Nokea
The nurse clarifies to a patient who is being evaluated for possible rheumatoid arthritis that the elevated erythrocyte sedimentation rate (ESR) indicates the presence of which process?
- A. A chronic infection
- B. Poor protein intake
- C. Increased inflammatory reaction in the body.
- D. A poor immune response to a microorganism
Correct Answer: C
Rationale: The ESR indicates an increase in the inflammatory reactions in the body. An elevated ESR does not indicate a chronic infection, poor protein intake or a poor immune response to a microorganism.
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The patient, age 58, is diagnosed with osteoporosis after densitometry testing. She has been menopausal for 5 years and has been concerned about her risk for osteoporosis because her mother has osteoporosis. When reinforcing instructions about her osteoporosis, which information does the nurse include?
- A. Even with a family history of osteoporosis, the calcium loss from bones can be slowed by increased calcium intake and exercise.
- B. Estrogen replacement therapy must be started to prevent rapid progression of her osteoporosis.
- C. With a family history of osteoporosis, there is no way to prevent or slow bone reabsorption.
- D. Continuous, low-dose corticosteroid treatment is effective in stopping the course of osteoporosis.
Correct Answer: A
Rationale: To prevent osteoporosis, women are advised to have an adequate daily intake of calcium and vitamin D; exercise regularly; avoid smoking; decrease caffeine intake; decrease excess protein in the diet; and engage in regular moderate activity such as walking, bike riding, or swimming at least 3 days a week. Estrogen does not increase bone formation. Prevention of osteoporosis should begin before bone loss has occurred. A contributing factor may be use of steroids.
Which is the main purpose of traction?
- A. Align and stabilize a fracture.
- B. Prevent deformities.
- C. Relieve muscle spasms.
- D. Promote bed rest.
- E. Increase circulation to the rest of the body.
Correct Answer: A,B,C
Rationale: Skin and skeletal traction provide alignment and stabilize a fracture. This prevents deformities. Traction may also be used to relieve muscle spasms. Traction is not used to promote bed rest or to increase circulation to the rest of the body.
The nurse reinforces instructions for the patient who is to have a unicompartmental knee replacement that which is a major advantage of this partial knee replacement?
- A. the patient will be up and walking 2 to 3 hours after the operation.
- B. the kneecap is completely removed.
- C. the procedure is especially helpful in the treatment of rheumatoid arthritis (RA).
- D. a small titanium disk replaces the worn cartilage.
Correct Answer: A
Rationale: Unicompartmental knee arthroplasty is also referred to as partial knee replacement in which the worn cartilage is replaced with a plastic disk. It is not as invasive as a full knee replacement and does not disturb the kneecap so that the patient can be up and walking in 2 to 3 hours after surgery. It is not recommended for patients with Rheumatoid Arthritis.
Which patient statement indicates the need for additional teaching for a patient with rheumatoid arthritis who is taking meloxicam?
- A. I am keeping a daily record of my blood pressure.'
- B. I take aspirin before I go to bed.'
- C. I know I can take meloxicam with or without regard to meals.'
- D. I weigh every day so I will be aware of any weight gain.'
Correct Answer: B
Rationale: Aspirin or products containing aspirin should be avoided while taking meloxicam. While taking meloxicam, there is no reason to record blood pressure readings. This medication can be taken without regard to meals. Meloxicam does not cause weight gain.
The nurse administering the drug colchicine for gout will give $0.5 \mathrm{mg}$ hourly for hours.
Correct Answer: 12
Rationale: Colchicine is given orally in a dose of $0.5 \mathrm{mg}$ for a period of 12 hours or until relief from pain is achieved or diarrhea occurs.