A 36-year-old woman is diagnosed with rheumatoid arthritis (RA) and asks the NP about her treatment options. Which of the following is considered first-line treatment for RA?
NSAIDs
Methotrexate
Corticosteroid injections
Opioids
The Correct Answer is B
Choice A reason: NSAIDs are commonly used to relieve pain and inflammation in RA, but they do not alter the disease course or prevent joint damage. They are considered adjunctive therapy rather than first-line disease-modifying treatment.
Choice B reason: Methotrexate is the cornerstone and first-line disease-modifying antirheumatic drug (DMARD) for RA. It reduces inflammation, slows disease progression, and prevents joint damage. It has a well-established efficacy and safety profile and is recommended by major rheumatology guidelines as the initial treatment for most patients with RA.
Choice C reason: Corticosteroid injections may be used for localized joint inflammation or as a bridge therapy while waiting for DMARDs to take effect. However, they are not considered first-line long-term treatment due to potential systemic side effects and lack of disease-modifying properties.
Choice D reason: Opioids are not recommended for RA management due to their risk of dependence and lack of anti-inflammatory or disease-modifying effects. They may be used in exceptional cases for severe pain but are not part of standard RA treatment protocols.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: These factors are associated with irritable bowel syndrome and other colonic disorders, not peptic ulcer disease. PUD affects the stomach and duodenum, not the colon.
Choice B reason: This describes the pathophysiology of inflammatory bowel diseases such as ulcerative colitis and Crohn’s disease. It does not apply to PUD, which is primarily driven by gastric acid and mucosal injury.
Choice C reason: PUD results from an imbalance between aggressive factors (e.g., gastric acid, pepsin, H. pylori, NSAIDs) and protective mechanisms (e.g., mucus, bicarbonate, mucosal blood flow). H. pylori disrupts mucosal defenses, and NSAIDs inhibit prostaglandin synthesis, both contributing to ulcer formation.
Choice D reason: LES dysfunction and TLESRs are associated with gastroesophageal reflux disease (GERD), not PUD. GERD involves reflux of gastric contents into the esophagus, whereas PUD involves mucosal erosion in the stomach or duodenum.
Correct Answer is D
Explanation
Choice A reason: This describes the pathophysiology of chronic bronchitis, a form of chronic obstructive pulmonary disease (COPD), not bacterial pneumonia. It involves inflammation of the bronchial walls and mucosal changes but does not explain the alveolar involvement seen in pneumonia.
Choice B reason: This is characteristic of emphysema, another form of COPD, where alveolar walls are destroyed leading to air trapping and reduced gas exchange. It is not the mechanism of bacterial pneumonia.
Choice C reason: This describes asthma, where airway obstruction results from smooth muscle contraction, mucus production, and inflammation. Pneumonia does not typically involve bronchospasm or reversible airway obstruction.
Choice D reason: This accurately describes bacterial pneumonia. The infection triggers an inflammatory response that increases permeability of the alveolar-capillary membrane, leading to fluid accumulation, impaired gas exchange, and reduced lung compliance. This results in symptoms such as dyspnea, cough, and hypoxia.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.