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A client with a diagnosis of rheumatoid arthritis is experiencing severe pain. Which medication is likely to be prescribed?
- A. Acetaminophen (Tylenol)
- B. Ibuprofen (Advil)
- C. Methotrexate (Rheumatrex)
- D. Prednisone (Deltasone)
Correct Answer: C
Rationale: The correct answer is C: Methotrexate (Rheumatrex). Methotrexate is a disease-modifying antirheumatic drug commonly prescribed for managing rheumatoid arthritis. It helps reduce inflammation and pain by targeting the immune system's overactivity. Acetaminophen (A) is a mild pain reliever and does not treat the underlying inflammation in rheumatoid arthritis. Ibuprofen (B) is a nonsteroidal anti-inflammatory drug (NSAID) that can help with pain and inflammation but is not as effective in managing rheumatoid arthritis as methotrexate. Prednisone (D) is a corticosteroid that can provide quick relief from inflammation and pain, but it is typically used for short-term management due to its potential side effects.
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A 45-year-old obese man arrives at a clinic reporting daytime sleepiness, difficulty falling asleep at night, and snoring. The nurse should recognize the manifestations of what health problem?
- A. Adenoiditis
- B. Chronic tonsillitis
- C. Obstructive sleep apnea
- D. Laryngeal cancer
Correct Answer: C
Rationale: The correct answer is C: Obstructive sleep apnea. The patient's symptoms of daytime sleepiness, difficulty falling asleep, and snoring are classic signs of obstructive sleep apnea, a condition where the upper airway collapses during sleep, leading to pauses in breathing. This results in poor sleep quality and daytime fatigue. Adenoiditis (choice A) and chronic tonsillitis (choice B) typically present with symptoms like sore throat and difficulty swallowing, which are not seen in this patient. Laryngeal cancer (choice D) would present with hoarseness, persistent cough, and difficulty swallowing, which are not mentioned in the patient's symptoms. Therefore, based on the patient's presentation, the most likely diagnosis is obstructive sleep apnea.
A client's healthcare provider has ordered a 'liver panel' in response to the client's development of jaundice. When reviewing the results of this laboratory testing, the nurse should expect to review what blood tests? Select one that doesn't apply.
- A. Alanine aminotransferase (ALT)
- B. C-reactive protein (CRP)
- C. Gamma-glutamyl transferase (GGT)
- D. Aspartate aminotransferase (AST)
Correct Answer: B
Rationale: The correct answer is B: C-reactive protein (CRP). A liver panel typically includes tests such as ALT, GGT, and AST to assess liver function, but CRP is not part of a standard liver panel. CRP is a marker of inflammation and infection, not specific to liver function. Therefore, when reviewing the results of a liver panel for a client with jaundice, the nurse should not expect to see CRP among the blood tests.
A client with rheumatoid arthritis is prescribed methotrexate. Which instruction should the nurse include in the client's teaching?
- A. Avoid alcohol while taking this medication.
- B. Take the medication with a full meal.
- C. Increase your intake of high-fiber foods.
- D. Avoid exposure to sunlight.
Correct Answer: A
Rationale: The correct answer is A: Avoid alcohol while taking this medication. Methotrexate can cause liver toxicity, and alcohol consumption can exacerbate this risk. It is important for the client to avoid alcohol to prevent potential harm to the liver.
B: Taking the medication with a full meal is not a necessary instruction for methotrexate. It is typically recommended to take methotrexate on an empty stomach.
C: Increasing intake of high-fiber foods is not directly related to methotrexate therapy. It is important for overall health but not specifically for this medication.
D: Avoiding exposure to sunlight is not a common instruction for methotrexate. While some medications can increase sensitivity to sunlight, this is not a typical concern with methotrexate.
A client has been diagnosed with an esophageal diverticulum after undergoing diagnostic imaging. When taking the health history, the nurse should expect the client to describe what sign or symptom?
- A. Burning pain on swallowing
- B. Regurgitation of undigested food
- C. Symptoms mimicking a myocardial infarction
- D. Chronic parotid abscesses
Correct Answer: B
Rationale: Rationale for Correct Answer B (Regurgitation of undigested food):
1. Esophageal diverticulum is a pouch-like protrusion in the esophageal wall, causing difficulty in swallowing.
2. Due to the diverticulum, food may get trapped and regurgitated, leading to regurgitation of undigested food.
3. This symptom is characteristic of esophageal diverticulum and indicates an abnormality in the esophageal functioning.
Summary of Incorrect Choices:
A: Burning pain on swallowing - Not a typical symptom of esophageal diverticulum; more indicative of conditions like GERD.
C: Symptoms mimicking a myocardial infarction - Unrelated to esophageal diverticulum and more suggestive of cardiac issues.
D: Chronic parotid abscesses - Not associated with esophageal diverticulum, as parotid abscesses involve the salivary glands.
A client with newly diagnosed type 2 diabetes is preparing for discharge. Which statement by the client indicates a need for further teaching?
- A. I will take my insulin shots only when my blood sugar is high
- B. I need to follow a balanced diet and exercise regularly
- C. I should monitor my blood sugar levels regularly
- D. I need to take my medication as prescribed by my doctor
Correct Answer: A
Rationale: The correct answer is A because insulin shots are not only taken when blood sugar is high in type 2 diabetes. Insulin therapy may be prescribed by the doctor to be taken at specific times regardless of blood sugar levels to manage the condition effectively. Choice B is correct as it emphasizes the importance of lifestyle modifications in managing diabetes. Choice C is correct as monitoring blood sugar levels is crucial for managing diabetes. Choice D is correct as adherence to prescribed medication is essential in controlling blood sugar levels.