A client presents to the clinic with fatigue, poor appetite, general malaise, and vague joint pain that improves mid-morning. The client has been taking over-the-counter ibuprofen for several months. The healthcare provider makes an initial diagnosis of rheumatoid arthritis (RA).

Which laboratory test(s) should the nurse report to the healthcare provider? Select all that apply.

Sedimentation rate

Anti-cyclic citrullinated peptide (anti-CCP) antibodies

D-Dimer

C-reactive protein

White blood cell count

Answer and Explanation

Correct Answer : A,B,D

Choice A reason: The sedimentation rate (ESR) is a common test used to detect inflammation associated with conditions such as rheumatoid arthritis. An elevated ESR indicates the presence of inflammation in the body.

Choice B reason: Anti-cyclic citrullinated peptide (anti-CCP) antibodies are highly specific for rheumatoid arthritis and are useful in confirming the diagnosis. The presence of these antibodies can help distinguish RA from other inflammatory conditions.

Choice C reason: D-Dimer is primarily used to rule out thrombotic conditions such as deep vein thrombosis and pulmonary embolism. It is not specifically related to the diagnosis or management of rheumatoid arthritis.

Choice D reason: C-reactive protein (CRP) is another marker of inflammation that is often elevated in rheumatoid arthritis. It provides information about the level of inflammation and can be used to monitor disease activity and response to treatment.

Choice E reason: While a white blood cell count can provide general information about infection or inflammation, it is not specific to rheumatoid arthritis and is not as useful as the other tests mentioned for diagnosing or managing RA.

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Correct Answer is B

Explanation

Choice A reason: Encouraging rest may not relieve the pain; sitting up and leaning forward is a common position for relief in pancreatitis.

Choice B reason: Positioning the bedside table allows the client to lean forward comfortably and may help alleviate the pain.

Choice C reason: Raising the head of the bed to a 90-degree angle may not provide the same relief as leaning forward.

Choice D reason: Reverse Trendelenburg position is not specifically indicated for pancreatitis pain relief.

A. Yellow expectorated sputum. B. Oral temperature of 100.5°F (38.1°C). C. Bilateral diffuse wheezing. D. Shortness of breath on exertion.

Correct Answer is C

Explanation

Choice A reason: Yellow expectorated sputum is indicative of an infection but does not require immediate intervention.

Choice B reason: An oral temperature of 100.5°F (38.1°C) suggests a mild fever, common with infections and manageable with antipyretics.

Choice C reason: Bilateral diffuse wheezing is a sign of airway obstruction and requires immediate intervention to ensure the client's airway remains open and they are able to breathe effectively.

Choice D reason: Shortness of breath on exertion is expected in clients with COPD and pneumonia but does not require the most immediate intervention compared to wheezing.

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Naxlex Comprehensive Predictor Exams

A client with pancreatitis reports severe epigastric pain, so the nurse administers a prescribed narcotic analgesic. Ten minutes later, the client insists on sitting up and leaning forward. Which intervention should the nurse implement?

Correct Answer is B

Explanation

Correct Answer is C

Explanation

The mother of a child with cerebral palsy (CP) asks the nurse if her child's impaired movements will worsen as the child grows. Which response provides the best explanation?

After inflating a blood pressure cuff and releasing the valve, the nurse hears silence followed by a Korotkoff sound. Which action should the nurse take next?

A client who weighs 160 pounds receives a prescription for gentamicin 5 mg/kg/day IV in divided doses every 8 hours. How many mg should the nurse administer with each dose? (Enter numerical value only. If rounding is required, round to the nearest whole number.)

A client with Parkinson's disease (PD) is admitted to the medical surgical unit and the nurse assesses the client's mobility needs. Which finding(s) indicate the need to plan interventions related to the client's mobility? Select all that apply.

A client presents to the emergency department (ED) reporting abdominal pain. The nurse observes the client's right cheek and eye are bruised and suspects possible domestic violence. Which approach is best for the nurse to use when interviewing the client?

Following a cardiac catheterization and placement of a stent in the right coronary artery, the nurse administers prasugrel to the client. To monitor for adverse effects from the medication, which assessment is most important for the nurse to include in this client's plan of care?

The nurse knows that a medication has the side effect of orthostatic hypotension. Which assessment should the nurse make before administering the medication?