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The nurse is caring for a client with suspected fibromyalgia. Which diagnostic test confirms the diagnosis of fibromyalgia?
- A. There is no diagnostic test to confirm fibromyalgia.
- B. A positive antinuclear antibody test.
- C. A magnetic resonance imaging (MRI) shows fibrosis.
- D. A negative erythrocyte sedimentation rate (ESR).
Correct Answer: A
Rationale: Fibromyalgia is diagnosed clinically, with no confirmatory test. ANA, MRI, and ESR are not diagnostic.
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The nurse is caring for clients on a medical floor. Which client should the nurse assess first?
- A. The client diagnosed with RA complaining of pain at a '3' on a 1-to-10 scale.
- B. The client diagnosed with SLE who has a rash across the bridge of the nose.
- C. The client diagnosed with advanced RA who is receiving antineoplastic drugs IV.
- D. The client diagnosed with scleroderma who has hard, waxlike skin near the eyes.
Correct Answer: C
Rationale: Antineoplastic drugs (e.g., methotrexate) pose risks like toxicity, requiring immediate assessment. Mild pain, rashes, and scleroderma are less acute.
The client diagnosed with myasthenia gravis is admitted with an acute exacerbation. Which interventions should the nurse implement? Select all that apply.
- A. Assist the client to turn and cough every two (2) hours.
- B. Place the client in a high or semi-Fowler's position.
- C. Assess the client's pulse oximeter reading every shift.
- D. Plan meals to promote medication effectiveness.
- E. Monitor the client's serum anticholinesterase levels.
Correct Answer: A,B,C,D
Rationale: Turning/coughing, Fowler’s position, pulse oximetry, and meal timing address respiratory risk and medication efficacy in myasthenia gravis. Serum anticholinesterase levels are not routinely monitored.
Which assessment data should the nurse assess in the client diagnosed with Guillain-Barré syndrome?
- A. An exaggerated startle reflex and memory changes.
- B. Cogwheel rigidity and inability to initiate voluntary movement.
- C. Sudden severe unilateral facial pain and inability to chew.
- D. Progressive ascending paralysis of the lower extremities and numbness.
Correct Answer: D
Rationale: Guillain-Barré syndrome presents with ascending paralysis and numbness due to peripheral nerve demyelination. Startle reflex, rigidity, and facial pain suggest other conditions.
The 26-year-old female client is complaining of a low-grade fever, arthralgias, fatigue, and a facial rash. Which laboratory tests should the nurse expect the HCP to order if SLE is suspected?
- A. Complete metabolic panel and liver function tests.
- B. Complete blood count and antinuclear antibody tests.
- C. Cholesterol and lipid profile tests.
- D. Blood urea nitrogen and glomerular filtration tests.
Correct Answer: B
Rationale: CBC and ANA tests detect anemia, leukopenia, and autoantibodies, supporting SLE diagnosis. Metabolic, lipid, and renal tests are less specific initially.
The charge nurse observes the primary nurse interacting with a client. Which action by the primary nurse warrants immediate intervention by the charge nurse?
- A. The nurse explains the IVP diuretic will make the client urinate.
- B. The nurse dons nonsterile gloves to remove the client's dressing.
- C. The nurse administers a medication without checking for allergies.
- D. The nurse asks the UAP for help moving a client up in bed.
Correct Answer: C
Rationale: Administering medication without checking allergies risks allergic reactions, requiring immediate intervention. Diuretic explanation, glove use, and UAP assistance are appropriate.