Your patient has just received a new diagnosis of Rheumatoid Arthritis. They are confused about their prescriptions, however. They ask you "Why am I receiving so many medications? I thought this 'MTX' drug was the one that would treat my arthritis?". What is your BEST response?

The MTX will stop the pain but not the progression of your disease, so we also give you NSAIDS and steroids

You have good insurance so we like to prescribe you a whole bunch of medications just in case

The MTX helps treat the nausea associated with the other meds that actually treat your disease

The MTX takes several weeks or months to reach full effect, so the other meds are started now to help your symptoms

Answer and Explanation

The Correct Answer is D

A.   Methotrexate (MTX) is a disease-modifying antirheumatic drug (DMARD) that helps slow disease progression but does not provide immediate pain relief. NSAIDs and steroids may be used for symptomatic relief, but MTX alone can manage both pain and disease progression over time.
B.   This response is unprofessional and dismissive. It implies that the medication regimen is based solely on the patient's insurance coverage rather than their medical needs. It does not address the patient’s question and could undermine trust in the healthcare team.
C.   Methotrexate does not primarily treat nausea; rather, it is used to manage rheumatoid arthritis. While some patients may experience nausea as a side effect of MTX or other medications, this is not its primary purpose.
D.   Methotrexate is indeed a DMARD that can take weeks to months to show its full benefits in controlling inflammation and slowing disease progression. Meanwhile, NSAIDs or corticosteroids may be prescribed to provide quicker relief from symptoms such as pain and swelling.

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

Explanation

A. Using a filtered IV line helps remove any particulate matter that could be present in the TPN solution, reducing the risk of complications such as phlebitis or embolism.
B. TPN should have its own dedicated line to prevent incompatibilities and ensure the TPN solution is delivered without interference. Infusing other medications through the same line can lead to complications and reduce the effectiveness of TPN.
C. If TPN gets stopped or runs out, a bag of 5% dextrose in water (D5W) should be hung to prevent hypoglycemia. D10% is too concentrated and can cause hyperglycemia.
D. To minimize the risk of infection and maintain sterility, TPN bags and tubing should be replaced every 24 hours. This helps prevent bacterial growth in the TPN solution.
E. TPN is typically administered through a central line because it allows for the infusion of hypertonic solutions that can irritate peripheral veins. Central lines provide better access to larger blood vessels, reducing the risk of complications.

A. Neutrophils B. Lymphocytes C. Basophils D. Eosinophils

Correct Answer is B

Explanation

A. Neutrophils are the most abundant type of WBC and are primarily involved in responding to bacterial infections. While they may increase during a viral infection, their primary function is to combat bacteria and fungi. Therefore, they are not the most specific indicator of viral illnesses.
B. Lymphocytes, which include T cells and B cells, are the most directly associated with viral infections. They play a crucial role in the adaptive immune response, recognizing and responding to viral pathogens. A significant increase in lymphocytes, particularly T cells, is commonly seen during viral infections.
C. Basophils are involved in allergic reactions and responses to parasites, releasing histamine and other mediators. They are not significantly involved in the response to viral infections and typically do not show a notable increase in these situations.
D. Eosinophils primarily respond to parasitic infections and allergic reactions. While they may be elevated in some allergic conditions and certain parasitic infections, they are not directly involved in the immune response to viral infections.

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Your patient has just received a new diagnosis of Rheumatoid Arthritis. They are confused about their prescriptions, however. They ask you "Why am I receiving so many medications? I thought this 'MTX' drug was the one that would treat my arthritis?". What is your BEST response?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following is are appropriate nursing interventions to ensure the safety of a patient who is receiving Total Parenteral Nutrition (TPN)? (Select all that apply)

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

Explanation

The medical team believes that your patient has been suffering from a severe Viral infection, and has ordered blood to be drawn for laboratory analysis. You know that which of the following types of white blood cells is MOST associated with a Viral illness?

Correct Answer is B

Explanation

Your patient with Iron deficiency anemia is receiving Iron Dextran when their blood pressure suddenly starts to drop, their respiratory rate increases, and their breath becomes wheezy- sounding. Your PRIORITY intervention will be:

A patient who has sickle cell disease was admitted with a vaso-occlusive crisis and reports severe abdominal and flank pain. Which of the following analgesic medications will be MOST appropriate to administer to the patient?

A nurse is caring for a patient who, upon awakening, was disoriented to person, place, and time. The client reports chills and chest pain that is worse upon inspiration. Which of the following actions is the nursing PRIORITY?

The nurse preceptor is teaching the newly graduated nurse about the care and treatment of patients with Chronic Kidney Disease (CKD) who are on dialysis treatment. Which of the following statements is TRUE?

Which of the following assessment findings is the MOST likely for a patient who is diagnosed with Aplastic Anemia? Select the BEST answer.

Patients receiving chemotherapy are at risk for thrombocytopenia related to chemotherapy or disease processes. Which actions. are needed for patients who must be placed on bleeding precautions? (Select all that apply)

Your patient has just received a new diagnosis of Rheumatoid Arthritis. They are confused about their prescriptions, however. They ask you "Why am I receiving so many medications? I thought this 'MTX' drug was the one that would treat my arthritis?". What is your BEST response?