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 C

Explanation

A. Weight gain is not a typical finding associated with SLE. Patients often experience weight loss due to decreased appetite, fatigue, or increased metabolism. Therefore, this choice is less likely to be expected.
B. While some patients with SLE may develop cardiac complications, such as pericarditis or valvular disease, a systolic murmur is not a common or characteristic finding of the disease itself. This choice is not specifically indicative of SLE.
C. Alopecia, or hair loss, is a common finding in patients with SLE. It can occur due to the disease itself or as a side effect of certain medications used in treatment. This choice is a typical manifestation of SLE.
D. Petechiae can occur in SLE, particularly when there is thrombocytopenia (low platelet count) or vasculitis associated with the condition. While it is not as common as alopecia, it can still be an expected finding in some cases of SLE.

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

A nurse is assessing a client who has a new diagnosis of SLE (Lupus). Which of the following findings should the nurse expect?

Correct Answer is C

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

You are planning to transfuse a unit of PRBC's to your patient. You know that when you arrive at the blood bank and they hand you the unit of blood, you have how long to start the transfusion from that time?

A nurse is caring for a client who has a WBC count of 22,000. The nurse should conclude that the client has which of the following?

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

A nurse is providing teaching for a client who has stage 3 HIV disease (AIDS). Which of the following statements by the client should indicate to the nurse an understanding of the teaching?

A nurse is caring for a client who has SLE and is experiencing an episode of Raynaud's phenomenon. Which of the following findings should the nurse anticipate?

The nurse is reviewing lab results for a patient and the white blood cell (WBC) count is elevated at 12,000. Which of the following is a cause of increasing WBC count? (Select all that apply)

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?

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