Test Bank For Medical-Surgical Nursing, 8th Edition (Linton,
2023), Chapter 1-63 , 9780323826716 , All Chapters with
Answers and Rationals
Which drug is contraindicated for a patient with rheumatoid arthritis and multiple sclerosis?
1. Celecoxib
2. Infliximab
3. Methotrexate
4. Hydroxychloroquine - ANSWER: 2. Infliximab
Rationale
Remind patients with multiple sclerosis (MS), tuberculosis (TB), or a positive TB test that they should
not receive TN F inhibitors because they make them more susceptible to flare-ups of these diseases.
Infliximab is a tumor necrosis factor-alpha (TNFA) inhibitor, which may be used for rheumatoid
arthritis. All TNFA inhibitor drugs should be avoided by a patient with multiple sclerosis. Celecoxib is
contraindicated in patients with cardiovascular disease. Methotrexate is not contraindicated in
patients with multiple sclerosis. Hydrochloroquine would not be recommended for patients with
retinal damage.
What is the cause of primary osteoarthritis?
1. Aging
2. Obesity
3. Joint injury
4. Heavy manual work - ANSWER: 1. Aging
Rationale
Primary osteoarthritis is caused by aging and genetic factors. As people age, proteoglycans, synovial
fluid, and water decrease in the joint. Enzymes in the joint break down the articular matrix and the
cartilage erodes. Eventually, inflammation will continue to cause deterioration in the joint space.
Obesity, joint injury, and heavy manual work are causes of secondary osteoarthritis.
In the process of phagocytosis, which substance coats the target cell to increase contact of the
immune cell with the target cell?
1. Opsonins
2. Histamine
3. Serotonin
4. Leukotriene - ANSWER: 1. Opsonins
Rationale
During the adherence phase of phagocytosis, opsonins coat the target cell in order to increase contact
of the phagocytic cell with its target. Histamine, serotonin, and leukotrienes are all substances that
are released from basophils during an inflammatory action. They bind to host cells to activate them,
not the cell that is targeted for destruction.
The patient who is diagnosed with severe psoriatic arthritis is scheduled
to receive an oral retinoid medication. Which medication will the nurse anticipate administering to
the patient?
1. Alefacept
2. Golimumab
3. Acitretin
4. Ustekinumab - ANSWER: 3. Acitretin
Rationale
Acitretin is an oral retinoid given for patients with severe psoriatic arthritis. Golimumab is the first
biological response modifier (biologic) that is administered only once each month for psoriatic
arthritis. Ustekinumab, which is also a biologic, targets the cytokines interleukin (IL)-12 and IL-23 to
decrease inflammation. Alefacept is an IV immunosuppressive drug.
Which minority group shows an increasing trend in human immunodeficiency virus (HIV) infection?
, 1. Hispanics
2. Caucasians
3. Asian Americans
4. American Indians - ANSWER: 1. Hispanics
Rationale
The Hispanic population is experiencing an increasing trend in H IV infections. Compared to
Caucasians, Asian Americans, and American Indians, HIV infections reported in the United States are
riding most among Hispanics.
A patient presents in the emergency department with dysphagia, periorbital edema, lilac eyelid rash
(DM), and severe muscle weakness. Which disease is consistent with these assessment findings?
1. Ankylosing spondylitis
2. Polymyalgia rheumatica
3. Polymyositis/dermatomyositis
4. Reiter's syndrome - ANSWER: 3. Polymyositis/dermatomyositis
Rationale
Dysphagia, periorbital edema, lilac eyelid rash (DM), and severe muscle weakness along with
malignant neoplasms in an older patient are signs and symptoms of polymyositis/dermatomyositis.
Ankylosing spondylitis, polymyalgia rheumatic, and Reiter's syndrome do not produce all these
symptoms.
In what stage of inflammation is there an increased number of circulating neutrophils and exudate
formed?
1. Stage I
2. Stage II
3. Stage III
4. Stage IV - ANSWER: 2. Stage II
Rationale
During stage II of inflammation, there is an increased number of circulating neutrophils and exudate
formed. Stage I is characterized by a vascular response that starts the changes in blood vessels. During
stage III, tissue repair and replacement occur. There is no stage IV of inflammation.
Which syndrome is characterized by the presence of rheumatoid nodules in the lungs?
1. Felty's syndrome
2. Caplan's syndrome
3. Sjogren's syndrome
4. Carpal tunnel syndrome - ANSWER: 2. Caplan's syndrome
Rationale
Caplan's syndrome is characterized by the presence of rheumatoid nodules in the lungs. Felty's
syndrome is characterized by leukopenia and hepatosplenomegaly. Dryness of the eyes, mouth, and
vagina is a characteristic feature of Sjogren's syndrome. Carpal tunnel syndrome is caused by the
compression of the median nerve in the wrist.
What is the function of a monocyte during inflammation?
1. Destruction of bacteria and cellular debris
2. Release of histamine and heparin in areas of tissue damage
3. Nonspecific ingestion and phagocytosis of microorganisms
4. Nonspecific recognition of foreign proteins and microorganisms - ANSWER: 1. Destruction of
bacteria and cellular debris
Rationale
During inflammation, monocytes destroy bacteria and cellular debris. Basophils releases histamine
and heparin in areas of tissue damage. The function of neutrophils is nonspecific ingestion and
phagocytosis of microorganisms. The function of macrophages is nonspecific recognition of foreign
proteins and microorganisms.
Which type of immunity does a patient acquire following a vaccination or immunization?
1. Natural active
2023), Chapter 1-63 , 9780323826716 , All Chapters with
Answers and Rationals
Which drug is contraindicated for a patient with rheumatoid arthritis and multiple sclerosis?
1. Celecoxib
2. Infliximab
3. Methotrexate
4. Hydroxychloroquine - ANSWER: 2. Infliximab
Rationale
Remind patients with multiple sclerosis (MS), tuberculosis (TB), or a positive TB test that they should
not receive TN F inhibitors because they make them more susceptible to flare-ups of these diseases.
Infliximab is a tumor necrosis factor-alpha (TNFA) inhibitor, which may be used for rheumatoid
arthritis. All TNFA inhibitor drugs should be avoided by a patient with multiple sclerosis. Celecoxib is
contraindicated in patients with cardiovascular disease. Methotrexate is not contraindicated in
patients with multiple sclerosis. Hydrochloroquine would not be recommended for patients with
retinal damage.
What is the cause of primary osteoarthritis?
1. Aging
2. Obesity
3. Joint injury
4. Heavy manual work - ANSWER: 1. Aging
Rationale
Primary osteoarthritis is caused by aging and genetic factors. As people age, proteoglycans, synovial
fluid, and water decrease in the joint. Enzymes in the joint break down the articular matrix and the
cartilage erodes. Eventually, inflammation will continue to cause deterioration in the joint space.
Obesity, joint injury, and heavy manual work are causes of secondary osteoarthritis.
In the process of phagocytosis, which substance coats the target cell to increase contact of the
immune cell with the target cell?
1. Opsonins
2. Histamine
3. Serotonin
4. Leukotriene - ANSWER: 1. Opsonins
Rationale
During the adherence phase of phagocytosis, opsonins coat the target cell in order to increase contact
of the phagocytic cell with its target. Histamine, serotonin, and leukotrienes are all substances that
are released from basophils during an inflammatory action. They bind to host cells to activate them,
not the cell that is targeted for destruction.
The patient who is diagnosed with severe psoriatic arthritis is scheduled
to receive an oral retinoid medication. Which medication will the nurse anticipate administering to
the patient?
1. Alefacept
2. Golimumab
3. Acitretin
4. Ustekinumab - ANSWER: 3. Acitretin
Rationale
Acitretin is an oral retinoid given for patients with severe psoriatic arthritis. Golimumab is the first
biological response modifier (biologic) that is administered only once each month for psoriatic
arthritis. Ustekinumab, which is also a biologic, targets the cytokines interleukin (IL)-12 and IL-23 to
decrease inflammation. Alefacept is an IV immunosuppressive drug.
Which minority group shows an increasing trend in human immunodeficiency virus (HIV) infection?
, 1. Hispanics
2. Caucasians
3. Asian Americans
4. American Indians - ANSWER: 1. Hispanics
Rationale
The Hispanic population is experiencing an increasing trend in H IV infections. Compared to
Caucasians, Asian Americans, and American Indians, HIV infections reported in the United States are
riding most among Hispanics.
A patient presents in the emergency department with dysphagia, periorbital edema, lilac eyelid rash
(DM), and severe muscle weakness. Which disease is consistent with these assessment findings?
1. Ankylosing spondylitis
2. Polymyalgia rheumatica
3. Polymyositis/dermatomyositis
4. Reiter's syndrome - ANSWER: 3. Polymyositis/dermatomyositis
Rationale
Dysphagia, periorbital edema, lilac eyelid rash (DM), and severe muscle weakness along with
malignant neoplasms in an older patient are signs and symptoms of polymyositis/dermatomyositis.
Ankylosing spondylitis, polymyalgia rheumatic, and Reiter's syndrome do not produce all these
symptoms.
In what stage of inflammation is there an increased number of circulating neutrophils and exudate
formed?
1. Stage I
2. Stage II
3. Stage III
4. Stage IV - ANSWER: 2. Stage II
Rationale
During stage II of inflammation, there is an increased number of circulating neutrophils and exudate
formed. Stage I is characterized by a vascular response that starts the changes in blood vessels. During
stage III, tissue repair and replacement occur. There is no stage IV of inflammation.
Which syndrome is characterized by the presence of rheumatoid nodules in the lungs?
1. Felty's syndrome
2. Caplan's syndrome
3. Sjogren's syndrome
4. Carpal tunnel syndrome - ANSWER: 2. Caplan's syndrome
Rationale
Caplan's syndrome is characterized by the presence of rheumatoid nodules in the lungs. Felty's
syndrome is characterized by leukopenia and hepatosplenomegaly. Dryness of the eyes, mouth, and
vagina is a characteristic feature of Sjogren's syndrome. Carpal tunnel syndrome is caused by the
compression of the median nerve in the wrist.
What is the function of a monocyte during inflammation?
1. Destruction of bacteria and cellular debris
2. Release of histamine and heparin in areas of tissue damage
3. Nonspecific ingestion and phagocytosis of microorganisms
4. Nonspecific recognition of foreign proteins and microorganisms - ANSWER: 1. Destruction of
bacteria and cellular debris
Rationale
During inflammation, monocytes destroy bacteria and cellular debris. Basophils releases histamine
and heparin in areas of tissue damage. The function of neutrophils is nonspecific ingestion and
phagocytosis of microorganisms. The function of macrophages is nonspecific recognition of foreign
proteins and microorganisms.
Which type of immunity does a patient acquire following a vaccination or immunization?
1. Natural active
