Nokea
The nurse is caring for a patient with gout and takes losartan for control of the condition. Which of the following laboratory results should the nurse plan to monitor in the patient?
- A. Blood glucose
- B. Blood pressure
- C. Erythrocyte count
- D. Lymphocyte count
Correct Answer: B
Rationale: Losartan, an angiotensin II receptor antagonist, will lower blood pressure. It does not affect blood glucose, red blood cell count (RBC), or lymphocytes.
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The nurse is conducting patient teaching with a patient who has systemic lupus erythematosus and is prescribed hydroxychloroquine. Which of the following information should the nurse include in the teaching plan?
- A. Has a rapid therapeutic response.
- B. Vision assessment every 6-12 months
- C. Does not prevent flare-ups of symptoms.
- D. Can only be administered intravenously.
Correct Answer: B
Rationale: Fundoscopic and visual field examinations must be performed by an ophthalmologist every 6-12 months when patients are on hydroxychloroquine. Hydroxychloroquine is often used to treat fatigue and moderate skin and joint problems. Unlike the rapid response noted with corticosteroids, effects of antimalarial therapy may not be noticed for several months. Flares may also be prevented with these drugs.
The nurse is planning care for a patient who has osteoarthritis. Which of the following medications should the nurse anticipate being prescribed for the patient?
- A. Adalimumab
- B. Prednisone
- C. Capsaicin cream
- D. Sulphasalazine
Correct Answer: C
Rationale: Capsaicin cream blocks the transmission of pain impulses and is helpful for some patients in treating OA. The other medications would be used for patients with RA.
The health care provider has prescribed the following collaborative interventions for a patient who is taking azathioprine for systemic lupus erythematosus. Which of the following orders should the nurse question?
- A. Draw anti-DNA blood titre.
- B. Administer varicella vaccine.
- C. Use naproxen 200 mg BID.
- D. Take famotidine 20 mg daily.
Correct Answer: B
Rationale: Live virus vaccines, such as varicella, are contraindicated in a patient taking immunosuppressive drugs. The other orders are appropriate for the patient.
Which of the following findings should the nurse expect when assessing an older-adult patient who has osteoarthritis (OA) of the left knee?
- A. Heberden nodules
- B. Pain upon joint movement
- C. Redness and swelling of the knee joint
- D. Stiffness that increases with movement
Correct Answer: B
Rationale: Initial symptoms of OA include pain with joint movement. Heberden nodules occur on the fingers. Redness of the joint is more strongly associated with rheumatoid arthritis (RA), and stiffness in OA is worse right after the patient rests and decreases with joint movement.
The nurse is teaching a patient who has rheumatoid arthritis (RA) about how to manage activities of daily living. Which of the following information should the nurse include in the teaching plan?
- A. Stand rather than sit when performing household chores.
- B. Avoid activities that require continuous use of the same muscles.
- C. Strengthen small hand muscles by wringing sponges or washcloths.
- D. Protect the knee joints by sleeping with a small pillow under the knees.
Correct Answer: B
Rationale: Patients are advised to avoid repetitious movements. Sitting during household chores is recommended to decrease stress on joints. Wringing water out of sponges would increase the joint stress. Patients are encouraged to position joints in the extended position and sleeping with a pillow behind the knees would decrease the ability of the knee to extend and also decrease knee range of motion (ROM).