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 C

Explanation

Choice A reason: Pale yellow is the normal color of urine, indicating adequate hydration and no bilirubin in the urine. Bilirubin is a pigment that is produced when red blood cells are broken down. It is normally excreted in the bile, but if the bile duct is obstructed, it can accumulate in the blood and urine, causing jaundice and dark urine.

Choice B reason: Red urine can indicate blood in the urine, which can be caused by various conditions such as urinary tract infection, kidney stones, trauma, or cancer. It is not related to bile duct obstruction or cholecystitis.

Choice C reason: Greenish-brown urine can indicate bilirubin in the urine, which can be caused by bile duct obstruction or liver disease. It is a sign of cholestasis, which is a reduced or stopped flow of bile. The nurse should monitor the client for other signs of cholestasis such as jaundice, clay-colored stools, pruritus, and abdominal pain.

Choice D reason: Dark and concentrated urine can indicate dehydration, which can be caused by various factors such as fluid loss, fever, vomiting, or diarrhea. It is not related to bile duct obstruction or cholecystitis.

A. Fatty stools B. Tenderness in the left upper abdomen C. Ecchymosis of the extremities D. Pale-colored urine

Correct Answer is A

Explanation

Choice A reason: This is a correct finding for a client with an obstruction of the common bile duct. Fatty stools are caused by the reduced or absent flow of bile into the intestine, which impairs the digestion and absorption of fats.

Choice B reason: This is not a correct finding for a client with an obstruction of the common bile duct. Tenderness in the left upper abdomen may indicate a problem with the spleen, the stomach, or the pancreas, but not the bile duct.

Choice C reason: This is not a correct finding for a client with an obstruction of the common bile duct. Ecchymosis of the extremities is a bruising of the skin due to bleeding under the surface. It may be caused by trauma, medication, or bleeding disorders, but not by bile duct obstruction.

Choice D reason: This is not a correct finding for a client with an obstruction of the common bile duct. Pale-colored urine is a sign of dilute or low concentration of urine, which may be caused by excessive fluid intake, diabetes insipidus, or kidney failure, but not by bile duct obstruction.

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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

A nurse is caring for a client who has cholecystitis with cholelithiasis and obstruction of the common bile duct. The nurse should expect the client's urine to appear which of the following colors?

Correct Answer is C

Explanation

A nurse is assessing a client who has an obstruction of the common bile duct resulting from chronic cholelithiasis. Which of the following findings should the nurse expect?

Correct Answer is A

Explanation

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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?