Which of the following is the most important nursing action to perform before initiating adalimumab therapy in a patient with Crohn's disease?

Assess for manifestations of infection

Obtain a baseline blood sugar level

Evaluate the patient's appetite

Check blood urea nitrogen levels

Answer and Explanation

The Correct Answer is A

A. Assess for manifestations of infection: Adalimumab is a tumor necrosis factor (TNF) inhibitor that suppresses the immune system to reduce inflammation in Crohn’s disease. Immunosuppression increases susceptibility to infections, including latent tuberculosis and opportunistic pathogens. Prior to initiating therapy, assessing for signs of active infection and screening for latent TB is critical to prevent serious complications.

B. Obtain a baseline blood sugar level: Monitoring blood glucose is important for patients on corticosteroids or other medications that affect glucose metabolism, but adalimumab does not directly impact blood sugar. Baseline glucose assessment is not a priority action before starting this biologic therapy.

C. Evaluate the patient's appetite: Appetite assessment provides general nutritional information but does not influence the safe initiation of adalimumab. While overall nutritional status may affect disease management, it is not the most urgent pre-treatment consideration.

D. Check blood urea nitrogen levels: BUN assessment evaluates renal function, which may be relevant for certain medications eliminated renally, but adalimumab is primarily metabolized via reticuloendothelial pathways. Baseline BUN is not essential before starting this immunosuppressive therapy.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is A

Explanation

A. Bradykinesia and stiff muscles: Parkinson’s disease is a progressive neurodegenerative disorder caused by the loss of dopaminergic neurons in the substantia nigra. The resulting dopamine deficiency leads to motor symptoms, including bradykinesia (slowness of movement), rigidity (stiff muscles), tremors at rest, and postural instability. These are hallmark manifestations used in clinical diagnosis and management of the disease.

B. Dry mouth and urinary retention: While some autonomic dysfunction can occur in Parkinson’s disease, these symptoms are more often side effects of anticholinergic medications rather than primary manifestations of the disorder. They are not considered core features of Parkinsonian motor deficits.

C. Hypertension and dizziness: Orthostatic hypotension can occur in Parkinson’s disease due to autonomic nervous system involvement, but hypertension is not a typical manifestation. Dizziness may be present if blood pressure fluctuations occur, but these are secondary findings rather than defining characteristics of the disease.

D. Numbness and tingling in the feet: Sensory neuropathy, including numbness or tingling, is not a primary symptom of Parkinson’s disease. Such manifestations are more commonly associated with peripheral neuropathies or conditions like diabetes mellitus, rather than central dopaminergic degeneration.

A. Genetics B. Environmental factors C. Upper respiratory Infections D. Autoimmune factors E. Urinary tract infections

Correct Answer is ["A","B","D"]

Explanation

A. Genetics: A family history of multiple sclerosis (MS) increases susceptibility, indicating a genetic predisposition. Specific human leukocyte antigen (HLA) genes are associated with higher risk, suggesting that inheritance plays a role in disease development, though MS is not strictly hereditary.

B. Environmental factors: Geographic location, low vitamin D levels, and reduced sun exposure have been implicated as environmental contributors to MS. Epidemiologic studies show higher prevalence in temperate regions, supporting the influence of environmental conditions on disease risk.

C. Upper respiratory infections: While infections (specifically viral infections like Epstein-Barr) are being studied as potential triggers that might kickstart the autoimmune response in susceptible people, ordinary bacterial URIs or UTIs are not identified as causes of the development of the disease.

D. Autoimmune factors: MS is widely considered an autoimmune disorder in which the body’s immune system erroneously targets central nervous system myelin. T-cell and B-cell mediated immune responses lead to demyelination and axonal injury, driving the characteristic neurologic deficits.

E. Urinary tract infections: While urinary tract infections are common complications in clients with MS due to neurogenic bladder dysfunction, they are not causative factors in the development of the disease. They exacerbate symptoms but do not contribute to disease onset.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Which of the following is the most important nursing action to perform before initiating adalimumab therapy in a patient with Crohn's disease?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has Parkinson's disease. Which of the following manifestations should the nurse expect?

Correct Answer is A

Explanation

A nurse is caring for a client who has Multiple Sclerosis, Which of the following factors should the nurse anticipate have been identified as contributing to the development of Multiple Sclerosis? (Select All that Apply.)

Correct Answer is ["A","B","D"]

Explanation

A nurse is teaching a client who has a history of Ulcerative Colitis and a new diagnosis of anemia. Which of the following manifestations of colitis should the nurse identify as a contributing factor to the development of the anemia?

A nurse is assessing a client who has Multiple Sclerosis. The client reports that, since the onset of the disease, there are times when their symptoms are active and then followed by a period with no symptoms. Which of the following types of Multiple Sclerosis does this pattern indicate?

A nurse is caring for a client with Parkinson's disease. The client has been prescribed oral diphenhydramine. Which of the following therapeutic outcomes should the nurse expect to see following administration of this medication?

A client has been administered lorazepam for acute seizure control. Which clinical manifestation is the nurse's priority to monitor for immediately following the administration?

A nurse is caring for a client who has a complete spinal cord injury at the level of cervical 7. Which of the following assessment findings should the nurse anticipate?

A nurse is presenting discharge instructions to a client who has Multiple Sclerosis. The client reports symptoms of diplopia, dysmetria, and sensory change. Which of the following nursing statements are appropriate?

A child with a history of febrile seizures is being monitored in the pediatric unit. The child has a current temperature of 39°C (102.2°F). Which nursing action should be prioritized to prevent another febrile seizure?

An acute care nurse receives shift report for a client who has increased intracranial pressure. The nurse is told that the client demonstrates decorticate posturing. Which of the following findings should the nurse expect to observe when assessing the client?