Nokea
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 client diagnosed with Multi Organ Dysfunction Syndrome (MODS) has renal, cardiovascular, and pulmonary dysfunction issues. Which statement by the nurse indicates an understanding of the client's prognosis?
- A. As long as the client is maintained on a ventilator, then the prognosis can be up to 60% recovery.
- B. The client will have less than a 2% potential for recovery from the MODS.
- C. When three or more body systems fail, the mortality rate can be 70% to 80%.
- D. More than one body system in failure reduces the recovery rate to 80% to 90%.
Correct Answer: C
Rationale: MODS with three or more organ failures has a 70–80% mortality rate. Ventilator use, 2% recovery, and 80–90% recovery are inaccurate.
Which referral should the nurse implement for a client with severe multiple allergies?
- A. Registered dietitian.
- B. Occupational therapist.
- C. Recreational therapist.
- D. Social worker.
Correct Answer: A
Rationale: A dietitian helps identify food allergens, critical for severe allergies. Other therapists are less relevant.
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.
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 client diagnosed with RA has developed swan-neck fingers. Which referral is most appropriate for the client?
- A. Physical therapy.
- B. Occupational therapy.
- C. Psychiatric counselor.
- D. Home health nurse.
Correct Answer: B
Rationale: Occupational therapy addresses hand function and adaptive devices for swan-neck deformities. Physical therapy, counseling, and home health are less specific.