What is a black box warning for tumor necrosis factor blockers?

Correct Answer: A

Rationale: The correct answer is A: Development of lymphomas or other cancers. Black box warnings are the most serious warnings issued by the FDA for medications. Tumor necrosis factor blockers are associated with an increased risk of developing lymphomas or other cancers due to their immunosuppressive effects. This risk is well-documented in clinical studies and post-marketing surveillance. The other choices, B, C, and D, are not typically associated with tumor necrosis factor blockers. GI bleeding is more commonly associated with NSAIDs, renal failure with certain medications like ACE inhibitors or NSAIDs, and CNS effects with medications that directly affect the central nervous system.

Correct Answer: A

Rationale: The correct answer is A: Hydroxychloroquine. It is used to reduce inflammation in rheumatoid arthritis by inhibiting the immune response. Hydroxychloroquine is a disease-modifying anti-rheumatic drug (DMARD) that helps control symptoms and slow the progression of the disease. Methotrexate (B) and Leflunomide (C) are also DMARDs used in RA treatment, but they have different mechanisms of action. Adalimumab (D) is a biologic drug that targets specific proteins in the immune system and is used for more severe cases of RA.

Correct Answer: C

Rationale: The correct answer is C: Inform the client not to drive or sign legal papers for 24 hours. This is because belimumab can cause dizziness or drowsiness as a side effect, which may impair the client's ability to drive or make important decisions. A: Observing the client for at least 2 hours afterward is important for monitoring immediate reactions to the medication. B: Instructing the client about the monthly infusion schedule is important for treatment adherence but not directly related to the first dose administration. D: Ensuring emergency equipment is working and nearby is important for safety but not specific to the first dose administration.

Correct Answer: A

Rationale: The correct answer is A: Parasitic infestation. Eosinophils are white blood cells that are typically elevated in response to parasitic infections. Parasites trigger an immune response that involves an increase in eosinophils to help combat the infection. Bacterial infections (choice B) usually lead to an increase in neutrophils, while viral infections (choice C) typically result in an increase in lymphocytes. Fungal reactions (choice D) can cause an increase in eosinophils, but parasitic infestations are more commonly associated with this finding. In this case, the increased eosinophil count is highly suggestive of a parasitic infestation based on the patient's clinical presentation and laboratory results.

Correct Answer: B

Rationale: The correct answer is B (Wearing a gown and gloves). When dealing with open and draining lesions like those seen in cutaneous Kaposi's sarcoma, it is important for the nurse to wear a gown and gloves to protect themselves from exposure to the serous fluid. The gown provides an additional layer of protection for the nurse's clothing, while gloves prevent direct contact with the fluid. Wearing just gloves (choice A) may not provide enough protection for the nurse's clothing. Adding a mask (choice C) is unnecessary since the serous fluid is not airborne. Choice D is incorrect as changing the bed linens with just gloves does not provide sufficient protection for the nurse's clothing.