Nokea
The nurse is discussing the new medication that a client will be taking for treatment of rheumatoid arthritis. Which disease-modifying antirheumatic drug (DMARD) will the nurse educate the client about?
- A. Methotrexate
- B. Celecoxib
- C. Methylprednisolone
- D. Mercaptopurine azathioprine
Correct Answer: A
Rationale: Methotrexate is a DMARD that reduces the amount of joint damage and slows the damage to other tissues as well. Celecoxib is a nonsteroidal anti-inflammatory drug (NSAID). Methylprednisolone is a steroid to reduce pain and inflammation and slow joint destruction. Mercaptopurine azathioprine is a cytotoxic drug.
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In osteoporosis, which of the following is the most common complication?
- A. Diabetes
- B. Hypertension
- C. Compression fractures of the vertebrae
- D. Cardiac disease
Correct Answer: C
Rationale: In osteoporosis, loss of bone substance exceeds bone formation. The total bone mass and density is reduced, resulting in bones that become progressively porous, brittle, and fragile. Compression fractures of the vertebrae are common. Diabetes, hypertension, and cardiac disease may occur in response to the aging process but are not the result of osteoporosis.
A client is taking large amounts of salicylates for the treatment of bursitis of the left shoulder. The client should be aware to report which symptoms of salicylism?
- A. Ringing in the ears
- B. Diarrhea
- C. Dry hacking cough
- D. Dry eyes
Correct Answer: A
Rationale: Signs of salicylate toxicity include headache, nausea, vomiting, tinnitus, increased pulse and respiratory rate, fever, mental confusion, and drowsiness. Dry hacking cough, diarrhea, and dry eyes are not symptoms of salicylate toxicity.
A client with degenerative joint disease asks the nurse for suggestions to avoid unusual stress on the joints. Which suggestion would be appropriate?
- A. Keep shifting weight from one foot to the other.
- B. Perform aerobic exercises.
- C. Maintain complete bed rest.
- D. Maintain good posture.
Correct Answer: D
Rationale: The nurse needs to remind the client with degenerative joint disease to maintain good posture to avoid unusual stress on a joint. Although the client need not maintain complete bed rest, performing aerobic exercises is not advisable because it may place undue stress on the joint worsening the condition. Shifting weight from one foot to the other does not help avoid unusual stress on a joint.
A client with rheumatoid arthritis has infiltration of the lacrimal and salivary glands with lymphocytes as a result of the disease. What does the nurse understand that this clinical manifestation is?
- A. Sicca syndrome
- B. Episcleritis
- C. Glaucoma
- D. Cataracts
Correct Answer: A
Rationale: Sicca syndrome is a condition of dry eyes and dry mouth that can result from infiltration of the lacrimal and salivary glands with lymphocytes. Episcleritis is an inflammatory condition of the connective tissue between the sclera and conjunctiva. Glaucoma results from increased intraocular pressure, and cataracts are a clouding of the lens in the eye.
A client with ankylosing spondylitis has a stooped position and is being positioned in the bed prior to the nurse taking vital signs. The nurse listens to the client's lungs after positioning. What finding related to the client's condition may the nurse hear when listening to lung sounds?
- A. Crackles in the bases
- B. Pericardial friction rub
- C. Lung sounds may be diminished in the apical area.
- D. Rhonchi
Correct Answer: C
Rationale: Lung sounds may be reduced, especially in the apical area. The nurse would not hear rhonchi, crackles, or a pericardial friction rub unless the client had underlying cardiac or respiratory disorders.