A patient with a history of rheumatoid arthritis is prescribed methotrexate. Which laboratory parameter should be monitored closely during methotrexate therapy?

Correct Answer: C

Rationale: Methotrexate is a medication commonly used in the treatment of rheumatoid arthritis. It is known to have potential hepatotoxic effects, meaning it can harm the liver. Monitoring liver function tests (such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), and bilirubin levels) is essential to detect any liver damage early on during methotrexate therapy. By closely monitoring liver function tests, healthcare providers can assess the medication's impact on the liver and determine if any dose adjustments or discontinuation of the drug is necessary to prevent further liver damage. Regular monitoring of liver function tests helps ensure the safe and effective use of methotrexate in patients with rheumatoid arthritis.

Correct Answer: D

Rationale: When performing an admission assessment, the nurse should expect to find clinical manifestations that are indicative of a variety of conditions. Paresthesia (abnormal sensation like tingling, prickling, or numbness) and muscle weakness of the upper body are commonly associated with neurological conditions such as peripheral neuropathy or cervical radiculopathy. These symptoms suggest dysfunction in the nerves that supply the upper body muscles, leading to sensory changes and weakness. This finding would prompt further assessment and evaluation by healthcare providers to determine the underlying cause and appropriate interventions. Rapid progressive muscular atrophy, ascending paralysis with ataxia, and hyperactive deep tendon reflexes are not typically expected findings during an admission assessment and may signal more specific neurological conditions such as amyotrophic lateral sclerosis, Guillain-Barré syndrome, or spinal cord injury, respectively.

Correct Answer: D

Rationale: It is NOT recommended to use the same syringe and needle in administering two different vaccines. This is to prevent contamination or mixing of different vaccines, which could potentially affect their effectiveness or pose a risk to the individual receiving the vaccines. It is important to use separate syringes and needles for each vaccine to ensure proper administration and prevent any adverse reactions.

Correct Answer: D

Rationale: Insulinoma is a rare neuroendocrine tumor that arises from pancreatic beta cells, leading to excessive production and secretion of insulin. The symptoms described in the patient, such as weight loss, fatigue, nausea, vomiting, abdominal pain, hypoglycemia, and elevated insulin levels, are characteristic of insulinoma.

Correct Answer: B

Rationale: Cervical intraepithelial neoplasia (CIN) is a precancerous condition of the cervix characterized by the presence of abnormal cells on the surface of the cervix. These abnormal cells are often classified as low-grade squamous intraepithelial lesions (LSIL) on cytology. CIN is not yet cervical cancer but can progress to invasive cancer if left untreated. LSIL is indicative of mild dysplasia or cervical intraepithelial neoplasia 1 (CIN 1), which is considered a precancerous lesion. Therefore, the presence of abnormal cervical cells classified as LSIL is more likely to be associated with CIN rather than cervical cancer, cervicitis, or cervical polyps.

Correct Answer: D

Rationale: Negligence is the failure to take proper care in doing something, which results in harm or injury to someone else. In this scenario, the client falling out of bed because side rails were not used indicates a lack of proper care or attention by the staff or caregiver responsible for the client. It shows a failure to protect the client from harm, which aligns with the definition of negligence. This situation does not fit the definitions of a felony, battery, or assault.

Correct Answer: A

Rationale: Nurses play a crucial role as collaborators in the diagnostic process of psychiatric patients. While nurses themselves do not diagnose psychiatric conditions, they work closely with other healthcare providers such as psychiatrists and psychologists in assessing and monitoring patients' mental health status. Nurses gather valuable information, observe patients' behaviors, and communicate effectively with the healthcare team to contribute to the overall diagnostic process. By actively participating in assessments and evaluations, nurses help ensure accurate diagnoses and appropriate treatment plans for psychiatric patients.

Correct Answer: B

Rationale: The gallbladder is the structure responsible for storing and concentrating bile produced by the liver until it is needed for digestion. Bile is a digestive fluid that helps in the breakdown of fats during the digestive process. When food containing fats enters the small intestine, the gallbladder contracts and releases bile into the small intestine to aid in the digestion and absorption of fats. The gallbladder acts as a reservoir for bile, storing it until it is needed for digestion.

Correct Answer: B

Rationale: The first step in the qualitative research process is typically conducting a review of existing literature on the topic of interest. This involves exploring existing research studies, theories, and findings related to the area being studied. By reviewing the literature, researchers can gain a better understanding of the current knowledge and identify gaps in the existing research that their study can address. This step helps researchers define the research question, refine the study design, and establish a strong theoretical framework for the study.