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 ["D","E"]

Explanation

A. Discoloration of the fingers is not typically associated with carpal tunnel syndrome, which mainly involves nerve compression.
B. Swelling of the entire hand is not a common finding in carpal tunnel syndrome, though localized swelling at the wrist may occur.
C. Pain in the forearm without hand involvement is not typical of carpal tunnel syndrome, which primarily affects the wrist and hand.
D. A positive Phalen's test is indicative of carpal tunnel syndrome, as it reproduces symptoms when the wrist is flexed.
E. A positive Tinel's sign, which involves tapping the median nerve at the wrist to elicit symptoms, is a classic test for carpal tunnel syndrome.
F. Pain relief with wrist extension is common in carpal tunnel syndrome, as extending the wrist relieves pressure on the median nerve.

A. Blood glucose level of 140 mg/dL with low insulin levels. B. Blood glucose level of 180 mg/dL with normal ketone levels. C. Blood glucose level of 250 mg/dL with normal ketone levels. D. Blood glucose level of 600 mg/dL with elevated ketone levels in blood and urine.

Correct Answer is D

Explanation

A. A blood glucose level of 140 mg/dL is too low for DKA, which typically involves hyperglycemia above 250 mg/dL.
B. A blood glucose level of 180 mg/dL and normal ketone levels are inconsistent with DKA, as DKA involves both high glucose and elevated ketones.
C. A blood glucose level of 250 mg/dL with normal ketone levels would not suggest DKA. Elevated ketones are a critical part of diagnosing DKA.
D. A blood glucose level of 600 mg/dL with elevated ketone levels in blood and urine confirms DKA, a life-threatening complication of Type 1 diabetes.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a patient who reports numbness and tingling in the fingers, especially at night. The patient works as a data entry clerk. Which findings support a diagnosis of carpal tunnel syndrome? (Select All that Apply.)

Correct Answer is ["D","E"]

Explanation

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Correct Answer is D

Explanation

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