Which lab result would be consistent with a diagnosis of rheumatoid arthritis?
Elevated rheumatoid factor
Decreased C-reactive protein
Normal erythrocyte sedimentation rate
Low antinuclear antibody levels
The Correct Answer is A
Choice A reason: Elevated rheumatoid factor (RF), an autoantibody, is present in 70-80% of rheumatoid arthritis (RA) patients. It contributes to immune complex formation, driving synovial inflammation and joint damage. This lab result is a key diagnostic marker, making it consistent with RA and critical for confirming the diagnosis.
Choice B reason: Decreased C-reactive protein (CRP) is inconsistent with RA, which typically shows elevated CRP due to systemic inflammation. CRP reflects acute-phase response in active RA, and low levels suggest inactive disease or another condition, making this result inaccurate for supporting an RA diagnosis.
Choice C reason: Normal erythrocyte sedimentation rate (ESR) is not typical in active RA, where ESR is elevated due to inflammation-driven increases in plasma proteins. Normal ESR may occur in remission but does not support an active RA diagnosis, making this result inconsistent with the condition.
Choice D reason: Low antinuclear antibody (ANA) levels are not specific to RA and are more associated with systemic lupus erythematosus. While some RA patients may have low ANA, it is not a diagnostic marker for RA, making this result irrelevant and inconsistent with confirming rheumatoid arthritis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: In fever, pyrogens reset the hypothalamic thermoregulatory set point, causing the body to raise core temperature via shivering and vasoconstriction. Once reached, diaphoresis and flushing occur to dissipate heat, preventing overheating. This statement accurately describes the body’s response to achieving the fever’s set point in pneumonia.
Choice B reason: Exogenous pyrogens (e.g., bacterial toxins) act via endogenous pyrogens (cytokines) to reset the hypothalamic, not anterior pituitary, set point. The pituitary regulates hormones, not thermoregulation. This statement is inaccurate, as it misidentifies the anatomical site and mechanism of fever induction.
Choice C reason: Hyperthermia involves uncontrolled heat gain (e.g., heat stroke), not a regulated fever like in pneumonia. The client’s diaphoresis and flushing indicate intact heat loss mechanisms, not failure. This statement is inaccurate, as fever, not hyperthermia, drives the observed symptoms in this scenario.
Choice D reason: Endogenous pyrogens (e.g., IL-1, IL-6) stimulate prostaglandins, not leukotrienes, to reset the hypothalamic set point in fever. Leukotrienes are involved in allergic responses, not thermoregulation. This statement is inaccurate, as it misattributes the biochemical mediator of fever in pneumonia.
Correct Answer is B
Explanation
Choice A reason: Crohn’s disease does not always spread to the liver. While it can cause liver complications like primary sclerosing cholangitis or fatty liver in some cases, this is not universal. This statement is inaccurate, as liver involvement is a complication, not a defining feature of Crohn’s disease.
Choice B reason: Crohn’s disease is characterized by a patchy, or “skip lesion,” pattern of bowel involvement, affecting any part of the gastrointestinal tract discontinuously. Inflammation is transmural, causing fistulas or strictures. This statement is accurate, as the patchy distribution is a hallmark distinguishing it from ulcerative colitis.
Choice C reason: Continuous bowel involvement is characteristic of ulcerative colitis, not Crohn’s disease. Crohn’s affects the bowel in a segmental, patchy manner, with healthy areas between lesions. This statement is inaccurate, as it incorrectly describes Crohn’s tissue involvement pattern, which is distinctly non-continuous.
Choice D reason: Crohn’s disease increases cardiovascular risk due to chronic inflammation, but stroke is not a well-established direct complication. Inflammatory markers may contribute to atherosclerosis, but stroke risk is less specific than patchy bowel involvement. This statement is inaccurate, as it overstates a specific stroke association.
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