A client with rheumatoid arthritis has an elevated serum rheumatoid factor. Which interpretation of this finding should the nurse make?

Confirmation of the autoimmune disease process.

Evidence of spread of the disease to the kidneys.

Indication of the onset of joint degeneration.

Representative of a decline in the client’s condition.

Answer and Explanation

The Correct Answer is A

Choice A reason: Rheumatoid factor is an antibody that is produced by the immune system and can bind to normal tissues, causing inflammation and damage. Rheumatoid factor is a marker of the autoimmune disease process that underlies rheumatoid arthritis, which is a chronic condition that affects the joints and other organs. A high level of rheumatoid factor can confirm the diagnosis of rheumatoid arthritis and indicate the severity of the disease.

Choice B reason: Rheumatoid factor is not a specific indicator of kidney involvement in rheumatoid arthritis, which is a rare but possible complication of the disease. Kidney damage can occur due to inflammation of the blood vessels, medication side effects, or dehydration. Kidney function can be assessed by other laboratory tests, such as blood urea nitrogen, creatinine, and urine analysis.

Choice C reason: Rheumatoid factor is not a direct cause of joint degeneration in rheumatoid arthritis, which is a progressive condition that leads to joint deformity and disability. Joint degeneration can occur due to chronic inflammation, erosion of cartilage and bone, and formation of nodules and cysts. Joint damage can be evaluated by physical examination, x-rays, and magnetic resonance imaging.

Choice D reason: Rheumatoid factor is not a reliable predictor of the client’s condition in rheumatoid arthritis, which is a variable and unpredictable disease that can have periods of remission and exacerbation. The client’s condition can be influenced by many factors, such as age, gender, genetics, lifestyle, and treatment. The client’s condition can be monitored by clinical symptoms, functional status, and quality of life.

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Correct Answer is A

Explanation

Choice A reason: Varicella is another name for chickenpox, which is caused by the varicella-zoster virus. Herpes zoster, also known as shingles, is a reactivation of the same virus that causes a painful rash along a nerve pathway. People who have had chickenpox are at risk of developing shingles later in life, especially if their immune system is weakened. Asking the client if everyone at home has already had varicella can help the nurse determine the risk of transmission and the need for isolation precautions.

Choice B reason: Antifungal creams are not effective for herpes zoster, which is caused by a virus, not a fungus. Antifungal creams are used to treat fungal infections, such as athlete's foot, ringworm, or candidiasis. Asking the client if the antifungal creams have been effective is not relevant to the condition and can indicate a lack of knowledge or a misdiagnosis.

Choice C reason: Dry patches on the feet and hands are not typical signs of herpes zoster, which usually causes a blistering rash along a nerve pathway. Dry patches on the feet and hands can be caused by other conditions, such as eczema, psoriasis, or diabetes. Asking the client if they have any dry patches on their feet and hands is not helpful to assess the condition and can divert the attention from the main problem.

Choice D reason: Sharing combs and brushes is not a common mode of transmission for herpes zoster, which is spread by direct contact with the fluid from the blisters. Sharing combs and brushes can transmit other infections, such as lice, scabies, or impetigo. Asking the client if their family members share combs and brushes is not pertinent to the condition and can imply a poor hygiene or a stigma.

A. Clear, dark amber-colored urine. B. Improved level of consciousness. C. Prothrombin time within normal limits. D. Decreased abdominal girth.

Correct Answer is D

Explanation

Choice A reason: Clear, dark amber-colored urine is not a sign of improvement for a client with cirrhosis and hepatic failure. It may indicate dehydration, which can worsen the condition of the liver and kidneys. The client should be encouraged to drink enough fluids to maintain hydration and urine output.

Choice B reason: Improved level of consciousness is a positive sign for a client with cirrhosis and hepatic failure, but it is not directly related to the treatment plan of low sodium diet and albumin infusions. It may indicate a reduction in ammonia levels, which can cause hepatic encephalopathy, a condition that affects the brain function. The client should be monitored for signs of mental status changes, such as confusion, lethargy, or coma.

Choice C reason: Prothrombin time within normal limits is also a good sign for a client with cirrhosis and hepatic failure, but it is not the main goal of the treatment plan of low sodium diet and albumin infusions. It may indicate an improvement in the liver's ability to produce clotting factors, which can prevent bleeding complications. The client should be checked for signs of bleeding, such as bruising, petechiae, or hematemesis.

Choice D reason: Decreased abdominal girth is the best indicator of progress toward the desired effect of the treatment plan of low sodium diet and albumin infusions. It means that the client has reduced fluid retention and ascites, which are common complications of cirrhosis and hepatic failure. The client should be measured for abdominal girth daily, and weighed regularly, to monitor the fluid status.

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A client with rheumatoid arthritis has an elevated serum rheumatoid factor. Which interpretation of this finding should the nurse make?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is assessing a client who has herpes zoster. Which question will allow the nurse to gather further information about this condition?

Correct Answer is A

Explanation

An older client with cirrhosis of the liver and hepatic failure is placed on a low sodium diet and is receiving periodic albumin infusions. Which assessment finding indicates progress toward the desired effect of this treatment plan?

Correct Answer is D

Explanation

Which admission assessment findings should the nurse document related to a client who has been diagnosed with Cushing’s syndrome?

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