A client has been newly diagnosed with rheumatoid arthritis.
The nurse recognizes that the healthcare provider will most likely order which drug classification as the first choice for treatment?
Opioids.
Acetaminophen.
Nonsteroidal anti-inflammatory drugs (NSAIDS).
Hormone replacement therapy (HRT).
The Correct Answer is C
Choice A rationale
Opioids are typically reserved for severe, chronic pain that does not respond to other therapies and are not considered first-line treatment for rheumatoid arthritis. They provide analgesia but do not address the underlying inflammatory processes or provide the anti-inflammatory benefits necessary to manage joint swelling and prevent damage. Furthermore, the risk for dependence and respiratory depression makes them less ideal for initial management.
Choice B rationale
Acetaminophen is an effective analgesic for mild to moderate pain, but it lacks significant anti-inflammatory properties. Because rheumatoid arthritis is a chronic systemic inflammatory disease characterized by synovitis and joint destruction, acetaminophen alone is insufficient for primary treatment. It might be used as an adjunct for pain control, but it cannot replace medications that actively target the inflammatory response occurring within the joints.
Choice C rationale
Nonsteroidal anti-inflammatory drugs are the first-line choice for managing the immediate symptoms of rheumatoid arthritis, such as pain and inflammation. They work by inhibiting cyclooxygenase enzymes, which reduces the production of prostaglandins that mediate the inflammatory response. While they do not slow the progression of the disease like DMARDs, they are essential for providing rapid symptomatic relief during the initial diagnostic and treatment phases.
Choice D rationale
Hormone replacement therapy is used to manage symptoms related to hormonal deficiencies, such as those occurring during menopause, and has no established role as a primary treatment for rheumatoid arthritis. While hormonal shifts can sometimes influence autoimmune conditions, HRT does not provide the analgesic or anti-inflammatory effects required to manage the joint inflammation and pain that characterize a new diagnosis of rheumatoid arthritis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["0.8"]
Explanation
Step 1 is 100 mg ÷ 250 mg × 2 mL.
Step 2 is 0.4 × 2 mL.
Step 3 is 0.8. The nurse should administer 0.8 mL.
Correct Answer is D
Explanation
Choice A rationale
Sign language is a complex visual-gestural language used primarily by individuals with profound or congenital deafness. Presbycusis is a gradual, age-related sensorineural hearing loss that usually involves the loss of high-frequency sounds. Most older adults with presbycusis have spent their lives as hearing individuals and do not know sign language. Implementing sign language without prior knowledge would hinder rather than help communication, making it an inappropriate nursing intervention for this specific type of hearing loss.
Choice B rationale
Shouting or talking loudly into the ear is often counterproductive for patients with presbycusis. This condition often involves recruitment, where sounds become uncomfortably loud or distorted once they reach a certain volume threshold. Shouting can increase sound distortion and cause physical discomfort to the patient. Effective communication requires clear articulation and a moderate volume rather than excessive loudness, which can strip away the clarity of consonants and make speech harder for the patient to understand.
Choice C rationale
While writing can be a backup method for communication, it is often time-consuming and can lead to social isolation for the client. Many clients with presbycusis can still hear speech if environmental conditions are optimized and the speaker uses proper techniques. Writing everything down should be reserved for complex instructions or when verbal communication fails completely. The goal of nursing care is to promote normal social interaction and use remaining hearing through effective verbal communication strategies.
Choice D rationale
Sitting and facing the client directly allows them to use visual cues, such as lip reading and facial expressions, to supplement their hearing. Speaking in a normal, clear tone at a lower pitch is most effective because presbycusis typically affects high-frequency sounds first. By ensuring the client can see the nurse's face and by minimizing background noise, the nurse facilitates the best possible environment for sound processing. This approach respects the client's dignity and maximizes their functional hearing.
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