Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is monitoring the laboratory values of a client who has rheumatoid arthritis and is taking methotrexate. Which of the following values should the nurse identify as an adverse effect of the medication?
A. Positive Rheumatoid factor
A positive Rheumatoid factor is associated with rheumatoid arthritis and is not an adverse effect of methotrexate.
B. WBC count 2.000/mm3
A low WBC count (leukopenia) is an adverse effect of methotrexate and can increase the risk of infection.
C. Hemoglobin 14.8 g/dL
A hemoglobin level of 14.8 g/dL is within a normal range and is not an adverse effect of methotrexate.
D. Erythrocyte sedimentation rate 24 mm/hr
An erythrocyte sedimentation rate (ESR) of 24 mm/hr is within a normal range and is not an adverse effect of methotrexate.
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Full Explanation
Choice A rationale:
A positive Rheumatoid factor is associated with rheumatoid arthritis and is not an adverse effect of methotrexate.
Choice B rationale:
A low WBC count (leukopenia) is an adverse effect of methotrexate and can increase the risk of infection.
Choice C rationale:
A hemoglobin level of 14.8 g/dL is within a normal range and is not an adverse effect of methotrexate.
Choice D rationale:
An erythrocyte sedimentation rate (ESR) of 24 mm/hr is within a normal range and is not an adverse effect of methotrexate.
Similar Questions
A nurse is providing a community presentation about identifying skin cancer lesions.Which of the following information should the nurse include about melanoma?
A. "Melanoma often originates from a mole."
Melanoma often originates from an existing mole or can develop as a new pigmented lesion on the skin.
B. "Melanoma is symmetrical in shape."
Melanoma lesions are typically asymmetrical, not symmetrical.
C. "Metastasis of a melanoma is rare."
Metastasis of melanoma is not rare and can occur if the disease is not diagnosed and treated early.
D. "Melanoma has one growth phase."
Melanoma has multiple growth phases, including radial and vertical growth.
Full Explanation
Choice A rationale:
Melanoma often originates from an existing mole or can develop as a new pigmented lesion on the skin.
Choice B rationale:
Melanoma lesions are typically asymmetrical, not symmetrical.
Choice C rationale:
Metastasis of melanoma is not rare and can occur if the disease is not diagnosed and treated early.
Choice D rationale:
Melanoma has multiple growth phases, including radial and vertical growth.
A nurse is teaching a client who has a family history of pancreatic cancer about manifestations associated with the disease. Which of the following findings should the nurse include?
A. Asterixis
Asterixis is a hand-flapping tremor that can be associated with hepatic encephalopathy, not pancreatic cancer.
B. Weight gain
Weight gain is not typically associated with pancreatic cancer and may not be a relevant manifestation to include.
C. Abdominal pain
Abdominal pain is a common manifestation of pancreatic cancer and should be included in the teaching.
D. Constipation
Constipation is not typically associated with pancreatic cancer and may not be a relevant manifestation to include.
Full Explanation
Choice A rationale:
Asterixis is a hand-flapping tremor that can be associated with hepatic encephalopathy, not pancreatic cancer.
Choice B rationale:
Weight gain is not typically associated with pancreatic cancer and may not be a relevant manifestation to include.
Choice C rationale:
Abdominal pain is a common manifestation of pancreatic cancer and should be included in the teaching.
Choice D rationale:
Constipation is not typically associated with pancreatic cancer and may not be a relevant manifestation to include.
A nurse is teaching a client who has amyotrophic lateral sclerosis (ALS) about the end stages of the disease process. Which of the following information should the nurse include in the teaching?
A. "You might wear splints over affected joints while you are sleeping."
Wearing splints over affected joints while sleeping is a strategy to prevent contractures, which are common in ALS.
B. "You will be given dexamethasone to treat muscle atrophy."
Dexamethasone is not used to treat muscle atrophy in ALS.
C. "You might require a machine to keep your airway open.
As ALS progresses, clients may lose the ability to control their respiratory muscles, and a machine such as a ventilator may be required to assist with breathing.
D. "You will receive nutrition through a central venous access device.
Nutrition through a central venous access device is not a standard intervention for ALS, as the focus is on preserving the client's ability to eat and swallow for as long as possible.
Full Explanation
Choice A rationale:
Wearing splints over affected joints while sleeping is a strategy to prevent contractures, which are common in ALS.
Choice B rationale:
Dexamethasone is not used to treat muscle atrophy in ALS.
Choice C rationale:
As ALS progresses, clients may lose the ability to control their respiratory muscles, and a machine such as a ventilator may be required to assist with breathing.
Choice D rationale:
Nutrition through a central venous access device is not a standard intervention for ALS, as the focus is on preserving the client's ability to eat and swallow for as long as possible.
