A nurse is caring for a client in an outpatient clinic.
Complete the following sentence by using the lists of options. The client is at highest risk for developing
The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B"}
- Rheumatoid arthritis is the most likely condition given the client’s bilateral wrist and shoulder stiffness lasting for several hours in the morning, fatigue, and loss of appetite. The elevated ESR and anemia further support chronic inflammation. Positive ANA, while not specific, can be present in RA and other autoimmune disorders.
- Osteoarthritis is incorrect because it typically presents with stiffness that improves within 30 minutes of activity, not lasting for several hours. It is also a non-inflammatory condition, whereas the client has elevated ESR and anemia, suggesting an inflammatory process.
- Gout is unlikely as it usually causes acute, severe joint pain with redness and swelling, often affecting the big toe. The client’s uric acid level is within normal range, making gout less probable.
- Carpal tunnel syndrome primarily causes numbness, tingling, and weakness in the hands due to median nerve compression. It does not typically cause prolonged morning stiffness, fatigue, or systemic inflammation.
- Positive ANA is not the best choice because while it is seen in rheumatoid arthritis, it is also present in other autoimmune diseases such as lupus. It does not specifically confirm RA.
- Normal WBC count does not support an inflammatory condition, as RA can lead to mild leukopenia, which is seen in the follow-up labs.
- Low blood pressure is not a defining feature of RA and does not correlate with the client’s symptoms or disease progression
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. "I will stop what I am doing and lie down." Stopping activity and resting helps reduce myocardial oxygen demand, which can relieve stable angina. Lying down also minimizes strain on the heart and decreases the risk of injury if the client becomes lightheaded.
B. "I will call the provider after taking one dose of nitroglycerin." Clients with stable angina should take one dose of sublingual nitroglycerin and wait five minutes. If pain persists after three doses taken five minutes apart, emergency medical services should be contacted instead of waiting to call the provider.
C. "I will hold my breath and bear down." The Valsalva maneuver can increase vagal tone, leading to bradycardia and decreased cardiac output, which may worsen angina rather than relieve it. This is not an appropriate response to chest pain.
D. "I will take two 325 milligram aspirin tablets at the same time." While aspirin is beneficial for preventing platelet aggregation, the usual recommended dose for acute chest pain is a single 160–325 mg tablet chewed immediately. Taking two full-dose aspirin tablets is unnecessary and may increase the risk of bleeding.
Correct Answer is D
Explanation
A. Rigid abdomen. A rigid or board-like abdomen is characteristic of placental abruption, not placenta previa. Placental abruption involves premature separation of the placenta from the uterine wall, leading to significant abdominal pain and uterine tenderness. In contrast, placenta previa typically presents with painless bleeding.
B. Increased fetal movement. Fetal movement is not directly affected by placenta previa unless there is severe hemorrhage leading to fetal distress. While decreased movement in cases of significant bleeding may indicate fetal compromise, increased movement is not a typical finding.
C. Persistent uterine contractions. Placenta previa does not usually cause persistent contractions. While mild uterine irritability may occur, placenta previa is primarily characterized by painless bleeding. Persistent contractions are more commonly associated with preterm labor or placental abruption.
D. Bright red vaginal bleeding. The hallmark sign of placenta previa is painless, bright red vaginal bleeding in the second or third trimester. This occurs due to the placenta covering or being near the cervical os, leading to bleeding as the cervix begins to dilate or efface.
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