Assessment and Management of Patients with Rheumatic Disorders

Which newer pharmacological therapy, used to treat osteoarthritis, is thought to prevent the loss of cartilage and repair chondral defects, as well as have some anti-inflammatory effects? A. Capasaicin B. Chondroitin C. Glucosamine D. Viscosupplementation

D. Viscosupplementation

Which is an appropriate nursing intervention in the care of the client with osteoarthritis? A. Encourage weight loss and an increase aerobic activity B. Avoid the use of topical analgesics C. Provide an analgesic after exercise D. Asssess for gastrointestinal complications associated with COX-2 inhibitors

A. Encourage weight loss and an increase aerobic activity

A client with gout has been advised to lose weight. The client informs the nurse of plans to go on a "guaranteed rapid weight loss" plan that involves fasting and heavy exercise. Which response would be most appropriate? A. "Try combining the fasting with moderate exercise." B. "There might be some difficulties with your plan and fasting." C. "Make sure to eat some fat occasionally with all that exercise." D. "The fasting is okay, but make sure you drink fluids when exercising."

B. "There might be some difficulties with your plan and fasting."

A client is complaining of severe pain in the left great toe. What lab studies that the nurse reviews indicate that the client may have gout? A. Elevated uric acid levels B. Elevated white blood count C. Decreased hemoglobin and hematocrit D. Increased AST and ALT

A. Elevated uric acid levels

Which of the following disorders is characterized by an increased autoantibody production? A. Systemic lupus erythematosus B. Polymyalgia rheumatic C. Scleroderma D. Rheumatoid arthritis (RA)

A. Systemic lupus erythematosus

A client is taking ibuprofen for the treatment of osteoarthritis. What education will the nurse give the client about the medication? A. Inform the healthcare provider if there is ringing in the ears. B. Take the medication on an empty stomach in order to increase effectiveness. C. Since the medication is able to be obtained over the counter, it has fewer side effects D. Take the medication with food to avoid stomach upset

D. Take the medication with food to avoid stomach upset

The nurse is completing a health history with a client in a clinic. What assessment finding best correlates with a diagnosis of osteoarthritis? A. Joint stiffness that decreases with activity B. Fever and malaise C. Anorexia and weight loss D. Erythema and edema over the affected joint

A. Joint stiffness that decreases with activity

The nurse is reviewing the diagnostic test findings of a client with rheumatoid arthritis. What would the nurse expect to find? A. Increase albumin levels B. Elevated erythrocytes sedimentation rate C. Increased C4 complement D. Increased red blood cell count

B. Elevated erythrocytes sedimentation rate

The nurse is performing a health history with a new client in the clinic. What is the most common reason for a client to seek medication attention for arthritis? A. Weakness B. Pain C. Stiffness D. Joint swelling

B. Pain

A client is being treated for hyperuricemia. Part of the treatment strategy is for the client to avoid contributing factors whenever possible. Which activities might being on an acute attack? A. Frequently ingesting salicylates B. Frequently drinking coffee C. Eating organ meats and sardines D. High carbohydrate intake

C. Eating organ meats and sardines

The nurse teaches the client that osteoarthritis is: A. The most common and frequently disabling of joint disorders B. Requires early treatment because most of the damage appears to occur early in the course of treatment C. Affects young males D. Affects the cartilaginous joints of the spine and surrounding tissues

A. The most common and frequently disabling of joint disorders

What intervention is a priority for a client diagnosed with osteoarthritis? A. Allopurinol B. Physical therapy and exercise C. Hydrotherapy D. Colchicine

B. Physical therapy and exercise

The nurse is teaching a client about rheumatic disease. What statement best helps to explain autoimmunity? A. "You have antigens to the disease, but they do not prevent the disease." B. "You have inherited your parent's immunity to the disease." C. "Your symptoms are the result of your body attacking itself." D. "You are not immune to the disease causing the symptoms."

C. "Your symptoms are the result of your body attacking itself."

A client with osteoarthritis asks for information concerning activity and exercise. When assisting the client, which concept should be included? A. Exercising immediately upon waking allows the client to participate in activities when he has the greatest amount of energy B. Time of day when exercise is performed isn't important C. Delaying exercise for at least 1 hour after waking allows the client to participate in exercise after some of the morning-related stiffness has subsided D. Exercising in the evening before bed is beneficial

C. Delaying exercise for at least 1 hour after waking allows the client to participate in exercise after some of the morning-related stiffness has subsided

The nurse is reviewing the medication administration record of the client. Which medication would lead the nurse to suspect that the client is suffering from an acute attack of gout? A. Penicillamine B. Methotrexate C. Prednisone D. Colchicine

D. Colchicine

The presence of crystals in synovial fluid obtained from arthrocentesis is indicative of: A. Inflammation B. Degeneration C. Infection D. Gout

D. Gout

A client comes to the emergency department complaining of pain in the right leg. When obtaining the history, the nurse learns that the client has a history of obesity and hypertension. Based on this information the nurse anticipates the client having which musculoskeletal disorder? A. Degenerative joint disease B. Muscular dystrophy C. Scoliosis D. Paget's disease

A. Degenerative joint disease

The nurse assesses a client in the healthcare provider's office. Which assessment findings support a suspicion of systemic lupus erythematosus (SLE)? A. Facial erythema, pericarditis, fever, and weight loss B. Photosensitivity, polyarthralgia, and painful mucous membrane ulcers C. Hypothermia, weight gain, lethargy, and edema of the arms D. Weight gain, hyper vigilance, hypothermia, and edema of the legs

A. Facial erythema, pericarditis, fever, and weight loss

The client with osteoarthritis is seen in the clinic. Which assessment finding indicates the client is having difficulty implementing self-care? A. Has a weight gain of 5 pounds B. Shows increased joint flexibility C. Reports ability to perform ADLs D. Reports decreased joint pain

A. Has a weight gain of 5 pounds

Which assessment suggests to the nurse that a client with systemic lupus erythematosus is having renal involvement? A. Hypertension B. Chest pain C. Behavioral changes D. Decreased cognitive ability

A. Hypertension

The nurse is discussing life management with the client with rheumatoid arthritis in a health clinic. What assessment finding indicates the client is having difficulty implementing self-care? A. Increased fatigue B. Ability to perform activities of daily living (ADLs) C. A weight gain of 2 pounds D. Decreased joint pain

A. Increased fatigue

Osteoarthritis is known as a disease that: A. Is the most common and frequently disabling of joint disorders B. Requires early treatment because most of the danger seems to occur early in the course of the disease C. Affects young males D. Affects the cartilaginous joints of the spine and surrounding tissues

A. Is the most common and frequently disabling of joint disorders

The client asks the nurse how to identify rheumatoid nodules with rheumatoid arthritis. What characteristic will the nurse include? A. Located over bony prominences B. Nonmoveable C. Tender to the touch D. Reddened

A. Located over bony prominences

Primary gout is often caused by an inherited disorder in which type of metabolism? A. Purine B. Fat C. Carbohydrate D. Glucose

A. Purine

A client with rheumatoid arthritis arrives at the clinic for a checkup. Which statement by he client refers to the most overt clinical manifestation of rheumatoid arthritis? A. "My legs feel weak." B. "My finger joints are oddly shaped." C. "I have pain in my hands." D. "I have trouble with my balance."

B. "My fingers joints are oddly shaped."

A client suspected of having systemic lupus erythematosus (SLE) is being scheduled for testing. The client asks which of the tests ordered will determine positivity for the disorder. Which statement by the nurse is most accurate? A. "SLE is a very serious systemic disorder." B. "The diagnosis won't be based on the findings of a single test but by combining all data found." C. "You should discuss that matter with your healthcare provider." D. "Tell me more about your concerns about this potential diagnosis."

B. "The diagnosis won't be based on the findings of a single test but by combining all data found."

The side effect of bone marrow depression may occur with which medication used to treat gout? A. Colchicine B. Allopurinol C. Prednisone D. Probenecid

B. Allopurinol

What is the priority intervention for a client who has been admitted repeatedly with attacks of gout? A. Increase fluids B. Assess diet and activity at home C. Insert a Foley catheter D. Place client on bedrest

B. Assess diet and activity at home

A nurse is caring for a client with a warm and painful toe from gout. What medication will the nurse administer? A. Calcium gluconate B. Colchicine C. Furosemide D. Aspirin

B. Colchicine

The nurse is caring for a client with a new onset of gout. What medication does the nurse anticipate will be ordered by the healthcare provider? A. Anturane B. Colchicine C. Probenecid D. Allopurinol

B. Colchicine

Which joint is most commonly affected by gout? A. Tarsal area B. Metatarsophalangeal C. Ankle D. Knee

B. Metatarsophalangeal

The nurse is teaching a newly diagnosed client about systemic lupus erythematosus (SLE). What statement by the client indicates the teaching was successful? A. "SLE has very specific manifestations that make diagnosis relatively easy." B. "This disorder is more common in men in their thirties and forties than in women." C. "The belief is that it is an autoimmune disorder with an unknown trigger." D. "The symptoms are primarily localized to the sin but may involve the joints."

C. "The belief is that it is an autoimmune disorder with an unknown trigger."

As part of the assessment process for a client suspected of having gout, the nurse evaluated the client's serum uric acid levels. Select the value that is considered above the saturation point for crystal formation. A. 5.4 mg/dL B. 4.0 mg/dL C. 6.8 mg/dL D. 3.2 mg/dL

C. 6.8 mg/dL

A client is being discharged from the hospital after being diagnosed with and treated for systemic lupus erythematosus (SLE). What would the nurse not include when teaching the client and family information about managing the disease? A. Pace activities B. Maintain a well-balanced diet and increase fluid intake to raise energy levels a promote tissue healing C. If you have problems with a medication, you may stop it until your next physician visit D. Avoid sunlight and ultraviolet radiation

C. If you have problems with a medication, you may stop it until your next physician visit

Which term indicates an accumulation of crystalline depositions in articular surfaces, bones, soft tissue, and cartilage? A. Joint effusion B. Pannus C. Tophi D. Subchondral bone

C. Tophi

The nurse is preparing a client with systemic lupus erythematosus (SLE) for discharge. Which instruction should the nurse include in the teaching plan? A. "Corticosteroids may be stopped when symptoms are relieved." B. "There are no activity limitations between flare-ups." C. "Exposure to sunlight will help control skin rashes." D. "Monitor your body temperature."

D. "Monitor your body temperature."

A client with rheumatoid arthritis tells the nurse about experiencing mild tinnitus, gastric intolerance, and rectal bleeding. What medication does the nurse suspect is causing these side effects? A. Hydrochloroquine B. Methotrexate C. Celecoxib D. Aspirin

D. Aspirin

The nurse is educating a client about the risks of stroke related to the new prescription for a COX-2 inhibitor and what symptoms to report. Which COX-2 inhibitor is the nurse educating the client about? A. Proxicam B. Tolmentin sodium C. Ibuprofen D. Celecoxib

D. Celecoxib

Nursing care for the client with fibromyalgia should be guided by the assumption that patients with fibromyalgia: A. Will eventually lose their ability to walk B. Rarely respond to treatment C. All have the same type of symptoms D. May feel as if their symptoms are not taken seriously

D. May feel as if their symptoms are not taken seriously

Which of the following would a nurse encourage a client with gout to limit? A. Fluid intake B. Carbohydrates C. Protein-rich foods D. Purine-rich foods

D. Purine-rich foods