Nokea
A client is receiving treatment for rheumatoid arthritis but reports being allergic to eggs. What medication would the client be unable to receive?
- A. Methotrexate (Rheumatrex)
- B. Synvisc
- C. Anakinra (Kineret)
- D. Prednisone
Correct Answer: B
Rationale: Clients allergic to eggs should not receive Synvisc injections because they will also be allergic to this. The other medications can be taken with an egg allergy.
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The nurse is conducting a new-patient assessment on a patient who reports having fibromyalgia. Which of the following would the nurse expect to assess as the most common finding associated with this condition?
- A. Heberden nodes
- B. Jaw locking
- C. Widespread chronic pain
- D. Butterfly facial rash
Correct Answer: C
Rationale: The most common finding associated with fibromyalgia is widespread and chronic pain, as clients experience an increased sensitivity to pain signals. Heberden nodes are associated with osteoarthritis. Jaw locking is a manifestation of temporomandibular joint dislocation. A butterfly facial rash is associated with systemic lupus erythematosus.
The nurse is reviewing the diagnostic test findings of a client with rheumatoid arthritis. What would the nurse expect to find?
- A. Increased red blood cell count
- B. Increased C4 complement
- C. Elevated erythrocyte sedimentation rate
- D. Increased albumin levels
Correct Answer: C
Rationale: The erythrocyte sedimentation rate (ESR) may be elevated, particularly as the disease progresses. ESR shows inflammation associated with RA. Red blood cell count and C4 complement component are decreased. Serum protein electrophoresis may disclose increased levels of gamma and alpha globulin but decreased albumin.
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.
A client is suspected to have Lyme disease and has a red macule at the site of the tick bite with a bull's-eye rash with round rings surrounding the center. In addition, the client has a severe headache with neck stiffness. What stage of Lyme disease does the nurse suspect?
- A. Early stage 1
- B. Mid-stage
- C. Later stage
- D. Latent stage
Correct Answer: A
Rationale: Early stage 1 symptoms for about one third of clients include a red macule or papule at the site of the tick bite, a characteristic bull's-eye rash (called erythema migrans) with round rings surrounding the center, severe headache, and neck stiffness. Mid-stage and later stage symptoms include more systemic involvement like joint pain or neurological symptoms, while the latent stage may be asymptomatic.