A patient has recent weight loss, fatigue, and recurrent low-grade fever along with pain and stiffness of knees and hands. The primary care nurse practitioner (NP) notes symmetric joint swelling and warmth of these joints. The NP should:
a. refer the patient to a specialist.
b. order erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), and antinuclear antibody (ANA) tests.
c. begin therapy with methotrexate.
d. order x-rays of the affected joints.
B
ESR is a very nonspecific but sensitive indication of inflammation. RF is positive in 75% to 85% of patients with rheumatoid arthritis (RA). ANAs are elevated in approximately 20% of patients with RA. These tests help confirm the diagnosis of RA. Once the diagnosis is more likely, referral to a specialist is warranted. Drug therapy is not begun until the diagnosis is confirmed. X-rays are usually the earliest way to detect changes but are not diagnostic in the early stages of the disease.
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The goal of transcultural nursing care is to
A) incorporate all aspects of a person's culture in planning and providing care. B) assess the patient's cultural and ethnic background. C) be certain that the patient follows prescribed medical treatment plans. D) help the patient understand the importance of following all of his or her doctor's orders.
A nurse is preparing an educational session with parents of newborns. Which of the following would be included in the teaching in relation to the differences seen in newborns and their gastrointestinal system? Select all that apply
1. Newborns have increased peristalsis. 2. Newborns get more gas in the abdomen. 3. Swallowing is voluntary at birth. 4. Newborns have decreased peristalsis. 5. Newborns have a smaller stomach capacity.
Which of the following are examples of open-ended questions? (Select all that apply.)
a. "Ms. Goode, did you have a productive therapy session?" b. "How are you?" c. "How do you feel about staying with your daughter?" d. "What would you like to discuss today while we take a walk?" e. "Are you having that problem with arthritis in your hand again?"
The nurse is teaching an adolescent about acne care. What statement by the adolescent indicates a need for further teaching?
a. "I will cleanse my face twice a day." b. "I will frequently shampoo my hair." c. "I will brush my hair away from my forehead." d. "I will use my antibacterial soap to cleanse my face."