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 B

Explanation

Choice A reason: MRI is not a diagnostic procedure for Barrett esophagus. MRI is a type of imaging test that uses magnetic fields and radio waves to create detailed pictures of the internal organs and tissues. It is mainly used to diagnose problems in the brain, spine, joints, and blood vessels.

Choice B reason: EGD is a diagnostic procedure for Barrett esophagus. EGD is a type of endoscopy that uses a flexible tube with a light and a camera to examine the esophagus, stomach, and duodenum. It can detect changes in the lining of the esophagus that may indicate Barrett esophagus, a condition where the normal squamous cells are replaced by columnar cells due to chronic acid exposure.

Choice C reason: Colonoscopy is not a diagnostic procedure for Barrett esophagus. Colonoscopy is a type of endoscopy that uses a flexible tube with a light and a camera to examine the colon and rectum. It is mainly used to screen for colorectal cancer and polyps, as well as to diagnose inflammatory bowel disease and other conditions affecting the lower gastrointestinal tract.

Choice D reason: CT scan is not a diagnostic procedure for Barrett esophagus. CT scan is a type of imaging test that uses X-rays and a computer to create cross-sectional pictures of the body. It is mainly used to diagnose problems in the chest, abdomen, pelvis, and bones.

A. Decreased heart rate B. Increased blood pressure C. Weak pulse D. Dyspnea

Correct Answer is C

Explanation

Choice A reason: Decreased heart rate is not a manifestation of hypovolemia. Hypovolemia is a condition where there is a decreased volume of blood in the body, which can result from blood loss, dehydration, or fluid shifts. Hypovolemia can cause the heart rate to increase, not decrease, as the body tries to compensate for the low blood pressure and maintain adequate perfusion.

Choice B reason: Increased blood pressure is not a manifestation of hypovolemia. Hypovolemia can cause the blood pressure to decrease, not increase, as the blood volume and cardiac output are reduced. The body may try to constrict the blood vessels to increase the blood pressure, but this is usually not enough to overcome the effects of hypovolemia.

Choice C reason: Weak pulse is a manifestation of hypovolemia. Hypovolemia can cause the pulse to become weak, thready, or difficult to palpate, as the blood flow and pressure are diminished. The pulse may also become irregular or rapid, as the heart tries to pump faster and harder to deliver oxygen to the tissues.

Choice D reason: Dyspnea is not a specific manifestation of hypovolemia. Dyspnea is a term for difficulty breathing, which can have many causes, such as asthma, pneumonia, or pulmonary edema. Hypovolemia can cause dyspnea if it leads to shock, which is a life-threatening condition where the organs and tissues are not receiving enough oxygen. However, dyspnea alone is not enough to indicate hypovolemia.

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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?

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Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

A nurse is caring for a client who sustained blood loss. Which of the following is a manifestation of hypovolemia?

Correct Answer is C

Explanation

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