A client with rheumatoid arthritis and psoriasis has been prescribed adalimumab, a biologic agent that blocks tumor necrosis factor alpha (TNF-alpha). Which of the following statements by the client indicates a need for further teaching?

I should avoid alcohol and other substances that can harm my liver.

I should take naproxen and aspirin as needed for pain relief.

I should report any signs of infection or fever to my doctor.

I should inject the medication under the skin of my abdomen or thigh.

Answer and Explanation

The Correct Answer is B

Choice A reason: This is not a statement that indicates a need for further teaching. The client should avoid alcohol and other substances that can harm the liver, as adalimumab can increase the risk of liver toxicity and hepatitis.

Choice B reason: This is a statement that indicates a need for further teaching. The client should not take naproxen and aspirin as needed for pain relief, as these are nonsteroidal anti-inflammatory drugs (NSAIDs) that can increase the risk of bleeding and gastrointestinal ulcers. Adalimumab can also increase the risk of bleeding and ulcers, as it suppresses the immune system and the inflammatory response.

Choice C reason: This is not a statement that indicates a need for further teaching. The client should report any signs of infection or fever to the doctor, as adalimumab can increase the risk of serious infections and sepsis. Adalimumab can also mask the symptoms of infection, such as inflammation and pain.

Choice D reason: This is not a statement that indicates a need for further teaching. The client should inject the medication under the skin of the abdomen or thigh, as this is the recommended route and site for adalimumab administration.

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Correct Answer is D

Explanation

Choice A reason: This is not a correct statement because these medications do not coat the ulcer. They are not antacids or mucosal protectants, which can form a protective layer over the ulcer and neutralize the stomach acid.

Choice B reason: This is not a correct statement because these medications do not stop the acid production. They only reduce it by inhibiting the proton pump, which is responsible for secreting acid into the stomach.

Choice C reason: This is not a correct statement because these medications should be taken as prescribed, not as needed. They are not analgesics or anti-inflammatory drugs, which can relieve the pain and inflammation of the ulcer.

Choice D reason: This is a correct statement because these medications have two effects: they kill the bacteria that cause the infection and inflammation of the ulcer, and they reduce the acid production that aggravates the ulcer. This can help heal the ulcer and prevent complications.

A. The client quit smoking 6 months ago. B. The client has a strong family history of obesity. C. The client drinks six to eight cans of beer daily. D. The client has poorly controlled type 2 diabetes.

Correct Answer is C

Explanation

Choice A reason: The client quitting smoking 6 months ago is not a factor that would exclude her from being an appropriate surgical candidate. In fact, smoking cessation is a requirement for bariatric surgery, as smoking increases the risk of complications such as infection, thrombosis, and poor wound healing.

Choice B reason: The client having a strong family history of obesity is not a factor that would exclude her from being an appropriate surgical candidate. Family history is one of the genetic factors that can contribute to obesity, but it does not determine the eligibility for bariatric surgery. Other factors such as BMI, comorbidities, lifestyle, and motivation are more important.

Choice C reason: The client drinking six to eight cans of beer daily is a factor that would exclude her from being an appropriate surgical candidate. Alcohol abuse is a contraindication for bariatric surgery, as it can cause liver damage, malnutrition, dehydration, and addiction transfer. The client would need to abstain from alcohol for at least 6 months before and after the surgery.

Choice D reason: The client having poorly controlled type 2 diabetes is not a factor that would exclude her from being an appropriate surgical candidate. Type 2 diabetes is one of the comorbidities that can qualify a client for bariatric surgery, as it can improve or resolve after the surgery. However, the client would need to have a good glycemic control before the surgery to reduce the risk of complications.

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A client with rheumatoid arthritis and psoriasis has been prescribed adalimumab, a biologic agent that blocks tumor necrosis factor alpha (TNF-alpha). Which of the following statements by the client indicates a need for further teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

An adult female client has a body mass index of 34.5 kg/m2 and has expressed interest in bariatric surgery. What characteristic of the client's health status may exclude her from being an appropriate surgical candidate?

Correct Answer is C

Explanation

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