A 55-year-old patient with rheumatoid arthritis is being evaluated for disease progression. Which of the following laboratory findings is most indicative of increased disease activity?

Presence of anti-cyclic citrullinated peptide (anti-CCP) antibodies

Elevated rheumatoid factor (RF) levels

Decreased erythrocyte sedimentation rate (ESR)

Elevated C-reactive protein (CRP) levels

Answer and Explanation

The Correct Answer is D

A.   Anti-cyclic citrullinated peptide (anti-CCP) antibodies are specific for rheumatoid arthritis but are not necessarily linked to disease activity.
B.   Elevated rheumatoid factor (RF) levels are common in rheumatoid arthritis but not always indicative of disease activity.
C.   A decreased erythrocyte sedimentation rate (ESR) is typically a sign of less inflammation, not more.
D.   Elevated C-reactive protein (CRP) levels are a direct marker of inflammation and are often correlated with increased disease activity in rheumatoid arthritis.

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Correct Answer is B

Explanation

A. Secondary progressive multiple sclerosis involves a steady decline in function with or without relapses, which is different from the relapsing-remitting pattern.
B. Relapsing-remitting multiple sclerosis (RRMS) is the most common type of MS and is characterized by flare-ups of symptoms followed by periods of partial or complete recovery with no symptoms.
C. Primary progressive multiple sclerosis involves a gradual worsening of symptoms without distinct relapses or remissions. This pattern does not match the client's description of periods without symptoms.
D. Clinically isolating syndrome refers to the first episode of neurologic symptoms that lasts for at least24 hours and is indicative of MS, but this is a different stage than relapsing-remitting MS.

A. Administer an anti-diarrheal medication as prescribed to control the symptoms. B. Increase the water flushes to improve hydration and dilute the feeding solution. C. Switch the feeding tube to a bolus feeding method instead of continuous feeding. D. Decrease the feeding rate and consult the dietitian for a fiber-enriched formula.

Correct Answer is D

Explanation

A. Administering an anti-diarrheal medication as prescribed might help control the symptoms, but it is important to address the underlying cause of the diarrhea first, such as adjusting the feeding.
B. Increasing water flushes may help with hydration, but it does not specifically address the diarrhea caused by the enteral feeding. It's more important to manage the feeding itself.
C. Switching the feeding method to bolus feeding could increase the risk of aspiration and discomfort. Continuous feeding is generally safer and better tolerated in this context.
D. Decreasing the feeding rate and consulting the dietitian for a fiber-enriched formula is the most appropriate response. Adjusting the feeding rate can help reduce gastrointestinal upset, and a fiber- enriched formula can help firm up stools.

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A 55-year-old patient with rheumatoid arthritis is being evaluated for disease progression. Which of the following laboratory findings is most indicative of increased disease activity?

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Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has multiple sclerosis. The client reports that, since the onset of the disease, there are times when their symptoms are active and then followed by a period with no symptoms. Which of the following types of multiple sclerosis does this pattern indicate?

Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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