Your patient has just received a new diagnosis of Rheumatoid Arthritis. They are confused about their prescriptions, however. They ask you "Why am I receiving so many medications? I thought this 'MTX' drug was the one that would treat my arthritis?". What is your BEST response?

The MTX will stop the pain but not the progression of your disease, so we also give you NSAIDS and steroids

You have good insurance so we like to prescribe you a whole bunch of medications just in case

The MTX helps treat the nausea associated with the other meds that actually treat your disease

The MTX takes several weeks or months to reach full effect, so the other meds are started now to help your symptoms

Answer and Explanation

The Correct Answer is D

A.   Methotrexate (MTX) is a disease-modifying antirheumatic drug (DMARD) that helps slow disease progression but does not provide immediate pain relief. NSAIDs and steroids may be used for symptomatic relief, but MTX alone can manage both pain and disease progression over time.
B.   This response is unprofessional and dismissive. It implies that the medication regimen is based solely on the patient's insurance coverage rather than their medical needs. It does not address the patient’s question and could undermine trust in the healthcare team.
C.   Methotrexate does not primarily treat nausea; rather, it is used to manage rheumatoid arthritis. While some patients may experience nausea as a side effect of MTX or other medications, this is not its primary purpose.
D.   Methotrexate is indeed a DMARD that can take weeks to months to show its full benefits in controlling inflammation and slowing disease progression. Meanwhile, NSAIDs or corticosteroids may be prescribed to provide quicker relief from symptoms such as pain and swelling.

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Correct Answer is A

Explanation

A. This is a crucial action following a bone marrow biopsy, as there is a risk of bleeding at the biopsy site. Monitoring for signs of bleeding or hematoma formation is essential to prevent complications, making this a highly appropriate nursing action.
B. While applying heat may provide comfort, it is generally not recommended immediately after a biopsy because it can increase blood flow to the area and potentially exacerbate bleeding. Thus, this action may not be appropriate right after the procedure.
C. While some level of rest is important after a procedure, keeping the patient NPO (nothing by mouth) is unnecessary unless there are specific orders due to anesthesia or other considerations. Additionally, remaining bedbound could increase discomfort or risk of complications like deep vein thrombosis (DVT) if not warranted.
D. Aspirin should be avoided in this scenario because it is an anticoagulant and can increase the risk of bleeding, particularly after a procedure like a bone marrow biopsy. Instead, other pain management strategies that do not affect clotting should be considered.

A. Show expected changes in white blood cell counts. B. Skin tests for tuberculosis may be falsely negative. C. Should receive influenza, pneumococcal, and shingles vaccinations. D. Higher risk for respiratory tract and genitourinary infections. E. Booster vaccinations are not likely needed as one ages. F. May not have a fever with severe infection.

Correct Answer is ["B","C","D","F"]

Explanation

A. While it's important for older adults to have regular blood tests to monitor their health, showing expected changes in white blood cell counts is not a specific risk factor for infections.
B. Skin tests for tuberculosis may be falsely negative in older adults due to a weakened immune response.
C. Older adults should stay up-to-date on their vaccinations, including influenza, pneumococcal, and shingles vaccinations, to help protect themselves against these infections.
D. Older adults are at increased risk for respiratory tract infections, such as pneumonia, and genitourinary infections, such as urinary tract infections.
E. Booster vaccinations are essential for older adults to maintain protection against diseases such as influenza, tetanus, diphtheria, and pertussis.
F. Older adults may not develop a fever in response to a severe infection. This can make it difficult to recognize the presence of an infection.

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Your patient has just received a new diagnosis of Rheumatoid Arthritis. They are confused about their prescriptions, however. They ask you "Why am I receiving so many medications? I thought this 'MTX' drug was the one that would treat my arthritis?". What is your BEST response?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Your patient has suspected aplastic anemia and has just returned to the unit to be cared for by you after having bone marrow biopsy done to confirm the diagnosis. Which of the following is the MOST appropriate nursing action?

Correct Answer is A

Explanation

The nurse is teaching an elderly client the risks of infection for older adults. Which of the following factors would the nurse include in the education? (Select all that apply.)

Correct Answer is ["B","C","D","F"]

Explanation

The nurse admits a patient who is in a sickle cell crisis. The nurse should prepare for which intervention as the top priority in the management of the patient?

A nurse is teaching the client with systemic lupus erythematosus about prednisone. What information is the priority?

Your patient with Iron deficiency anemia is receiving Iron Dextran when their blood pressure suddenly starts to drop, their respiratory rate increases, and their breath becomes wheezy- sounding. Your PRIORITY intervention will be:

A transfusion of packed red blood cells (PRBCs) has been infusing for 5 minutes when the patient becomes flushes and tachypneic and says, "I'm having chills. Please get me a blanket." Which action should the nurse take first?

You are reading the Physician's notes on your patient when you notice that the Dr. wrote that the patient has a Hallux Valgus deformity. What is this describing?

Your patient had an open colon resection a week ago and developed a subsequent infection of their surgical incision. Now the patient's blood pressure has been dropping for the past 2 hours and is currently 89/65. What type of shock is the patient experiencing?

You are planning on transfusing a unit of blood. Which of the following are appropriate measures to take? (Select all that apply)

A nurse is caring for a client who has pneumonia. Assessment findings include T 100.4 deg F, RR 30, BP 130/76, HR 100, and SpO2 91% on room air. Which of the following is the PRIORITY intervention?