Nokea
The 20-year-old female client diagnosed with advanced unremitting RA is being admitted to receive a regimen of immunosuppressive medications. Which question should the nurse ask during the admission process regarding the medications?
- A. Are you sexually active, and, if so, are you using birth control?
- B. Have you discussed taking these drugs with your parents?
- C. Which arm do you prefer to have an IV in for four (4) days?
- D. Have you signed an informed consent for investigational drugs?
Correct Answer: A
Rationale: Immunosuppressants are teratogenic, making contraception critical. Parental discussion, IV preference, and investigational consent are less relevant.
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Which statement indicates the female client with systemic lupus erythematosus (SLE) understands the discharge instructions?
- A. I should wear sunscreen with at least a 5 SPF.
- B. I am not going to any activities with large crowds.
- C. I should not get pregnant because I have SLE.
- D. I must avoid using hypoallergenic products.
Correct Answer: C
Rationale: Avoiding pregnancy prevents SLE complications, indicating understanding. SPF 5 is inadequate, crowd avoidance is not standard, and hypoallergenic products are safe.
Which surgical procedure should the nurse anticipate the client with myasthenia gravis undergoing to help prevent the signs/symptoms of the disease process?
- A. There is no surgical option.
- B. A transsphenoidal hypophysectomy.
- C. A thymectomy.
- D. An adrenalectomy.
Correct Answer: C
Rationale: Thymectomy can reduce symptoms in myasthenia gravis by removing the thymus, often implicated in autoimmunity. Other surgeries are irrelevant.
The client diagnosed with an acute exacerbation of SLE is being discharged with a prescription for an oral steroid which will be discontinued gradually. Which statement is the scientific rationale for this type of medication dosing?
- A. Tapering the medication prevents the client from having withdrawal symptoms.
- B. So the thyroid gland starts working, because this medication stops it from working.
- C. Tapering the dose allows the adrenal glands to begin to produce cortisol again.
- D. This is the health-care provider's personal choice in prescribing the medication.
Correct Answer: C
Rationale: Tapering steroids allows adrenal glands to resume cortisol production, preventing adrenal insufficiency. Withdrawal symptoms are secondary, thyroid is unaffected, and it’s not provider preference.
The client has had an anaphylactic reaction to insect venom, a bee sting. Which discharge instruction should the nurse discuss with the client?
- A. Take a corticosteroid dose pack when stung by a bee.
- B. Take antihistamines prior to outdoor activities.
- C. Use a cromolyn sodium (Intal) inhaler prophylactically.
- D. Carry a bee sting kit, especially when going outside.
Correct Answer: D
Rationale: Carrying a bee sting kit (EpiPen) is critical for managing future anaphylaxis. Steroids, antihistamines, and cromolyn are less effective prophylactically.
Which signs/symptoms should the nurse expect to assess in the client diagnosed with Sjögren's syndrome?
- A. Complaints of dry mouth and eyes.
- B. Complaints of peripheral joint pain.
- C. Complaints of muscle weakness.
- D. Complaints of severe itching.
Correct Answer: A
Rationale: Dry mouth and eyes (sicca symptoms) are hallmark signs of Sjögren’s syndrome. Joint pain, weakness, and itching are less specific.