which information should be included when teaching Terry how to manage her chronic pain?
ANSWER
Protect joints from stress.
R: While RA is a progressive chronic disease, emphasis needs to be made to help Terry identify
ways to alter her tasks to put less stress on joints.
Alternate scheduled rest period with activity throughout the day.
R: This will help to relieve fatigue and pain.
Question 5.
What is the nurse's best response?
ANSWER
i. "You seem very concerned about how this is impacting your family and you."
ii. R: Clarification of Terry's feelings is a therapeutic technique which will encourage further
communication.
Question 6.
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?
ANSWER
Joints tender, painful, and warm to the touch.
R: In RA, joints are tender, painful, and warm to the touch.
Fever.
R: A persistent low-grade fever is a common early manifestation of this inflammatory disease.
Remember, RA is both a local and systemic inflammatory disease with many generalized
symptoms such as fever, fatigue, and weakness, along with multiple lung, cardiac, and renal
manifestations.
Bilateral symmetric joint involvement.
R: The symptoms usually include bilateral, symmetric joint involvement.
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