Which teaching point should have highest priority in the plan of care that the student is developing for adult c asthma?

Take prescribed medications as scheduled.

Belimumab for treatment of lupus. Which finding below requires further evaluation?

The patient reports trouble sleeping and loss of energy

Discharging SLE pt, RN knows patient has understood health education when the patient makes what statement?

Ill make sure to monitor my body temperature on aregular basis.

respiratory alkalosis. Which clinical findings commonly accompany respiratory alkalosis?

Light-headedness or paresthesia

Suspected CF pt. Which of the following test results is associated with a diagnosis of cystic fibrosis?

Elevated sweat chloride concentration

Which points should be included in the medication teaching plan for a client taking adalimumab?

It is important to monitor for injection site reactions.

A client is experiencing an acute exacerbation of rheumatoid arthritis. What should the nursing priority be?

Administering ordered analgesics and monitoring their effects

Which of the following statements related to osteoporosis is most accurate?

Slow discontinuation of corticosteroid can halt progression osteoporosis.

Emphysema pt is experiencing SOB. To relieve this patients symptoms, the nurse should assist her into what position?

Sitting upright, leaning forward slightly

Lupus Nephritis. What are some signs and symptoms that correlate with this complication of SLE? Select all that apply:

Edema in upper and lower extremities, Increased BUN, 48 hour urinary output of 720 mL, Proteinuria

Pt asks RN about the difference between osteoarthritis (OA)and rheumatoid arthritis (RA). What is the best response?

OA is non-inflammatory joint disease. RA inflamed, swollen joints

Hydroxychloroquine. Select all the educational points you will include in the patient's education about this medication:

doesn't produce results immediately. pt may not see results for months, must have their eyes checked regularly to monitor the retina, It is used long-term to help prevent flares

Pt admitted c COPD exacerbation. How can RN best help patient achieve goal of maintaining effective oxygenation?

Teach the patient strategies for promoting diaphragmatic breathing.

care of a patient with emphysema who will soon be discharged. What teaching should the nurse prioritize in plan of care?

Setting realistic short-term and long-range goals

Treatment of FVE involves dietary restriction of sodium. Which ood choices would be part of a low-sodium diet

3oz of light or dark meat chicken, 1 cup of spaghetti and a garden salad

exacerbation of SLE pt expressesanger/irritation when call bell isnt answered immediately.Most appropriate response?

You seem like youre angry. Is that something that we could talk about?

Which testing will RN anticipate pt will need before RA medications are started? Select all that apply.

Testing for hepatitis C, Testing for hepatitis B, Liver function tests, Tuberculin skin test

RN reviewing the diagnostic test findings of a client with rheumatoid arthritis. What would the nurse expect to find?

Elevated erythrocyte sedimentation rate

Pt asks which test ordered will dx positivity for SLE disorder. Which statement by the nurse is most accurate?

The Dx won't be based on asingle test but by combining all data found

Exercises for patients with rheumatoid disordersshould have which of the following goals?

Preserve and increase range of motion while limiting joint stress

auscultating SLE pts apical heart rate, RN notes the presence of a distinct scratching sound. Most appropriate action?

Inform the primary care provider that afriction rub may be present.

(SLE) takes the medication Azathioprine. Which statement by the patient requires re-education?

I've made sure all my vaccines are up-to-date, and I'm getting the Shingles

Which statement by the client refers to the most overt clinical manifestation of rheumatoid arthritis?

"My finger joints are oddly shaped."

RA. What is the most important client focus for disease management?

strategies for remaining active

Teaching plan for a patient with COPD. What should thenurse include as the most important area of teaching?

Setting and accepting realistic short- and long-range goals

10yo girl who is having an asthma attack. Peferred intervention to alleviate this clients airflow obstruction?

Administer an inhaled beta-adrenergic agonist

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COPD, OA, RA SLE

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1
Which teaching point should have highest priority in the plan of care that the student is developing for adult c asthma?
Avoid goose-down pillows.
Change filters on heaters and air conditioners frequently.
Take prescribed medications as scheduled.
Gradually increase levels of physical exertion.
2
Belimumab for treatment of lupus. Which finding below requires further evaluation?
The patient declines a flu shot via the intranasal route
The patient administers medication in the subcutaneous tissue on the abd
The patient says they have not noticed a change in symptoms
The patient reports trouble sleeping and loss of energy
3
Discharging SLE pt, RN knows patient has understood health education when the patient makes what statement?
Ill make sure to monitor my body temperature on aregular basis.
Ill try to be as physically active as possible between flare-ups.
Ill make sure I get exposure to sunlight to keep up my vitamin D levels.
Ill stop taking my steroids when I get relief from my symptoms.
4
Suspected RA, testing aspiration of synovial fluid from the knee for a definitive diagnosis. which procedure?
Arthocentesis
Angiography
Paracentesis
Myelography
5
respiratory alkalosis. Which clinical findings commonly accompany respiratory alkalosis?
Nausea, vomiting, abdominal pain, and diarrhea
Hallucinations
Light-headedness or paresthesia
Tinnitus
6
Suspected CF pt. Which of the following test results is associated with a diagnosis of cystic fibrosis?
Malignancy on lung biopsy
Elevated sweat chloride concentration
Positive phenylketonuria
Presence of protein in the urine
7
Admission assessment on a patient with COPD. Itis most important for the nurse to reviewwhich of the following?
Available diagnostic tests
Social work assessment
Chloride levels
Insurance coverage
8
Which points should be included in the medication teaching plan for a client taking adalimumab?
The medication is given at room temperature.
It is important to monitor for injection site reactions.
The client should continue taking the medication if fever occurs.
The medication is administered intramuscularly.
9
SLE Which finding will RN recognize most likely indicates pt is experiencing a change to the cardiovascular system?
Peripheral edema
Jugular vein distention
Pericardial friction rub
Bounding peripheral pulses
10
Which medication would lead the nurse to suspect that the client is suffering from an acute attack of gout?
penicillamine
prednisone
methotrexate
colchicine
11
A client is experiencing an acute exacerbation of rheumatoid arthritis. What should the nursing priority be?
adaptive devices, such as a zipper-pull, easy-to-open beverage cartons,
Administering ordered analgesics and monitoring their effects
comprehensive teaching; including symptoms of disorder, treatment options
Performing meticulous skin care
12
age-related processes that contribute to bone loss and osteoporosis. What is the nurse's best response?
Increase in calcitonin
Increase of vitamin D
Decrease in estrogen
Increase in calcitonin
13
Which of the following statements related to osteoporosis is most accurate?
Osteoporosis is categorized as a disease of the elderly.
Secondary osteoporosis occurs in women after menopause.
Slow discontinuation of corticosteroid can halt progression osteoporosis.
Anonmodifiable risk factor for osteoporosis is a persons level of activity.
14
Home health visit for RA pt. On what aspect of the patients health should the nurse focus most closely during the visit?
The patients risk for cardiopulmonary complications
The patients social support system
The patients functional status
The patients understanding of rheumatoid arthritis
15
Emphysema pt is experiencing SOB. To relieve this patients symptoms, the nurse should assist her into what position?
Low Fowlers, with the neck slightly hyperextended
Trendelenburg
Sitting upright, leaning forward slightly
Prone
16
Lupus Nephritis. What are some signs and symptoms that correlate with this complication of SLE? Select all that apply:
Edema in upper and lower extremities
Decreased Creatinine
Increased BUN
48 hour urinary output of 720 mL
Proteinuria
17
Pt asks RN about the difference between osteoarthritis (OA)and rheumatoid arthritis (RA). What is the best response?
SIMILAR OA affects smaller joints such as fingers, RA affects larger joints
OA is non-inflammatory joint disease. RA inflamed, swollen joints
OA is impaired immune function; RA consequence of physical damage.
OA originates with infection. RA results of bodys cells attacking eachother
18
severe diarrhea. The nurse recognizes that the client is at risk for developing which acid-base imbalance?
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis
Respiratory acidosis
19
Pt with COPD. When teaching the client about breathing exercises, what should the nurse include in the teaching?
Avoid pursed lip breathing
Use chest breathing
Use diaphragmatic breathing
Lie supine to facilitate air entry
20
RA. What assessment finding indicates the client is having difficulty implementing self-care?
increased fatigue
ability to perform activities of daily living (ADL)
a weight gain of 2 pounds
decreased joint pain
21
older adult client. Which of the following would require the nurse to assess for chronic respiratory acidosis?
decreased renal function
overuse of sodium bicarbonate
erratic meal patterns
thoracic skeletal change
22
Hydroxychloroquine. Select all the educational points you will include in the patient's education about this medication:
binds with a protein supports activity of B-c, decreases activity of B-c
Hydroxychloroquine is considered a Biologic medication
doesn't produce results immediately. pt may not see results for months
must have their eyes checked regularly to monitor the retina
It is used long-term to help prevent flares
23
Pt admitted c COPD exacerbation. How can RN best help patient achieve goal of maintaining effective oxygenation?
Teach the patient strategies for promoting diaphragmatic breathing.
Assist the patient in developing an appropriate exercise program.
Teach the patient to perform airway suctioning.
Administer supplementary oxygen by simple face mask.
24
RA pt prescribed cyclophosphamide (Cytoxan). RN subsequent assessments should address what potential adverse effect?
Acute confusion
Malignant hyperthermia
Infection
Sedation
25
care of a patient with emphysema who will soon be discharged. What teaching should the nurse prioritize in plan of care?
Avoiding airplanes, buses,and other crowded public places
Adhering to the treatment regimen in order to cure the disease
Setting realistic short-term and long-range goals
Taking prophylactic antibiotics as ordered
26
Treatment of FVE involves dietary restriction of sodium. Which ood choices would be part of a low-sodium diet
Three ounces of sliced ham, beets, and a salad
A frozen, packaged low-fat dinner with a side salad
3oz of light or dark meat chicken, 1 cup of spaghetti and a garden salad
Tomato juice, low-fat cottage cheese, and three slices of bacon
27
Older woman with osteoporosis discharging from hospital. Rn teaching should include what priority teaching point?
Dowagers hump
Bone Fracture
Loss of estrogen
Negative Calcium Balance
28
Respiratory disease characterized by chronic hyperinflation of the lungs. What would the nurse most likely assess ?
Long, thin fingers
Chronic chest pain
A barrel chest
Signs of oxygen toxicity
29
exacerbation of SLE pt expressesanger/irritation when call bell isnt answered immediately.Most appropriate response?
Try to remember that stress can make your symptoms worse.
Would you like to talk about the problem with the nursing supervisor?
You seem like youre angry. Is that something that we could talk about?
Ican see youre angry. Ill come back when youve calmed down.
30
Med not for long-term usage, and can lead to weight gain, susceptibility to infection, diabetes, and osteoporosis?
Belimumab
Hydroxychloroquine
Prednisone
Azathioprine
31
Which testing will RN anticipate pt will need before RA medications are started? Select all that apply.
Testing for hepatitis C
Serum electrolytes
Testing for hepatitis B
Liver function tests
Tuberculin skin test
32
RN reviewing the diagnostic test findings of a client with rheumatoid arthritis. What would the nurse expect to find?
Increased albumin levels
Increased C4 complement
Increased red blood cell count
Elevated erythrocyte sedimentation rate
33
Pt asks which test ordered will dx positivity for SLE disorder. Which statement by the nurse is most accurate?
Tell me more about your concerns about this potential diagnosis
You should discuss that matter with your health care provider
The Dx won't be based on asingle test but by combining all data found
SLE is a very serious systemic disorder
34
Exercises for patients with rheumatoid disordersshould have which of the following goals?
Increase joint size and strength
Preserve and increase range of motion while limiting joint stress
Limit energy output in order to preserve strength for healing
Maximize range of motion while minimizing exertion
35
What hormone should the nurse identify as inhibiting bone resorption and promoting bone formation?
Parathyroid hormone (PTH)
Progesterone
Estrogen
Calcitonin
36
auscultating SLE pts apical heart rate, RN notes the presence of a distinct scratching sound. Most appropriate action?
Document the presence of S3 and monitor the patient closely.
Inform the primary care provider that afriction rub may be present.
Inform the primary care provider that the patient may have pneumonia.
Reposition the patient and auscultate posteriorly.
37
Type 1 Diabetes.severe vomiting/diarrhea. low pH and low plasma HCO3 concentration should RN assess for?
Respiratory Alkalosis
Metabolic Alkalosis
Respiratory Acidosis
Metabolic Acidosis
38
(SLE) takes the medication Azathioprine. Which statement by the patient requires re-education?
This medication lowers my immune system
It's “steroid-sparing”so it may help lower the amount of steroids I need
This medication can increase my chances for developing infection
I've made sure all my vaccines are up-to-date, and I'm getting the Shingles
39
Which statement by the client refers to the most overt clinical manifestation of rheumatoid arthritis?
"I have pain in my hands."
"My legs feel weak."
"My finger joints are oddly shaped."
"I have trouble with my balance."
40
pt has been vomiting for 3 days pH of 7.50, (PaCO2) of 43, PaO2) of 75, (HCO3-) of 42. Type of acid-base imbalance?
Metabolic alkalosis
Respiratory Acidosis
Respiratory Alkalosis
Metabolic acidosis
41
RA. What is the most important client focus for disease management?
detection of systemic complications
disease-modifying antirheumatic drug therapy
strategies for remaining active
prevention of joint deformity
42
near-drowning in saltwater. tremors, restlessness, lethargic. RN anticipates client’s serum sodium value would be:
135 mEq/L (135 mmol/L)
125 mEq/L (125 mmol/L)
155 mEq/L (155 mmol/L)
145 mEq/L (145 mmol/L)
43
suspected gout. Explaining the pathophysiology of gout to the patient, the nurse should describe which of the following?
Autoimmune processes in the joints
Unstable serum calcium levels
Increased uric acid levels
Chronic metabolic acidosis
44
osteoporosis. When teaching the client, the nurse should include information about which major complication?
Negative calcium balance
Loss of estrogen
Dowager's hump
Bone fracture
45
treatment of RA. Which disease-modifying antirheumatic drug (DMARD) will the nurse educate the client about?
Celecoxib
Methylprednisolone
Mercaptopurine azathioprine
Methotrexate
46
Teaching plan for a patient with COPD. What should thenurse include as the most important area of teaching?
Avoiding emotional disturbances and stressful situations
Avoiding extremes of heat and cold
Setting and accepting realistic short- and long-range goals
Adopting alifestyle of moderate activity
47
10yo girl who is having an asthma attack. Peferred intervention to alleviate this clients airflow obstruction?
Administer corticosteroids by metered dose inhaler
Administer inhaled anticholinergics
Administer an inhaled beta-adrenergic agonist
Utilize a peak flowmonitoring device
48
Pt c rheumatic disease is complaining of stomatitis. RN caring forpt should assess pt for adverse effects of what meds?
Antimalarials
Gold-containing compounds
Salicylate therapy
Corticosteroids
49
Dx imaging and culture of synovial fluid in painful inflamed joint reveals septic arthritis. priority treatment?
Oral and IV corticosteroids
Maintenance of adequeate serum levels of vit D
Fall and fracture prevention teaching
IV antibiotics
50
RA pt has been Rx'd antimalarials for treatment, RN knows to teach the pt to self-monitor for what adverse effect?
Hirsutism
Tinnitus
Stomatitis
Visual changes
51
SLE pt expresses she wants a baby soon. Advise how long to be in remission before trying to concieve?
2 months
6 months
1 year
2 years
52
COPD teaching. Nurse emphasizes the importance of smoking cessation because smoking has what pathophysiologic effect?
Collapses the alveoli in the lungs
Shrinks the alveoli in the lungs
Destabilizes hemoglobin
Increases the amount of mucus production
53
Caring for pt with history of OA. When planning the patients care, what goal should the nurse include?
The patient will express satisfaction with her ability to perform ADLs.
The patient will deny signs or symptoms of OA.
The patient will adhere to the prescribed plan of care.
The patient will recover from OAwithin 6 months.
54
exacerbationmyasthenia gravis. RN notes sever depressed respirations. RN anticipates which acid-base disturbance?
Respiratory alkalosis
Respiratory acidosis
Metabolic acidosis
Metabolic alkalosis
55
Newly dx SLE pt admitted. Which of the following nursing diagnoses is the most plausible inclusion in the plan of care?
Risk for Ineffective Tissue Perfusion Related to Increased Hematocrit
Risk for Ineffective Tissue Perfusion Related to Venous Thromboembolism
Acute Confusion Related to Increased Serum Ammonia Levels
Fatigue Related to Anemia
56
health promotion intervention focused on COPD. What should the nurse identify as acomplication of COPD?
Respiratory failure
Cystic fibrosis
Lung cancer
Hemothorax
57
What is the name of the process in the body that is responsible for the death of a cell?
Meiosis
Apoptosis
Mitosis
Osmosis
58
Older pt with COPD. What characteristic pts current health status would preclude the safe and effective use of a MDI?
The patient requires both corticosteroids and beta2-agonists.
The patient has not yet quit smoking.
The patient has severe arthritis in her hands.
The patient has cataracts.
59
RN cares for pt c possible acid-base prob.Most important indications of an acid-base imbalance that is shown in an ABG
Carbon Dioxide
Potential Hydrogen
Sp02
Bicarbonate
60
COPD pt on new bronchodilator. Assessment parameters suggest consequent improvement in respiratory status? Select all
Relief of dyspnea
Increased viscosity of lung secretions
Negative sputum culture
Increased respiratory rate
Increased expiratory flowrate
61
older adult womans current med regimen includes alendronate (Fosamax).What outcome would indicate successful therapy?
Relief of bone pain
Increased bone mass
Resolution of infection
Absence of tumor spread
62
Risk factors known to contribute to OsteoArthritis.What assessment finding would the nurse interpret as arisk factor?
The patient has primary hypertension.
The patients body mass index is 34 (obese).
The patient is 58 years old.
The patient has a 30 pack-year smoking history.
63
Which clinical findings commonly accompany respiratory alkalosis?
Abdominal pain or diarrhea
Headache or blurry vision
Light-headedness or paresthesia
Hallucinations or tinnitus
64
COPD pt.diminished lung sounds, signifying changes airway. Changesindicate to RN to monitor the patient for what?
Bradypneaand pursed lip breathing
Sepsis and pneumothorax
Kyphosis and clubbing of the fingers
Dyspneaand hypoxemia
65
COPD pt assessment. What assessment finding would suggest that the patient is experiencing bronchospasm?
Wheezes or diminished breath sounds on auscultation
Slow, deliberate respirations
Fine or coarse crackles on auscultation
Reduced respiratory rate or lethargy
66
Pt presents c pneumonia: pH, 7.51, PaCO2, 28, PaO2, 70, HCO3--, 24 What do these values indicate?
Metabolic acidosis
Metabolic Alkalosis
Respiratory Alkalosis
Respiratory acidosis
67
Dx c early stage of rheumatoid arthritis. The nurse should anticipate the administration of which of the following?
Allopurinol (Zyloprim)
Hydromorphone (Dilaudid)
Prednisone
Methotrexate (Rheumatrex)
68
What lab findings below are associated with this condition? Select all that apply
ow C3 and C4
Positive Anti-dsDNA
Negative Anti-Sm
Decreased ESR and CRP
Positive ANA
69
21yo male has just been dx with a spondyloarthropathy. What willbe a priority nursing intervention for this patient?
Setting up an exercise program
Referral for assistive devices
Teaching about symptom management
Referral to classes to stop smoking
70
alpha1-antitrypsin deficiency. This deficiency predisposes the patient to what health problem?
Cystic fibrosis (CF)
Empyema
Pulmonary edema
Lobular emphysema
71
Care plan for a patient with COPD. What would be the most important component for the nurse to emphasize?
(ADLs) should be clustered in the early morning hours.
Minor respiratory infections considered to be self-limited and not treated
Chronic inhalation of indoor toxins can cause lung damage.
Smoking up to one-half of a pack of cigarettes weekly is allowable.
72
Which statements below are INCORRECT about Systemic Lupus Erythematosus? Select all that apply:
Lupus is a chronic condition that has periods of flare-ups and remission
The joints and skin are rarely affected in lupus
Systemic Lupus Erythematosus (SLE) is the most common form of lupus
Lupus mainly affects Black, Asian, and Hispanic men
73
ankylosing spondylitis (AS). Which medication will the nurse expect to be prescribed for this client?
Anticoagulants
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Antibiotics
Oral corticosteroids
74
pH, 7.12, (PaCO2), 40, (HCO3-), 15. These ABG values suggest which disorder?
Metabolic Alkalosis
Respiratory acidosis
Respiratory Alkalosis
Metabolic acidosis
75
Which confirms the nursing problem statement of dehydration. Select all that apply.
An elevated hematocrit level
Absence of ketones in urine
Low protein level in the urine
A low urine specific gravity
Electrolyte imbalance
76
Assessing pt recently diagnoses c SLE. What skin manifestation would the nurse expect to observe on inspection?
Petechiae
Skin sloughing
Butterfly rash
Jaundice
77
Assessing pt c RA. What assessment finding is mostconsistent with the clinical presentation of RA?
Signs of systemic infection
Joint stiffness,especially in the morning
Cool joints with decreased range of motion
Visible atrophy of the knee and shoulder joints
78
COPD patient asks the nurse what he could have done to minimize the risk of contracting this disease. Best answer
The most important risk factor for COPD is exposure to dust and pollen.
The most important risk factor for COPD is cigarette smoking.
The most important risk factor for COPD is exposure to occupational toxins.
The most important risk factor for COPD is inadequate exercise.
79
RA pt treated with salicylate therapy. What statement would indicate that the patient is experiencing adverse effects
I feel so foggy in the mornings and it takes me so long to wake up.
I have this ringing in my ears that just wont go away.
When Ieat a meal thats high in fat, I get really nauseous.
I seem to have lost my appetite, which is unusual for me.
80
pH, 7.12, PaCO2 40, HCO3 15. These ABG values suggest which disorder?
Respiratory acidosis
Respiratory alkalosis
Metabolic alkalosis
Metabolic acidosis

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