Nokea
A client has had several diagnostic tests to determine systemic lupus erythematosus (SLE). What result is very specific indicator of this diagnosis?
- A. Positive Anti-dsDNA antibody test
- B. Positive Anti-Sm antibodies
- C. Positive ANA titer
- D. Elevated ESR
Correct Answer: A
Rationale: Anti-double-stranded DNA (anti-dsDNA) antibody test is a test that shows high titers of antibodies against native DNA. This is very specific for SLE because this test is not positive for other autoimmune disorders. Anti-Smith (anti-Sm) antibodies are specific for SLE, but are found in only 20% to 30% of clients with SLE. ANA titer shows the presence of an autoimmune disease but is not specific to SLE. The other lab studies may also indicate multisystem involvement.
You may also like to solve these questions
In osteoporosis, which of the following is the most common complication?
- A. Diabetes
- B. Hypertension
- C. Compression fractures of the vertebrae
- D. Cardiac disease
Correct Answer: C
Rationale: In osteoporosis, loss of bone substance exceeds bone formation. The total bone mass and density is reduced, resulting in bones that become progressively porous, brittle, and fragile. Compression fractures of the vertebrae are common. Diabetes, hypertension, and cardiac disease may occur in response to the aging process but are not the result of osteoporosis.
A client is taking large amounts of salicylates for the treatment of bursitis of the left shoulder. The client should be aware to report which symptoms of salicylism?
- A. Ringing in the ears
- B. Diarrhea
- C. Dry hacking cough
- D. Dry eyes
Correct Answer: A
Rationale: Signs of salicylate toxicity include headache, nausea, vomiting, tinnitus, increased pulse and respiratory rate, fever, mental confusion, and drowsiness. Dry hacking cough, diarrhea, and dry eyes are not symptoms of salicylate toxicity.
The nurse is discussing the new medication that a client will be taking for treatment of rheumatoid arthritis. Which disease-modifying antirheumatic drug (DMARD) will the nurse educate the client about?
- A. Methotrexate
- B. Celecoxib
- C. Methylprednisolone
- D. Mercaptopurine azathioprine
Correct Answer: A
Rationale: Methotrexate is a DMARD that reduces the amount of joint damage and slows the damage to other tissues as well. Celecoxib is a nonsteroidal anti-inflammatory drug (NSAID). Methylprednisolone is a steroid to reduce pain and inflammation and slow joint destruction. Mercaptopurine azathioprine is a cytotoxic drug.
A client with ankylosing spondylitis has a stooped position and is being positioned in the bed prior to the nurse taking vital signs. The nurse listens to the client's lungs after positioning. What finding related to the client's condition may the nurse hear when listening to lung sounds?
- A. Crackles in the bases
- B. Pericardial friction rub
- C. Lung sounds may be diminished in the apical area.
- D. Rhonchi
Correct Answer: C
Rationale: Lung sounds may be reduced, especially in the apical area. The nurse would not hear rhonchi, crackles, or a pericardial friction rub unless the client had underlying cardiac or respiratory disorders.
The nurse is planning care in the home for a client with rheumatoid arthritis. What instruction(s) should the nurse include in the plan of care? Select all that apply.
- A. Collaborate with occupational therapists for specialized equipment.
- B. Identify the exercise regimen planned by physical therapist.
- C. Provide nursing assistance for ADLs.
- D. Teach the nursing assistant to allow extra time in the evening for hygiene or other procedures.
- E. Ensure the home environment is safe.
Correct Answer: A,B,C,E
Rationale: The nurse should collaborate with occupational therapists for specialized equipment, identify the exercise regimen planned by physical therapist, provide nursing assistance for ADLs, and ensure the home environment is safe. The nurse should teach the nursing assistant to allow extra time in the morning, not the evening, for hygiene or other procedures.