Adult Health-Test 3-Immunity-Rheumatoid Arthritis (Exemplar 8.3) & Systemic Lupus Erythematosus (Exemplar 8.4)

What integumentary change does the nurse expect to find in a patient with suspected systemic lupus erythematosus (SLE)?

Alopecia

Which patient diagnosed with systemic lupus erythematous (SLE) is at the highest risk for experiencing health care disparity?

An African American female

A patient is suspected of having systemic lupus erythematosus (SLE). Which would be considered diagnostic for systemic lupus erythematosus?

Anti-Smith antibody

A patient has been taking an antimalarial drug prescribed for systemic lupus erythematosus (SLE) but is unable to tolerate the side effects. What medication does the nurse anticipate educating the patient about that would be an alternate?

Antileprosy drug

Antineoplastics

Antineoplastic agents may also be used to treat other medical conditions such as rheumatoid arthritis and cancers

What marker is found in a majority of patients diagnosed with systemic lupus erythematosus (SLE)?

Antinuclear antibody (ANA)

A patient bitten by a tick suspects that they may have contracted Lyme disease but does not want to seek treatment at this time. What should the nurse inform the patient is important to prevent and why early intervention is important?

Arthritis

The nurse is caring for a patient with systemic lupus erythematosus. To prevent an exacerbation of the condition, what should the nurse instruct the patient to avoid?

Becoming fatigued

A patient is suspected of having systemic lupus erythematosus. What indication does the nurse have when assessing this patient that is a classic feature of this disease?

Butterfly rash

What feature is characteristic of systemic lupus erythematosus (SLE)?

Butterfly rash

Which finding leads the nurse to suspect that a patient has long-standing dermatomyositis?

Calcinosis cutis

The public health nurse is planning to provide community education to increase the number of people who seek health care promptly after a tick bite. What information should the nurse provide when teaching people who are at risk for a tick bite?

Check for an enlarging reddened area with a clear center

A patient is diagnosed with antiphospholipid syndrome secondary to systemic lupus erythematous (SLE). For which complication should the nurse closely monitor the patient?

Coagulation disorder

A nurse is assessing a patient with osteoarthritis. What finding would be expected with this disorder?

Crepitation in the weight-bearing joints

A patient has osteoarthritis of the knees. What finding would the nurse assess on examination of the patient's knees?

Crepitus upon movement of knee joints

Which assessment finding would alert the nurse to the presence of osteoarthritis in a patient admitted to the hospital after a fall?

Crepitus with knee movement

The nurse is performing an assessment for a patient with suspected systemic lupus erythematosus (SLE). Which finding would the nurse determine is due to Raynaud's phenomenon?

Cyanosis of fingers

Diagnostic test used to treat rheumatoid arthritis

Cyclic Citrullinated Peptide Antibody (CCP)

Which is an immunosuppressive agent used to treat lupus nephritis in systemic lupus erythematosus (SLE) patients?

Cyclophosphamide

A nurse is caring for a patient with osteoarthritis (OA). In assessing the patient's understanding of this disorder, the nurse concludes teaching has been effective when the patient uses which description of the condition?

Degeneration of articular cartilage in synovial joints

The nurse is caring for a patient with osteoarthritis. What statement made by the patient demonstrates accurate knowledge of the disorder?

Degeneration of cartilage in synovial joints

A patient has just been given a diagnosis of osteoarthritis. The nurse explains that the associated changes in the joint are the result of what type of process?

Degenerative

A patient has an erythematous symmetric rash and swelling around the eyes. The nurse assesses red, smooth patches on the hands sparing the interphalangeal spaces. Which disease does the nurse suspect?

Dermatomyositis

The nurse is performing an assessment for a patient with reports of fatigue and muscular aches in the shoulder and pelvis. A raised, scaly rash is observed on the knuckles. What does the nurse infer from these symptoms?

Dermatomyositis

The nurse observes Gottron's sign while assessing a patient. What does the nurse suspect the patient will be diagnosed with?

Dermatomyositis

Risk for Coronary Heart Disease (SLE):

Direct effects on blood vessels Increased risk for: Low HDL levels High cholesterol and triglycerides Hypertension High homocysteine levels

DMARDS:

Disease-modifying antirheumatic drugs (DMARDs) is a category of otherwise unrelated drugs defined by their use in rheumatoid arthritis to slow down disease progression.

The nurse is educating a patient with rheumatoid arthritis (RA) about small joint protection. What information should the nurse be sure to include?

Do not knit or sew for long periods

A patient with systemic lupus erythematosus (SLE) reports a persistently erythematous rash over the cheeks and the bridge of the nose. The rash appeared after spending a day outside at a theme park. What is the priority action by the nurse?

Educate the patient that this is not unexpected for someone with SLE

After a patient is diagnosed with systemic lupus erythematosus (SLE), the nurse educates the patient on the effects of sunlight on the disease. What is the best way for the nurse to do this?

Educates the patient on the importance of planning outdoor activities

The nurse is caring for a patient diagnosed with fibromyalgia. What action should the nurse consider while caring for this patient?

Encouraging the patient to reduce the intake of coffee and alcohol

A patient has bilateral osteoarthritis of the knees. What should the nurse teach the patient that the most beneficial measure to protect the joints is?

Exercise regularly and maintain a well-balanced diet

A patient reports to a rheumatology clinic with a swan neck deformity of the fingers of the left hand and is referred for laboratory testing for systemic lupus erythematosus (SLE). The patient calls back several days later saying, "The healthcare provider must be wrong. This has to be arthritis like my mother has." What is the nurse's best response?

Explain that arthritis is not the only medical condition that can cause joint deformities

A patient with a long history of rheumatoid arthritis (RA) presents with an enlarged spleen and a low white blood cell (WBC) count. The nurse is concerned the patient is experiencing which condition?

Felty syndrome

A common diagnostic feature of systemic lupus erythematosus (SLE) is the malar rash, which is characterized by what features?

Fixed erythema, flat or raised, usually in a butterfly pattern

To diagnose a patient with systemic lupus erythematosus (SLE), the patient must meet how many of the distinct criteria either simultaneously or in sequential evaluation?

Four

What type of pain is associated with fibromyalgia?

Generalized

Gold salts:

Gold sodium thiomalate is a gold-containing chemical (salt) used in treating rheumatoid arthritis. Other gold salts available include injectable aurothioglucose (Solganal) and oral auranofin (Ridaura). It is not well understood exactly how gold salts work.

Which condition is characterized by violet or erythematous papules and small plaques that may develop over the distal interphalangeal or metacarpophalangeal joint areas?

Gottron's papules

The nurse is preparing a patient for serum analysis of uric acid levels. Which condition does the nurse anticipate in the patient?

Gout

Pt just started taking an alpha blocker medication to treat BPH. What instruction related to the medication side effects, will the nurse give to the UAP who will assist the patient with activities of daily living (ADLs)?

Have him sit up slowly and pause before standing

The nurse is performing an assessment for a patient with osteoarthritis (OA). When observing small nodules on the distal interphalangeal joints of the fingers, how does the nurse document these nodules?

Heberden's nodes

What can result in primary hyperuricemia in the patient with gout?

Hereditary error of purine metabolism

A patient with an acute systemic lupus erythematosus (SLE) flare is tearful and anxious. What is the most appropriate action of the nurse?

Hold the patient's hand and provide emotional support

Older patient has enlarged prostate with chronic urinary retention but declines to seek treatment because "it's been that way for a long time". The nurse would encourage a follow-up appointment to precent which complicate not this chronic condition?

Hydronephrosis

A patient with systemic lupus erythematosus (SLE) has comorbid hypertension and hypercholesterolemia. The nurse educates the patient that he or she is at risk for secondary antiphospholipid syndrome, which could have which effect(s)?

Increased risk of stroke, heart attack, and gangrene

A patient with osteoarthritis (OA) is prescribed sulfasalazine and reports an orange discoloration of the urine. What is the most appropriate action for the nurse to take?

Inform the patient that orange discoloration of the urine often occurs with sulfasalazine, and there is no need for concern.

The nurse is performing an assessment for a pregnant patient with systemic lupus erythematosus (SLE) that has just had an ultrasound. Which complication should the nurse be sure to assess for in this patient?

Intrauterine growth restriction

The nurse is caring for a patient diagnosed with Reiter's syndrome. What does the nurse recognize is characteristic of this disease?

It is most often seen in individuals who are positive for HLA-B27

The nurse is assessing a patient reporting bone pain. Which of the patient's assessment data is most likely to be related to osteoarthritis (OA)?

Joint stiffness after rest; stiffness usually subsides 30 minutes after activity is resumed

A patient with systemic lupus erythematosus (SLE) arrives at the clinic with a one-month history of a cough. The patient also says, "Sometimes I feel like my heart is racing." What does the nurse suspect the patient may have?

Lung disease

A patient has been bitten by an infected deer tick and is experiencing joint pain. Which arthritic disorder is transmitted by the bite of an infected deer tick?

Lyme disease

The nurse is assessing a patient that has been bitten by a tick and has a "bulls eye rash" at the site. What disease should the nurse anticipate screening the patient for related to these symptoms?

Lyme disease

Repetitive physical activity that results in osteoarthritis is an example of what?

Mechanical stress

A varus deformity (bowlegged) is a result of what type of arthritis?

Medial joint arthritis

Methotrexate:

Methotrexate is one of the most effective and widely used medications for treating rheumatoid arthritis (RA) and other inflammatory types of arthritis.

A patient is newly diagnosed with systemic lupus erythematosus (SLE) and reports joint pain. Which class of medication does the nurse anticipate educating the patient about that can relieve the pain?

Nonsteroidal antiinflammatory drugs (NSAIDs)

A patient with rheumatoid arthritis (RA) requires interventions to increase independence with assistive devices. Which interdisciplinary team member would best be able to assist with simplifying these tasks?

Occupational therapist

Which of the following is a slow, progressive noninflammatory disorder of the synovial joints?

Osteoarthritis (OA)

An older adult patient is receiving corticosteroid therapy for rheumatoid arthritis. What should the nurse inform the patient a complication of this therapy might be?

Osteopenia -Osteopenia refers to bone density that is lower than normal peak density but not low enough to be classified as osteoporosis. Bone density is a measurement of how dense and strong the bones are.

A patient has osteoarthritis of the knees. Which finding would the nurse expect upon examination of the patient's knees?

Pain with joint movement

The nurse is admitting a patient who is scheduled for knee arthroscopy related to osteoarthritis (OA). Which finding should the nurse expect to be present on assessment of the patient's knees?

Pain with joint movement

The nurse is performing an assessment on a patient with systemic lupus erythematosus (SLE) who reports chest pain. Which cardiovascular complication does the nurse know can occur with this disease process?

Pericarditis

While assessing a patient with dermatomyositis, the nurse notes that the patient has an erythematous scaling rash on the buttocks. What condition is indicated by the assessment findings as recognized by the nurse?

Poikiloderma

The nurse is caring for four newly diagnosed patients with various connective tissue disorders. The nurse should be most aware of safety issues and interstitial lung involvement in the patient with which diagnosis?

Polymyositis

A patient with systemic lupus erythematosus has developed osteoporosis related to the disease process. Which drug therapy does the nurse anticipate the patient will be prescribed?

Prasterone

A patient receiving long-term nonsteroidal antiinflammatory drug (NSAID) therapy for osteoarthritis develops gastrointestinal bleeding and erosion. What should be the first intervention?

Proton pump inhibitor therapy

On the assessment of a new admission, the nurse finds the toes and fingers to be a bluish hue with reports of tingling and numbness. What does the nurse suspect is occurring with this patient?

Raynaud's phenomenon

A patient has a low-grade fever, conjunctivitis, and arthritic pain in the long joints, which is asymmetric. The patient informs the nurse of a genitourinary infection in the recent past. What do these clinical manifestations lead the nurse to suspect is occurring?

Reactive arthritis

Discharge instructions to a pt. who had a TURP. What does the nurse include in the instructions?

Reassurance that loss of control of urination or dribbling of urine is temporary

A nurse is assessing the recent health history of a patient with osteoarthritis (OA). The nurse determines that the patient is trying to manage the condition appropriately when the patient describes which activity pattern?

Regular exercise program that involves walking

When caring for a patient with systemic lupus erythematosus, the nurse recognizes which major and serious complication of the disorder?

Renal failure

UAP hygiene instructions for an older patient who is uncircumcised. What does the nurse instruct the UAP do?

Replace the foreskin over the penis after bathing

A patient is experiencing a side effect of antimalarial agent therapy for the treatment of systemic lupus erythematosus (SLE) patients. Which disorder does the nurse educate the patient is reversible when treatment is discontinued?

Retinopathy

A woman with systemic lupus erythematosus (SLE) who is one-month postpartum reports to the emergency room with fever, malaise, and severe pain for two days. She had been discharged from the hospital with similar symptoms one week ago. What is the most likely reason for readmission?

SLE flares are common in the postpartum period

When assessing a patient, the nurse notes that the fingers are fixed in a semiflexed position, with tightened skin to the wrist. Which condition is indicated by the symptoms recognized by the nurse?

Sclerodactyly

The nurse is caring for a patient who has difficulty breathing, along with symptoms suggestive of Raynaud's phenomenon. Which disease does the nurse suspect is the cause of the symptoms?

Scleroderma

While assessing a patient, the nurse notes red spots on the hands, forearms, palms, face, and lips. Which condition does the nurse suspect?

Scleroderma

A patient with extensive muscle atrophy and joint deformity has rheumatoid arthritis. Which stage of rheumatoid arthritis does the nurse determine the patient is experiencing?

Severe stage

A patient informs the nurse they have dry eyes and a decrease in the amount of saliva being produced. Which condition does the nurse associate with the symptoms described by the patient?

Sjogren's syndrome

A patient has been diagnosed with increased joint inflammation that spreads across cartilage into the joint cavity. Which stage of rheumatoid arthritis does the nurse determine the patient has?

Stage II

A patient diagnosed with Raynaud's phenomenon has intermittent vasospasms of the fingertips. What does the nurse teach the patient is a trigger for Raynaud's phenomenon?

Stress

A patient with systemic lupus erythematosus (SLE) arrives at a rheumatology clinic with persistent facial lesions, photosensitivity, polyarthralgia, and mild proteinuria. The nurse knows these symptoms constitute which syndrome?

Subacute cutaneous lupus

A patient presents with muscle atrophy and tendon destruction causing one joint to slip past the other. What does the nurse suspect is occurring in this patient?

Subluxation

The nurse is educating a patient with systemic lupus erythematosus (SLE) about precipitating factors of the disease. Which precipitating factors should the nurse be sure to include when discussing them?

Sun exposure, hydralazine, and oral contraceptives

Synovectomy (RA)

Synovectomy- excision of synovial membrane

Connective tissue disease

Systemic lupus erythematosus (SLE)

A patient with gout asks the nurse why a low-purine diet is recommended. What explanation should the nurse provide?

The metabolism of purine results in the formation of uric acid

A patient with osteoarthritis has been prescribed treatment with celecoxib. What is the reason to justify this pharmacologic therapy?

The patient does not tolerate traditional nonsteroidal antiinflammatory agents (NSAIDs).

The nurse is obtaining a health history and performing a physical assessment for a patient with gout. What indication does the nurse have that the patient has developed a complication from gout?

The patient has developed renal calculi

The nurse is creating a plan of care for a patient with osteoarthritis. What would the nurse plan as an appropriate short-term goal for this patient?

The patient will participate in physical therapy activities

A patient with osteoarthritis of the knees has been taking celecoxib 200 mg every 12 hours. The patient states that the drug does not seem to work as well as it used to in controlling the pain. What does the nurse infer from the patient's statement?

This patient may respond better to an alternate nonsteroidal antiinflammatory drug (NSAID).

What type of surgery is most commonly used to treat BPH?

Transurethral resection of the prostate (TURP)

A patient with osteoarthritis (OA) is prescribed ibuprofen 800mg every eight hours for pain. What is an important nursing instruction when teaching the patient about safe drug administration?

Try to take ibuprofen with a meal or a snack

A 30-year-old female patient with severe rheumatoid arthritis (RA) is prescribed methotrexate for disease management. What should the nurse instruct the patient to do?

Use effective contraception during and three months after treatment with methotrexate

The nurse is preparing to educate a patient about capsaicin for the treatment of osteoarthritic pain. What should the nurse be sure to include when discussing this medication with the patient?

Use the capsaicin at regular intervals

The nurse is assessing the recent health history of a patient with osteoarthritis. The nurse determines that the patient was managing the condition well when the patient states that their activity pattern has consisted of which of the following?

Walking and swimming regularly

common risk factor for Rheumatoid arthiritis

genetics

rhuematoid arthritis affects the heart by increasing what?

homocysteine levels

The RA drug Plaquenil may result in this?

visual changes -Antimalarial drugs: Like Plaquenil (reduces the frequency of acute episodes of SLE)

When reinforcing health teaching about the management of osteoarthritis, the nurse determines that the patient needs additional instruction after making which statement?

"A cold shower in the morning will help relieve the stiffness I have when I get up."

A patient voices concerns to the nurse about taking procainamide, stating that a friend was recently hospitalized for drug-induced systemic lupus erythematosus (SLE). What is the nurse's best response?

"Drug-induced SLE generally occurs months to year after continuous use of this drug."

When reinforcing health teaching about the management of osteoarthritis (OA), the nurse determines that the patient needs additional instruction after making which statement?

"I should try to stay standing all day to keep my joints from becoming stiff."

A patient's complex symptomatology over the past year has led to a diagnosis of systemic lupus erythematosus (SLE). Which statement demonstrates the patient's need for further teaching about the disease?

"I'm hoping that surgery will be an option for me in the future."

A patient with systemic lupus erythematosus (SLE) has persistent proteinuria, for which the healthcare provider prescribed both oral steroids and a cytotoxic agent. When the patient asks why two medications are necessary, what is the nurse's best response?

"Oral steroids are used in the initial treatment period while the cytotoxic agent takes effect."

The nurse is reinforcing general health teaching for a patient with osteoarthritis of the knees. Which statement by the patient demonstrates correct understanding of osteoarthritis?

"Osteoarthritis is more common with aging, but usually it remains confined to a few joints and does not cause crippling."

A patient with systemic lupus erythematosus (SLE) reports a low-grade fever and malaise. What response by the nurse would be the most appropriate?

"Please schedule a sick visit with the healthcare provider."

A patient has been diagnosed with chronic fatigue syndrome (CFS) and asks the nurse what can be done to control the symptoms of the syndrome. What education can the nurse provide to help the patient with control of symptoms?

"Take an antiinflammatory drug if you have pain or fever."

A patient informs the nurse that the appearance of a malar rash is concerning. What is the most appropriate response to this patient regarding treatment options?

"Topical immunomodulators can be used instead of corticosteroids to treat serious skin conditions."

During an appointment, a patient with systemic lupus erythematosus (SLE) and suspected lung disease says she is interested in getting pregnant. How should the nurse best counsel the patient?

"Women with advanced SLE should consider alternative family-building options."

A woman with advanced systemic lupus erythematosus (SLE) who suffers from profound kidney and lung dysfunction would like to become pregnant. Based on the nurse's knowledge of SLE, what can the nurse tell the patient?

"Women with profound effects from SLE should not become pregnant."

The nurse provides education to a caregiver related to management of a patient with polymyositis. Which statements made by the caregiver indicate the need for further teaching? Select all that apply.

-"I should encourage the patient to take a nap immediately after meals." -"I should keep the head end of the bed at 45 degrees when feeding the patient."

As a part of discharge teaching, the nurse has explained to a patient with osteoarthritis about the disease and its treatment. Which statements by the patient indicate the need for furthering education? Select all that apply.

-"I'll never use a staircase." -"My bones have become weak and fragile." -"I can skip doses if I don't have any symptoms."

A patient has a new diagnosis of Sjögren's syndrome. When educating the patient about the disorder, what should the nurse be sure to include? Select all that apply.

-"It may lead to painful intercourse." -"It may lead to non-Hodgkin's lymphoma." -"It may cause dryness of the eyes and mouth."

The nurse is educating a patient with arthritis in ways to protect the small joints. What should the nurse be sure to include when discussing these interventions? Select all that apply.

-"Slide objects instead of picking them up." -"Carry your laundry basket with both hands." -"Use door knobs that are pushed rather than turned."

The nurse is educating a patient with a new diagnosis of scleroderma. What should the nurse include in the education? Select all that apply.

-"Use moist heat applications on your skin." -"Use paraffin baths in order to take good care of your skin."

A patient newly diagnosed with systemic lupus erythematosus (SLE) is setting care goals with the nurse. What are the most appropriate goals for this patient? Select all that apply.

-Adhere to the therapeutic regimen. -Have satisfactory pain management -Maintain optimal role function and positive self-image -Demonstrate awareness of an avoid activities that worsen the disease

Survival in patients with systemic lupus erythematosus (SLE) is dependent on which factors? Select all that apply.

-Age -Sex -Race -Comorbid conditions

A patient reports feeling frustrated with unexplained, persistent, relapsing chronic fatigue not substantially alleviated by rest. The patient reports flulike symptoms. Which medications may the nurse anticipate to be administered for the treatment of such a condition? Select all that apply.

-Antihistamines -Tricyclic antidepressants -Nonsteroidal analgesics

The patient with fibromyalgia has pain at 12 of the 18 identification sites, including the neck and upper back and the knees. The patient also reports nonrefreshing sleep, depression, and being anxious when dealing with multiple tasks. About what treatments should the nurse teach this patient? Select all that apply.

-Antiseizure drug pregabalin -Low-impact aerobic exercise -Relaxation strategy (biofeedback) -Serotonin reuptake inhibitor (e.g. sertraline)

A nurse is assessing a patient with rheumatoid arthritis. What questions should the nurse ask as part of this assessment? Select all that apply.

-Are you allergic to aspirin? -Do you feel stiffness in your joints? -Have you undergone any joint surgery? -Are you taking any medications currently?

The nurse is educating a patient at the clinic. Which measures can the nurse discuss with the patient to reduce the risk of osteoarthritis? Select all that apply.

-Avoiding forceful, repetitive movements -Avoiding bending the knee past 90 degrees

The nurse is educating a patient about the prevention of osteoarthritis. What information would be most beneficial for the nurse to discuss with the patient? Select all that apply.

-Avoiding smoking -Maintaining a healthy weight -Promptly treating any joint injury

A patient is diagnosed with scleroderma. What should the nurse anticipate educating the patient regarding the pharmacologic treatment plan? Select all that apply.

-Bosentan -Reserpine -Cyclophosphamide

Which are characteristics specific to rheumatoid arthritis (RA)? Select all that apply

-Common effusions -Young to middle-age onset -Stiffness lasting an hour to all day

Which are characteristics specific to rheumatoid arthritis (RA)? Select all that apply.

-Common effusions -Young to middle-age onset -Stiffness lasting an hour to all day

A nurse is caring for an older adult admitted to the hospital for osteoarthritis. What diagnostic tests will the nurse prepare the patient for that will determine the severity of the disease and plan the course of treatment? Select all that apply.

-Computed tomography (CT) scan -Magnetic resonance imaging (MRI) -Erythrocyte sedimentation rate (ESR) blood test

The nurse is caring for a patient with systemic lupus erythematosus (SLE). Which cardiopulmonary manifestations should the nurse closely monitor for? Select all that apply.

-Cough -Tachypnea -Dysrhythmias

The nurse is caring for a patient with scleroderma. Which medications does the nurse anticipate educating the patient regarding? Select all that apply.

-Diltiazem -Reserpine -Epoprostenol

The community health nurse is teaching a group of adults about prevention of osteoarthritis (OA). What important teaching points should the nurse include? Select all that apply.

-Eat a balanced diet -Avoid cigarette smoking -Maintain a healthy weight

A patient with scleroderma reports hyperacidity and epigastric pain. What instructions should the nurse give to the patient to help alleviate this condition? Select all that apply.

-Elevate head position while sleeping -Use antacids 45 to 60 minutes after meal -Do not sleep immediately after eating food

A patient observes discoloration of urine during the course of the treatment for arthritis. What does the nurse infer from this observation? Select all that apply.

-Excess medication is excreted in the urine -It will stop once the therapy is discontinued -This is a result of the interaction between the medications with the urine

An older adult patient presents to the clinic reporting joint pain. The nurse reviews the patient's medical record and discovers which risk factors for osteoarthritis (OA)? Select all that apply.

-History of fractured right ankle -Played football in high school and college -Frequent exacerbations of chronic obstructive pulmonary disease (COPD) with steroid use

The nurse is planning the discharge teaching for a patient with rheumatoid arthritis. Which alternative therapies should the nurse suggest? Select all that apply.

-Hypnosis -Use of a firm mattress -Transcutaneous electrical nerve stimulation

The nurse is caring for a patient with mucocutaneous lesions, urethritis, and conjunctivitis. Which drug therapy does the nurse expect the primary health care provider to prescribe for the patient? Select all that apply.

-Ibuprofen -Methotrexate -Sulfasalazine

A nurse is reviewing subjective and objective data from the examination of a patient with rheumatoid arthritis. Which assessment findings indicate rheumatoid arthritis? Select all that apply.

-Joint stiffness -Rheumatoid nodules -High white blood cell (WBC) count

The nurse is assessing a patient suspected of having fibromyalgia. Which sites should the nurse assess for tenderness? Select all that apply.

-Knee -Low cervical area

Which hematologic disorders are frequently associated with systemic lupus erythematosus (SLE)? Select all that apply.

-Leukopenia -Hemolytic anemia -Thrombocytopenia

A patient reports to the primary care clinic after being diagnosed with systemic lupus erythematosus (SLE). The patient's blood pressure is 175/90 mmHg. What does the nurse expect the healthcare provider to recommend? Select all that apply.

-Low-sodium diet -Complete metabolic panel -Aggressive antihypertensive therapy with oral medications

Which approaches does interprofessional care for the patient diagnosed with osteoarthritis (OA) include? Select all that apply.

-Managing pain -Prevention of disability -Managing inflammation -Improving joint function

The nurse is caring for a patient with systemic lupus erythematosus (SLE). Which interventions would be beneficial for this patient? Select all that apply.

-Massage -Warm compresses -Recommending avoidance of strenuous physical activity

A patient is admitted to the hospital for further management of a systemic lupus erythematosus (SLE) flare. What actions does the nurse anticipate performing in the care of this patient? Select all that apply.

-Obtain weight daily -Observe and record intake and output -Administer 125 mg methylprednisolone intravenously every six hours -Administer 2 mg hydromorphone intravenously (IV) as needed for pain rated 7 to 10

A patient with systemic lupus erythematosus (SLE) arrives at the emergency department with a two-day history of intermittent fever, fatigue, and pain. Which subjective symptoms does the nurse know must be assessed immediately? Select all that apply

-Pain ratings -Fever patterns -Joint inflammation

How will the nurse determine how dermatomyositis (DM) is different than polymyositis (PM)? Select all that apply.

-Patients with DM have more severe disease than patients with PM -Patients with DM may show Gottron's sign, which is absent in patients with PM -DM is associated with humoral immunity, whereas PM is associated with cell-mediated injury

A patient who has been on a high dose of corticosteroids for one week for the treatment of polymyositis reports generalized weakness. What measures should be taken to ensure that the patient adheres to the therapy? Select all that apply.

-Pay special attention to patient safety -Inform that benefit of therapy is often delayed -Use assistive devices as a fall prevention strategy

The nurse is educating a patient newly diagnosed with systemic lupus erythematosus (SLE). What should the nurse include in the education about things to avoid? Select all that apply.

-Physical and emotional stress -Exposure to individuals with infections -Drying soaps, powders, and household chemicals

The nurse is reviewing the report of a patient's synovial fluid analysis. Which findings would suggest the presence of rheumatoid arthritis? Select all that apply.

-Presence of fibrin flecks -Elevated white blood cell (WBC) count -Increased matrix metallopeptidase (MMP)-3 enzyme

The nurse is caring for a patient with gout. Which actions are appropriate for the nurse to perform? Select all that apply.

-Provide warm compresses -Decrease joint mobilization -Encourage increased oral water intake

Which body systems can be affected in patients with systemic lupus erythematosus (SLE) who become pregnant? Select all that apply.

-Renal -Pulmonary -Cardiovascular -Central nervous system (CNS)

Which disorders may cause peripheral neuropathy? Select all that apply.

-Rheumatoid arthritis -Systemic lupus erythematosus (SLE)

A nurse is educating a patient with a history of gout. What are the factors the nurse should discuss with the patient that may precipitate gout? Select all that apply.

-Starvation -Niacin administration -Aspirin administration

What environmental factors are believed to contribute to the occurrence of systemic lupus erythematosus (SLE)? Select all that apply.

-Stress -Viral infections -Ultraviolet (UV) light exposure -Exposure to chemicals and toxins

Which diagnostic laboratory studies are utilized in the evaluation of systemic lupus erythematosus (SLE)? Select all that apply.

-Urinalysis -Serum complement -Complete blood cell count (CBC)

A patient has recently been diagnosed with systemic lupus erythematosus (SLE). A nurse is educating the patient about common complications of this disorder, noting that it most commonly affects which body systems? Select all that apply.

-Urologic -Neurologic -Integumentary -Musculoskeletal -Cardiopulmonary

A nurse caring for a patient with osteoarthritis instructs the patient about the various nonpharmaceutical interventions for the management of pain. Which information should the nurse include in these instructions? Select all that apply.

-Use of paraffin baths or hot packs -Use of crutches or walker if required -Regulation of a normal body mass index (BMI)

Arthodesis (RA)

-joint fusion

Arthroplasty (RA)

-total joint replacement

Which image of typical deformities of rheumatoid arthritis shows ulnar drift?

1

A patient reports joint pain in six small joints going on for four weeks. There is a high positive rheumatoid factor (RF) and abnormal erythrocyte sedimentation rate (ESR). What is the patient's score according to rheumatoid arthritis classification criteria?

7

Which patient should the nurse expect to be at the highest risk for systemic lupus erythematosus (SLE)?

A 28-year-old Asian American female

A patient comes into the clinic requesting a blood test for Lyme disease after being bitten by a tick. What should the nurse inform the patient about Lyme disease?

A bull's eye rash occurs in 70% to 80% of infected patients at the site of the tick bite.

Patients with which condition meet the criteria for a having a TURP?

Acute urinary retention Hydronephrosis Hematuria

The patient developed gout while hospitalized for a heart attack. When doing discharge teaching for this patient, who takes aspirin for its antiplatelet effect, what should the nurse include about preventing future attacks of gout?

Administration of allopurinol

A patient was started on hydralazine for hypertension after a recent hospitalization. The patient is accompanied by a parent who has systemic lupus erythematosus (SLE). What is the best intervention by the nurse?

Alert the healthcare provider to the medication and family history