A nurse is caring for a client who has hemophilia. The client reports pain and swelling in a joint following an injury. Which of the following actions should the nurse take?

Correct Answer: A

Rationale: Correct Answer: A Rationale: 1. Hemophilia is a bleeding disorder due to missing clotting factors. 2. Pain and swelling in a joint indicate internal bleeding. 3. Replacement of the missing clotting factor is crucial to stop bleeding. 4. Administering aspirin can worsen bleeding due to its antiplatelet effects. 5. Applying heat can increase bleeding by dilating blood vessels. 6. Elevating the joint alone may not address the underlying bleeding issue.

Correct Answer: B

Rationale: The correct answer is B: Adalimumab. Adalimumab is a tumor necrosis factor (TNF) blocker used to treat autoimmune diseases like rheumatoid arthritis and Crohn's disease. It works by inhibiting TNF, a key inflammatory cytokine. Methotrexate (A) is an immunosuppressant, Leflunomide (C) is a disease-modifying antirheumatic drug, and Prednisone (D) is a corticosteroid. These medications work differently and are not TNF blockers.

Correct Answer: A

Rationale: The correct answer is A because colchicine commonly causes gastrointestinal (GI) upset as a side effect. This is due to its mechanism of action on the gastrointestinal tract. Retinal damage (B), bone marrow suppression (C), and hepatotoxicity (D) are not commonly associated with colchicine use, making them incorrect choices. It's crucial to monitor patients for GI symptoms when taking colchicine to ensure their safety and manage any adverse effects promptly.

Correct Answer: A

Rationale: The correct answer is A: Celecoxib. Celecoxib is a selective COX-2 inhibitor, which has been associated with an increased risk of cardiac events, such as heart attacks and strokes. This is due to its mechanism of action, which can lead to elevated blood pressure and interfere with normal blood clotting. Celecoxib is specifically known to increase the risk of cardiovascular events compared to other nonsteroidal anti-inflammatory drugs (NSAIDs) like diclofenac, ibuprofen, and naproxen. Diclofenac, ibuprofen, and naproxen are traditional NSAIDs that can also have cardiovascular risks, but the risk is generally lower compared to celecoxib. In summary, celecoxib is associated with an increased risk of cardiac events due to its selective COX-2 inhibition, while the other choices are less likely to have as significant of an impact on cardiovascular health.

Correct Answer: C

Rationale: The correct answer is C: Painful, deformed small joints. This is consistent with systemic lupus erythematosus (SLE) as it can cause joint pain and inflammation, leading to joint deformities. A: Discoid rash on skin exposed to sunlight is a characteristic of cutaneous lupus, not systemic lupus. B: Urinalysis positive for casts and protein is more indicative of lupus nephritis, a complication of SLE affecting the kidneys. D: Pain on inspiration is more suggestive of pleurisy, a common symptom in SLE but not specific to the disease.