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: The upper right quadrant is not the correct location for McBurney's point. This quadrant contains the liver, gallbladder, right kidney, and part of the colon. Pain in this area may indicate problems with these organs, such as hepatitis, gallstones, or kidney infection.

Choice B reason: The upper left quadrant is not the correct location for McBurney's point. This quadrant contains the stomach, spleen, left kidney, and part of the colon. Pain in this area may indicate problems with these organs, such as gastritis, splenomegaly, or kidney stones.

Choice C reason: The lower right quadrant is the correct location for McBurney's point. This quadrant contains the appendix, right ovary, and right fallopian tube. McBurney's point is a point on the abdomen that is one-third of the distance from the right anterior superior iliac spine to the umbilicus. Pain in this area may indicate appendicitis, ovarian cyst, or ectopic pregnancy.

Choice D reason: The lower left quadrant is not the correct location for McBurney's point. This quadrant contains the sigmoid colon, left ovary, and left fallopian tube. Pain in this area may indicate problems with these organs, such as diverticulitis, ovarian torsion, or pelvic inflammatory disease.

A. An obese client whose parents and siblings are not obese B. A client with long-standing obesity who has recently been diagnosed with type 2 diabetes C. A client whose obesity has been attributed to a reversible endocrine disorder like hypothyroidism D. A client whose obesity is characterized as android rather than gynoid

Correct Answer is C

Explanation

Choice A reason: An obese client whose parents and siblings are not obese may have obesity due to environmental or behavioral factors, such as diet, physical activity, or stress. Medication may not be effective for this type of obesity, and lifestyle changes may be more appropriate.

Choice B reason: A client with long-standing obesity who has recently been diagnosed with type 2 diabetes may have obesity due to insulin resistance, which impairs the body's ability to use glucose and increases fat storage. Medication may help with glucose control, but it may not resolve the obesity. The client may also need to follow a diabetic diet and exercise regimen.

Choice C reason: A client whose obesity has been attributed to a reversible endocrine disorder like hypothyroidism may have obesity due to hormonal imbalance, which affects the metabolism and energy expenditure. Medication may be effective for this type of obesity, as it can restore the normal function of the thyroid gland and increase the metabolic rate.

Choice D reason: A client whose obesity is characterized as android rather than gynoid may have obesity due to genetic or gender factors, such as the distribution of fat in the upper body or the influence of male hormones. Medication may not be effective for this type of obesity, and the client may benefit from other interventions such as surgery or counseling.

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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 admitting a client with suspected appendicitis. Identify where the nurse will palpate to assess for pain at McBurney's point. (Selectable areas, or "Hot Spots," are outlined in the artwork below. Select only the outlined area that corresponds to your answer)

Correct Answer is C

Explanation

The nurse provides care for several clients who have obesity. Which client's obesity is most likely to resolve with medication?

Correct Answer is C

Explanation

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?

A client reports having heartburn, dysphagia, and frequent dyspepsia. What does the nurse suspect that these clinical manifestations indicate?

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?

A nurse is discussing early signs of hypervolemia with a patient admitted with congestive heart failure. Which signs should the nurse include in their teaching?

A nurse is planning care for a client who has diverticulitis. The nurse should plan to monitor the client for which of the following complications of diverticulitis?

A client presents to the clinic reporting vomiting and burning in her mid-epigastric area. The nurse knows that in the process of confirming peptic ulcer disease, the health care provider is likely to order a diagnostic test to detect the presence of what?

The nurse is caring for a client who has developed dumping syndrome while recovering from a bariatric surgery. What recommendation should the nurse make to the client?

A nurse is caring for several patients with fluid imbalances. A priority nursing intervention for a client with hypervolemia involves which of the following?