463 Final

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A patient who requires daily use of a nonsteroidal antiinflammatory drug (NSAID) for the management of severe rheumatoid arthritis has recently developed melena. The nurse will anticipate teaching the patient about

cytotec and protection of GI mucosa

What concern should the nurse anticipate for a patient who had a right hemisphere stroke?

denial/impulsive

A patient being admitted with a stroke has right-sided facial drooping and right-sided arm and leg paralysis. Which finding should the nurse expect?

difficulty comprehending instructions

A patient treated for human immunodeficiency virus (HIV) infection for 6 years has developed fat redistribution to the trunk with wasting of the arms, legs, and face. What recommendation will the nurse give to the patient?

discuss changes in therapy

Which result for a patient with systemic lupus erythematosus (SLE) is most important for the nurse to communicate to the health care provider?

elevated BUN

Eight years after seroconversion, a patient with human immunodeficiency virus infection has a CD4+ cell count of 800/μL and an undetectable viral load. What should be included in the plan of care at this time?

encourage adequate diet and exercise

Which action will the nurse include in the plan of care for a patient with a new diagnosis of rheumatoid arthritis (RA)?

encourage the pt to take afternoon naps

The nurse palpates enlarged cervical lymph nodes on a patient diagnosed with acute human immunodeficiency virus (HIV) infection. Which action would be appropriate for the nurse to take?

expected finding

FAST

face, arms, speech, time

labs to watch with RA

glucose, sodium, potassium

A patient is being admitted with a possible stroke. Which information from the assessment indicates that the nurse should consult with the health care provider before giving a prescribed dose of aspirin?

headache

scans

hemorrhagic= ct will be + ischemic= MRI will be + TIA= both -

right sided strok

impaired judgment, impulsive, agnosia, depression, language

left sided stroke

impaired memory, aphasia

What topic should the nurse anticipate teaching a patient who had a brief episode of tinnitus, diplopia, and dysarthria with no residual effects?

low dose aspirin

An older adult who takes medications for coronary artery disease and hypertension is newly diagnosed with HIV infection and is starting antiretroviral therapy. Which information will the nurse include in patient teaching?

many drug interactions

symptom management RA

methotrexate (chemo drug for acute exacerbation), prednisone, vegetarian, NSAID

how will a TIA present

negative CT/MRI, symptoms resolve in 48-72 hours

common issue with lupus

nephritis, watch urine output, pericarditis

A patient with carotid atherosclerosis asks the nurse to describe a carotid endarterectomy. Which response by the nurse is accurate?

plaque is surgically removed

A patient in the emergency department with sudden-onset right-sided weakness is diagnosed with an intracerebral hemorrhage. Which information about the patient is most important to communicate to the health care provider?

pt has afib and takes warfarin

Which patient who has arrived at the human immunodeficiency virus (HIV) clinic should the nurse assess first?

pt who had 10 liquid stools

how to diagnose RA

rheumatoid factor >30

nursing lupus

risk for impaired skin integrity

plan with stroke

rule out/in hemorrhagic then treat occlusive, if neither= TIA

hemorrhagic stroke

severe, ruptured blood vessel causes bleeding (15%), progress over time

When the nurse brings medications to a patient with rheumatoid arthritis, the patient refuses the prescribed methotrexate. The patient tells the nurse, ―My arthritis isn't that bad yet. The side effects of methotrexate are worse than the arthritis.‖ The most appropriate response by the nurse is

start it early

A patient arrives in the emergency department with hemiparesis and dysarthria that started 2 hours previously. Health records show a history of several transient ischemic attacks (TIAs). What should the nurse anticipate for this patient?

tPa infusion

TIA

temporary clot, pre-stroke

The home health nurse is making a follow-up visit to a patient with recently diagnosed rheumatoid arthritis (RA). Which assessment made by the nurse indicates more patient teaching is needed

the pt sleeps with two pillows under their head

A 29 - yr - old woman is taking methotrexate to treat rheumatoid arthritis. Which information from the patient's health history is important for the nurse to report to the health care provider related to the methotrexate

trying to get pregnant

The health care provider has prescribed the following interventions for a patient who is taking azathioprine (Imuran) for systemic lupus erythematosus. Which order will the nurse question?

varicella vaccine

During change of shift report, a nurse is told that a patient has an occluded left posterior cerebral artery. What finding should the nurse anticipate?

visual deficits

how quick for tpa

within 60 mins

RA nursing

chronic pain, impaired mobility, body image

test for lupus

ANA, if >1.1

skin in lupus

butterfly rash

finger with lupus

swan fingers

A new clinic patient with joint swelling and pain is being tested for systemic lupus erythematosus. Which test will provide the most specific findings for the nurse to review?

Anti-Smith antibody (Anti-Sm)

what will be elevated 48 hours after stroke

BP

Which laboratory result will the nurse monitor to determine if prednisone has been effective for a patient with an acute exacerbation of rheumatoid arthritis?

C-reactive protein

first test for stroke

CT

Which intervention should the nurse include in the plan of care for a patient with new right-sided homonymous hemianopsia after a stroke?

Place needed objects on the patient's left side.

A patient informed of a positive rapid screening test result for human immunodeficiency virus (HIV) is anxious and does not appear to hear what the nurse is saying. What action by the nurse is most important at this time?

Remind the patient to return for retesting to verify the results.

The nurse is advising a patient who was exposed 4 days ago to human immunodeficiency virus (HIV) through unprotected sexual intercourse. The patient's antigen-antibody test has just been reported as negative for HIV. What information should the nurse give to this patient?

You will need to be retested in 2 weeks

The nurse suggests that a patient recently diagnosed with rheumatoid arthritis (RA) plan to start each day with

a warm bath

A 70-yr-old female patient with left-sided hemiparesis arrives by ambulance to the emergency department. Which action should the nurse take first?

check respirations

risk for ischemic stroke

afib

Which information about a patient population would be most useful to help the nurse plan for human immunodeficiency virus (HIV) testing needs?

age

What instructions about plasmapheresis should the nurse include in the teaching plan for a patient diagnosed with systemic lupus erythematosus (SLE)

antibody-antigen complex

A patient has a ruptured cerebral aneurysm and subarachnoid hemorrhage. Which intervention will the nurse include in the plan of care?

apply SCD

Which information will the nurse include when preparing teaching materials for a patient with an exacerbation of rheumatoid arthritis?

apply cold packs

A female patient who had a stroke 24 hours ago has expressive aphasia. What is an appropriate nursing intervention to help the patient communicate?

ask yes/no questions

A patient in the clinic reports a recent episode of dysphasia and left-sided weakness at home that resolved after 2 hours. What topic should the nurse anticipate teaching the patient?

aspirin

A patient being seen in the clinic has rheumatoid nodules on the elbows. Which action will the nurse take?

assess nodules for skin breakdown

A patient will attempt oral feedings for the first time after having a stroke. After assessing the gag reflex, what action should the nurse take?

assist pt into chair

A left-handed patient with left-sided hemiplegia has difficulty feeding himself. Which intervention should the nurse include in the plan of care?

assit pt to eat with right hand

The nurse teaching a support group of women with rheumatoid arthritis (RA) about how to manage activities of daily living suggests they should

avoid activities requiring repetitive use

what can cause lupus flare ups

birth control, pregnancy, stress, sun

Ischemic stroke

blood clot/plaque that occludes blood flow (85%),immediate onset

most severe type of stroke

brain stem- autonomic function, heart beat, breathing


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