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 C

Explanation

Choice A reason: Pyuria, or pus in the urine, is not a direct sign of fluid volume overload. It may indicate a urinary tract infection, kidney stones, or other renal problems.

Choice B reason: Weight loss is not a typical finding of fluid volume overload. In fact, weight gain is a common symptom of fluid retention, as the body holds more fluid than it excretes.

Choice C reason: Jugular vein distention, or the bulging of the neck veins, is a serious indicator of fluid volume overload. It reflects increased pressure in the right side of the heart and the systemic circulation. It may also signal heart failure, pulmonary hypertension, or pericardial tamponade.

Choice D reason: Muscle contractions are not directly related to fluid volume overload. They may be caused by electrolyte imbalances, dehydration, muscle fatigue, or nerve disorders.

A. Sliced ham with green salad B. Pork tenderloin with green peas C. Turkey sandwich with celery sticks D. Grilled chicken breast with white bread

Correct Answer is D

Explanation

Choice A reason: Sliced ham with green salad is not a good choice for a client who has diverticulitis. Diverticulitis is a condition where small pouches in the colon become inflamed or infected. The client should avoid foods that are high in fat, such as ham, or that contain seeds, nuts, or skins, such as green salad, as they can irritate the colon and worsen the symptoms.

Choice B reason: Pork tenderloin with green peas is not a suitable choice for a client who has diverticulitis. Pork tenderloin is a high-fat food that can increase the inflammation and pain in the colon. Green peas are also a source of fiber that can be hard to digest and can cause gas and bloating.

Choice C reason: Turkey sandwich with celery sticks is not an appropriate choice for a client who has diverticulitis. Turkey sandwich may contain mayonnaise, cheese, or other ingredients that are high in fat and can aggravate the condition. Celery sticks are high in fiber and have strings that can get trapped in the pouches and cause infection.

Choice D reason: Grilled chicken breast with white bread is the best choice for a client who has diverticulitis. Grilled chicken breast is a lean protein that can help the client heal and prevent malnutrition. White bread is a low-fiber food that can be easily digested and does not irritate the colon.

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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 assessing a client with suspected fluid volume overload. Which finding requires further action?

Correct Answer is C

Explanation

A nurse is planning care for a client who has diverticulitis. Which of the following menu selections should the nurse include in the plan?

Correct Answer is D

Explanation

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