A nurse is caring for a client who is taking naproxen following an exacerbation of rheumatoid arthritis. Which of the following statements by the client requires further discussion by the nurse?

I've lost 2 pounds since my appointment 2 weeks ago

I signed up for a swimming class

I've been taking an antibiotic

The naproxen is easier to take when I push it into applesauce .

Answer and Explanation

The Correct Answer is C

Choice A rationale:
Losing 2 pounds in 2 weeks is not a significant weight loss and may not be a cause for concern in this context. It's important to monitor weight trends over time, but this isolated statement doesn't necessarily require immediate discussion.
Choice B rationale:

Engaging in physical activity like swimming is generally beneficial for individuals with rheumatoid arthritis. It can help improve joint mobility, reduce pain, and enhance overall well-being. The nurse might encourage the client to discuss any specific concerns or limitations with their healthcare provider, but the activity itself is not alarming.
Choice C rationale:
Taking an antibiotic concurrently with naproxen can potentially increase the risk of adverse effects. Some antibiotics, like those in the fluoroquinolone class (e.g., ciprofloxacin, levofloxacin), can interact with naproxen and increase the risk of tendonitis or tendon rupture. This interaction warrants further discussion to ensure the client is aware of potential risks and to explore alternative medications if necessary.
Choice D rationale:
Using applesauce to facilitate medication intake is a common and acceptable practice. It does not affect the absorption or efficacy of naproxen.

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Correct Answer is C

Explanation

Choice A rationale:
A high-purine diet is actually contraindicated in gout because purines are metabolized into uric acid, which can accumulate in the joints and trigger gout attacks. Therefore, a low-purine diet is recommended.

Choice B rationale:
Aspirin is not typically recommended for gout because it can interfere with the excretion of uric acid and potentially worsen the condition. While low-dose aspirin might be used for specific cardiovascular benefits in some gout patients, it's not a general treatment for gout itself.

Choice C rationale:Alcohol intake is a common trigger for gout attacks because it can increase uric acid levels in the blood. Therefore, limiting alcohol intake is an important part of managing gout.

Choice D rationale:
Fluid intake should be increased, not limited, in gout patients. This is because adequate hydration helps to flush uric acid out of the body and reduce the risk of gout attacks.

A. Pitting edema of the hands and fingers B. Grey colored, non-purpuric papular rash C. Dry, red rash across the bridge of the nose and on the cheeks D. Subcutaneous nodules on the ulnar side of the arm

Correct Answer is C

Explanation

Choice A rationale:
Pitting edema of the hands and fingers is not a typical finding in SLE. It can occur in some cases, but it is more commonly associated with other conditions such as kidney disease or heart failure.

Choice B rationale:
Grey colored, non-purpuric papular rash is not a characteristic of SLE. This type of rash is more commonly seen in conditions such as lichen planus or sarcoidosis.

Choice C rationale:
A dry, red rash across the bridge of the nose and on the cheeks, also known as a malar rash, is a classic sign of SLE. It is often described as a "butterfly rash" because of its shape. The rash is caused by inflammation of the small blood vessels in the skin. It is typically worsened by sun exposure.

Choice D rationale:
Subcutaneous nodules on the ulnar side of the arm are a characteristic finding in rheumatoid arthritis, not SLE.

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A nurse is caring for a client who is taking naproxen following an exacerbation of rheumatoid arthritis. Which of the following statements by the client requires further discussion by the nurse?

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