A client with rheumatoid arthritis and psoriasis has been prescribed adalimumab, a biologic agent that blocks tumor necrosis factor alpha (TNF-alpha). Which of the following statements by the client indicates a need for further teaching?

I should avoid alcohol and other substances that can harm my liver.

I should take naproxen and aspirin as needed for pain relief.

I should report any signs of infection or fever to my doctor.

I should inject the medication under the skin of my abdomen or thigh.

Answer and Explanation

The Correct Answer is B

Choice A reason: This is not a statement that indicates a need for further teaching. The client should avoid alcohol and other substances that can harm the liver, as adalimumab can increase the risk of liver toxicity and hepatitis.

Choice B reason: This is a statement that indicates a need for further teaching. The client should not take naproxen and aspirin as needed for pain relief, as these are nonsteroidal anti-inflammatory drugs (NSAIDs) that can increase the risk of bleeding and gastrointestinal ulcers. Adalimumab can also increase the risk of bleeding and ulcers, as it suppresses the immune system and the inflammatory response.

Choice C reason: This is not a statement that indicates a need for further teaching. The client should report any signs of infection or fever to the doctor, as adalimumab can increase the risk of serious infections and sepsis. Adalimumab can also mask the symptoms of infection, such as inflammation and pain.

Choice D reason: This is not a statement that indicates a need for further teaching. The client should inject the medication under the skin of the abdomen or thigh, as this is the recommended route and site for adalimumab administration.

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Correct Answer is A

Explanation

Choice A reason: Fried chicken is a food that the nurse should tell the client to avoid eating. Fried chicken is high in fat, which can trigger or worsen the symptoms of GERD. Fat can relax the lower esophageal sphincter, which is the muscle that prevents the stomach acid from flowing back into the esophagus. Fat can also delay the stomach emptying, which can increase the pressure and acid production in the stomach.

Choice B reason: Nonfat milk is not a food that the nurse should tell the client to avoid eating. Nonfat milk is low in fat, which can help prevent or reduce the symptoms of GERD. Nonfat milk can also provide calcium and protein, which are essential nutrients for the client's health.

Choice C reason: Bananas are not a food that the nurse should tell the client to avoid eating. Bananas are low in acid, which can help neutralize the stomach acid and soothe the esophagus. Bananas are also rich in fiber, which can promote digestion and prevent constipation.

Choice D reason: Oatmeal is not a food that the nurse should tell the client to avoid eating. Oatmeal is a whole grain that is low in fat and high in fiber, which can help prevent or reduce the symptoms of GERD. Oatmeal can also absorb the excess acid in the stomach and prevent it from refluxing into the esophagus.

A. Call the primary provider and report that the client may be obstructed. B. Position the client supine and insert an NG tube. C. Administer a fleet enema as prescribed and remain with the client. D. Contact the primary provider promptly and report these signs of perforation.

Correct Answer is D

Explanation

Choice A reason: This is not the best response because it does not accurately describe the client's condition. Obstruction is a possible complication of diverticulitis, but it is not indicated by fever and abdominal rigidity. Obstruction is more likely to cause symptoms such as nausea, vomiting, constipation, and abdominal distension.

Choice B reason: This is not the best response because it can worsen the client's condition. Positioning the client supine and inserting an NG tube are interventions for gastric outlet obstruction, not diverticulitis. An NG tube can increase the risk of infection and perforation in the inflamed colon. Supine position can also increase the pressure on the abdomen and cause more pain and discomfort.

Choice C reason: This is not the best response because it can be harmful to the client. Administering a fleet enema is contraindicated for diverticulitis, as it can cause more inflammation, bleeding, or perforation in the colon. A fleet enema is a type of laxative that contains sodium phosphate and is used to relieve constipation or prepare for colonoscopy.

Choice D reason: This is the best response because it is the most appropriate and urgent action for the client. Contacting the primary provider promptly and reporting these signs of perforation is essential for the client's safety and treatment. Perforation is a life-threatening complication of diverticulitis, where the colon wall ruptures and causes peritonitis, which is inflammation of the abdominal cavity. Perforation can cause symptoms such as fever, abdominal rigidity, tenderness, and rebound pain. Perforation requires immediate surgical intervention and antibiotic therapy.

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A client with rheumatoid arthritis and psoriasis has been prescribed adalimumab, a biologic agent that blocks tumor necrosis factor alpha (TNF-alpha). Which of the following statements by the client indicates a need for further teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing teaching for a client who has a new diagnosis of gastroesophageal reflux disease (GERD). The client asks about foods he should avoid eating. Which of the following foods should the nurse tell him to avoid?

Correct Answer is A

Explanation

A client admitted with acute diverticulitis has experienced a sudden increase in temperature and reports a sudden onset of extreme abdominal tenderness. The nurse's rapid assessment reveals that the client's abdomen is uncharacteristically rigid on palpation. What is the nurse's best response?

Correct Answer is D

Explanation

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