A nurse in a provider's office is caring for a client.

Exhibits

Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.

Answer and Explanation

The Correct Answer is []

Rationale:

The client exhibits hallmark symptoms of Systemic Lupus Erythematosus (SLE), including a butterfly rash on the cheeks, alopecia, joint tenderness, and elevated ANA and ESR levels. These findings, combined with anemia and thrombocytopenia, are consistent with SLE, an autoimmune disorder characterized by systemic inflammation and tissue damage.

Multiple sclerosis is primarily a neurological condition and does not align with the client’s dermatological and hematological findings. Celiac disease is associated with gastrointestinal symptoms and gluten sensitivity, which the client denies. Type 1 diabetes mellitus involves hyperglycemia and insulin deficiency, which are not relevant to the presented symptoms.

Helping the client identify aggravating factors (e.g., sunlight exposure, stress) is crucial for managing SLE. Recommending low-impact exercises can help maintain joint mobility and reduce inflammation.

Monitoring adherence to corticosteroid therapy is essential since these medications are often used to control inflammation in SLE. Assessing for depression related to body image is important due to the physical manifestations of SLE, such as alopecia and hyperpigmentation, which may affect the client’s mental health.

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Correct Answer is B

Explanation

A. Yogurt does not have a significant effect on the INR or interact with warfarin.

B. Kale is high in vitamin K, which can affect the INR by promoting clotting. Vitamin K antagonizes the action of warfarin, which works by inhibiting vitamin K-dependent clotting factors. Consistent intake of vitamin K-rich foods, like kale, should be monitored and discussed with clients on warfarin.

C. Orange juice does not significantly affect the INR or interact with warfarin.

D. Beef stew does not have a significant effect on the INR or interact with warfarin. However, some foods high in fat may interfere with warfarin absorption, but beef stew is not a major concern in this context.

A. Blood glucose level B. Bowel sounds C. Blood pressure D. Pain level E. Electrocardiogram findings F. Lung sounds G. Troponin T level

Correct Answer is ["C","D","E","G"]

Explanation

A. Blood glucose level: The blood glucose level is within the normal range (103 mg/dL), so there is no immediate concern for hypoglycemia or hyperglycemia at this moment. While the client has diabetes, this finding does not require immediate follow-up.

B. Bowel sounds: Bowel sounds are present in all 4 quadrants, indicating normal gastrointestinal function. There is no indication of gastrointestinal distress, so this does not require immediate follow-up.

C. Blood pressure: The blood pressure is not provided in the scenario, but if it were hypotensive or elevated, it would be important to follow up. Hypotension could indicate a lack of perfusion, and hypertension could indicate worsening cardiac stress. Blood pressure should be monitored closely in this client, especially with suspected cardiac issues.

D. Pain level: The client reports chest pain radiating to the left arm, which is a classic symptom of myocardial infarction (MI). Immediate follow-up is needed to address pain management and investigate the cause of the pain. This could be a sign of acute coronary syndrome, requiring urgent intervention.

E. Electrocardiogram findings: The electrocardiogram (ECG) shows tachycardia with ST segment elevation and T wave changes, which are indicative of a myocardial infarction (MI). These findings require immediate follow-up and urgent medical intervention to assess and treat the possible heart attack.

F. Lung sounds: The lung sounds are clear in all lobes, indicating no respiratory distress or issues with lung function. This does not require immediate follow-up.

G. Troponin T level: The troponin T level is elevated at 0.40 ng/mL (normal is less than 0.1 ng/mL), which is a key marker for myocardial injury. This finding requires immediate follow-up to assess the severity of the cardiac event and initiate treatment for potential myocardial infarction.

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Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who has a new prescription for warfarin about foods that affect the INR. The nurse should include in the teaching that which of the following foods interacts with this medication?

Correct Answer is B

Explanation

A nurse is admitting a client who reports tightness in their chest that radiates to left arm. Exhibits The nurse is reviewing the client's medical record. Select the four findings that require immediate follow-up.

Correct Answer is ["C","D","E","G"]

Explanation

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