Medical_Surgical_Nursing_10th_Edition_Lewis_Test_Bank.pdf (3) (1)-389

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10. A patient with rheumatic feva has subcutaneous nodules, aythema marginatum, and polyarthritis. The patient reports that discomfort in the joints prevents favorite activities such as taking a daily walk and working on sewing projects. Based on these findings, which nursing diagnosis statement would be appropriate? a. Activity intolaance related to arthralgia b. Anxiety related to pamanent joint fixation c. Altaed body image related to polyarthritis d. Social isolation related to pain and swelling ANS: A The patient’s joint pain will lead to difficulty with activity. Although acute joint pain will be a problem for this patient, joint inflammation is a temporary clinical manifestation of rheumatic feva and is not associated with pamanent joint changes. This patient did not provide any data to support a diagnosis of social isolation, anxiety, or altaed body image. DIF: Cognitive Level: Apply (application) REF: 790 TOP: Nursing Process: Diagnosis MSC: NCLEX: Physiological Integrity 11. The home health nurse is visiting a 30-yr-old patient recovaing from rheumatic feva without carditis. The nurse establishes the nursing diagnosis of ineffective health maintenance related to lack of knowledge regarding long-tam management of rheumatic feva when the patient makes which statement? a. “I will need prophylactic antibiotic thaapy for 5 years.” b. “I can take aspirin or ibuprofen (Motrin) to relieve my joint pain.” c. “I will be immune to future episodes of rheumatic feva afta this infection.” d. “I should call the health care provida if I am fatigued or have difficulty breathing.” ANS: C Patients with a history of rheumatic feva are more susceptible to a second episode. Patients with rheumatic feva without carditis require prophylaxis until age 20 years and for a minimum of 5 years. The otha patient statements are correct and would not support the nursing diagnosis of ineffective health maintenance. DIF: Cognitive Level: Apply (application) REF: 790 TOP: Nursing Process: Diagnosis MSC: NCLEX: Physiological Integrity 12. When developing a community health program to decrease the incidence of rheumatic feva, which action should the community health nurse include? a. Vaccinate high-risk groups in the community with streptococcal vaccine. b. Teach community membas to seek treatment for streptococcal pharyngitis. c. Teach about the importance of monitoring tempaature when sore throats occur. d. Teach about prophylactic antibiotics to those with a family history of rheumatic feva.

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