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 B

Explanation

A. A positive ketone result indicates the presence of ketones in the urine, which can occur in conditions such as diabetes, fasting, or starvation. It is not indicative of a UTI.
B. A positive leukocyte esterase test indicates the presence of white blood cells (WBCs) in the urine, suggesting inflammation or infection, commonly associated with a UTI. This enzyme is released by WBCs, making it a key marker for infections.
C. The presence of crystals in the urine can indicate various conditions, including kidney stones or metabolic disorders, but it is not a specific marker for a UTI.
D. Hyaline casts may appear in the urine in response to dehydration or concentrated urine but are not specific to urinary tract infections. They can be seen in various renal conditions and do not indicate infection.

A. PT/INR B. C-reactive protein (CRP) C. Erythrocyte sedimentation rate (ESR) D. Procalcitonin (PCT)

Correct Answer is A

Explanation

A. PT (Prothrombin Time) and INR (International Normalized Ratio) are tests primarily used to evaluate blood coagulation and the effectiveness of anticoagulant therapy. While they can provide some insight into a patient's overall health, they are not specific indicators of inflammation.
B. CRP is a protein produced by the liver in response to inflammation. It is a well-established marker for detecting acute inflammation and is commonly used in clinical settings to assess inflammatory conditions.
C. ESR measures how quickly red blood cells settle at the bottom of a test tube. An elevated ESR is a classic indicator of inflammation in the body and is commonly used in diagnosing various inflammatory conditions.
D. Procalcitonin is a biomarker that can indicate bacterial infections and systemic inflammation. It is increasingly used in clinical practice to assess the severity of infection and inflammation, particularly in cases of sepsis.

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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

A nurse is reviewing urinalysis results for four clients. Which of the following urinalysis results indicates urinary tract infection?

Correct Answer is B

Explanation

Which of the following lab tests is NOT commonly ordered to ascertain whether the patient is experiencing large amounts of inflammation?

Correct Answer is A

Explanation

A clinic nurse is working with an older client. What action is most important for preventing infections in this client?

As a nurse, you understand that when patients have latent TB:

You are caring for a patient with an Absolute Neutrophil Count (ANC) of 400. The physician orders the patient to be placed on neutropenic precautions. Which of the following would be appropriate to implement? (Select all that apply)

The nurse is teaching an elderly client the risks of infection for older adults. Which of the following factors would the nurse include in the education? (Select all that apply.)

Which of the following are common signs and symptoms that can be present when your patient has Rheumatoid Arthritis? (Select all that apply)

A nurse in the Emergency Department (ED) is caring for a client who is having acute asthma attack. Which of the following assessments indicates that the respiratory status is declining?(Select all that apply)

A nurse is reviewing the plan of care for a client who has systemic lupus erythematosus (SLE). The client reports fatigue, joint tenderness, swelling, and difficulty urinating. Which of the following laboratory findings should the nurse anticipate? (Select all that apply)

A nurse is providing teaching for a client who has stage 2 HIV disease and is having difficulty maintaining normal weight. Which of the following statements by the client should indicate to the nurse an understanding of the teaching?