A client presents to the clinic with fatigue, poor appetite, general malaise, and vague joint pain that improves mid-morning. The client has been taking over-the-counter ibuprofen for several months. The healthcare provider makes an initial diagnosis of rheumatoid arthritis (RA).

Which laboratory test(s) should the nurse report to the healthcare provider? Select all that apply.

Sedimentation rate

Anti-cyclic citrullinated peptide (anti-CCP) antibodies

D-Dimer

C-reactive protein

White blood cell count

Answer and Explanation

Correct Answer : A,B,D

Choice A reason: The sedimentation rate (ESR) is a common test used to detect inflammation associated with conditions such as rheumatoid arthritis. An elevated ESR indicates the presence of inflammation in the body.

Choice B reason: Anti-cyclic citrullinated peptide (anti-CCP) antibodies are highly specific for rheumatoid arthritis and are useful in confirming the diagnosis. The presence of these antibodies can help distinguish RA from other inflammatory conditions.

Choice C reason: D-Dimer is primarily used to rule out thrombotic conditions such as deep vein thrombosis and pulmonary embolism. It is not specifically related to the diagnosis or management of rheumatoid arthritis.

Choice D reason: C-reactive protein (CRP) is another marker of inflammation that is often elevated in rheumatoid arthritis. It provides information about the level of inflammation and can be used to monitor disease activity and response to treatment.

Choice E reason: While a white blood cell count can provide general information about infection or inflammation, it is not specific to rheumatoid arthritis and is not as useful as the other tests mentioned for diagnosing or managing RA.

Nursing Test Bank

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Correct Answer is ["A","B"]

Explanation

Choice A reason: Obtaining a clean catch urine sample for culture and sensitivity is crucial for identifying the specific bacteria causing the infection and determining the appropriate antibiotic treatment.

Choice B reason: Initiating broad spectrum IV antibiotics is important to start treating the infection immediately, especially given the severity of the symptoms.

Choice C reason: Collecting a serum sample for hemoglobin and hematocrit is not immediately necessary in this scenario. The focus should be on diagnosing and treating the infection.

Choice D reason: Giving diphenhydramine prep for intravenous pyelogram is not relevant to the immediate management of the client's condition.

Choice E reason: Forcing oral fluids can help flush out the urinary system, but it is not the most critical initial intervention compared to obtaining a urine culture and starting antibiotics.

Correct Answer is ["12.5"]

Explanation

Calculation Steps:

Step 1: Convert grams to milligrams: 1.5 grams × 1000 mg/gram = 1500 mg. Result = 1500 mg.

Step 2: Calculate the dose per administration: 1500 mg/day ÷ 3 doses/day = 500 mg/dose. Result = 500 mg/dose.

Step 3: Determine the volume for each dose: 200 mg/5 mL = 40 mg/mL, 500 mg ÷ 40 mg/mL = 12.5 mL.

Result = 12.5 mL.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

An adult is admitted with acute flank pain, a 102°F (38.9°C) oral temperature, hematuria, dysuria, urgency, and fishy-smelling urine. Which admitting prescription(s) are most important for the nurse to implement? Select all that apply.

Correct Answer is ["A","B"]

Explanation

Correct Answer is ["12.5"]

Explanation

A client is admitted to the intensive care unit (ICU) with a spinal cord injury following a motor vehicle collision. Which nurse should be contacted to coordinate the progression of the client's care?

A client with a history of unstable angina presents to the emergency department with constant chest pressure that is unrelieved with rest. The client appears anxious, pale, and diaphoretic. After obtaining the client's vital signs, which action should the nurse take next?

Which assessment technique provides the most useful data when the nurse is concerned about possible urinary retention?

A client with generalized anxiety disorder does not want to communicate with friends, smokes 2 to 3 packages of cigarettes a day, and describes difficulty concentrating at work. Which coping strategy should the nurse include in the plan of care?

The nurse is admitting a client from the postanesthesia care unit (PACU) to the postoperative surgical care unit. Which prescription should the nurse implement first?

The nurse has received funding to design a health promotion project for African-American women who are at risk for developing breast cancer. Which resource is most important in designing this program?

After a scheduled downtime, the computer documentation system fails to restart. Which action should the nurse take first?

The mother of a child with cerebral palsy (CP) asks the nurse if her child's impaired movements will worsen as the child grows. Which response provides the best explanation?