Ch 50

Which diagnostic finding has been strongly linked to systematic lupus erythematosus?

Elevated anti-nuclear antibodies (ANA)

The nurse is assessing a client in early stage of rheumatoid arthritis. Which assessment findings with the nurse expect to find? Select all that apply

Erythema, tenderness, warmth, swelling

The nurse assesses for the classic signs and symptoms of adverse reaction to NSAIDs and a client with rheumatoid arthritis by assessing for which organ abnormality? Select all that apply

Gastric irritation, kidney damage, gastrointestinal bleeding, fluid retention

Which statement is true regarding the development of juvenile idiopathic arthritis?

Generalized stunted growth can occur.

Which assessment findings will help the nurse to confirm the diagnosis of rheumatoid arthritis? Select all that apply

Limited joint mobility, joint stiffness, wrist pain, finger and hand pain

When planning care for the client with severe osteoarthritis (OA) for the hip, the nurse includes which of the following in a teaching session with the patient?

"Try to balance your rest and exercise" - "a walker may be helpful to avoid excess pressure on your hips" - "using heat or cold to relieve pain may be helpful" - "losing weight or maintaining your ideal weight reduces stress on your joints"

The nurse determines that additional patient education is needed when a patient with gout makes which one of the following statements?

"When I have an exacerbation of my symptoms, a glass of red wine will be helpful."

When administering a corticosteroid to a client with rheumatoid arthritis, a nurse includes which education to the patient about the medication? Select all that apply

- "Corticosteroids do not prevent joint destruction" - "These drugs are for short term use" - " pain is relieved with use of corticosteroid medications"

While speaking to a senior citizen club about osteoarthritis (OA), which of the following facts are accurate to share? Select all that apply.

- By the time you are in your 70s, about 85% of adults will have some form of OA - Obesity in women has been correlated to having OA in the knees

Which of the following individuals is most likely to develop a form of reactive arthritis?

A 24-year-old male who completed treatment for a chlamydial infection 1 year ago

What are the criteria categories required for diagnosis of early onset rheumatoid arthritis? Select all that apply

Acute phase reactants, serology, duration of symptoms, joint involvement

A new patient arrives at the clinic. The physician is suspecting that the patient may have systemic lupus erythematosus (SLE) given the clinical manifestations related to joint pain, skin changes, and a history of pleural effusions. The nurse should anticipate which of the following diagnostic test will be a priority to facilitate with the diagnosis?

Anti-DNA antibody test

When working with a patient with diffuse scleroderma who is exhibiting a "stone face" expression, the nurse should consider which of the following to be a priority nursing diagnosis for this patient?

Aspiration, risk related to swallowing impairments

Which symptoms are required for a diagnosis of psoriatic arthritis? Select all that apply

Characteristic skin changes are evident, evidence of nail changes

A nurse is caring for an adolescent female who is undergoing diagnostic studies for systemic lupus erythematosus. Which assessment findings does the nurse recognize as being consistent with childhood SLE? Select all that apply

Child is between eight and 15 years of age, child is fatigued and generally feels "under the weather", child has increased serum creatinine

The nurse is assessing a patient for osteoarthritis of the knee. Which should the nurse consider to be expected findings? Select all that apply

Crepitus, limitation of motion, localized pain, quadricep atrophy

A 16-year-old boy has been diagnosed with ankylosing spondylitis. Which of the following etiologies is responsible for his health problem?

Immune response

Which disease in children presents with an inflammatory myopathy primarily involving skin and muscle with a heliotrope rash around the eyes?

Juvenile dermatomyositis

Due to her progressing osteoarthritis (OA), an 80-year-old woman is no longer able to perform her activities of daily living without assistance. Which of the following phenomena most likely underlies the woman's situation?

Loss of articular cartilage and synovitis has resulted from inflammation caused when joint cartilage attempted to repair itself.

Which of the following pathophysiological phenomena would be most indicative of ankylosing spondylitis?

Loss of motion in the spinal column and eventual kyphosis

The nurse is assessing a patient with Ankylosing spondylitis. Which of the following does the nurse expect to find?

Lower back pain

When a nurse is assessing a patient with osteoarthritis, which of the following factors poses a risk factor for the disease?

Obesity

Giant cell arteritis is a comorbid condition of which of the following?

Polymalgia rheumatica

The nurse assessing a patient with scleroderma with CREST variant would include an assessment for which of the following?

Raynaud's phenomenon

A client is experiencing an episode of gout. The nurse recognizes that the condition is a result of

Serum uric acid levels

An 8-year-old child has just been diagnosed with systemic lupus erythematosus (SLE). The parents wonder what the child's prognosis is going to be. Which of the following findings would be considered a good prognostic indicator of the extent/seriousness of the disease?

Swelling in the face and eyes and rust/blood-colored urine

While reviewing the following diagnostic findings on a group of patients with joint complaints, which finding would be a priority for further investigation and possible medical intervention?

Synovial fluid aspiration indicates the presence of monosodium urate crystals.

The nurse is providing patient education related to an intra-articular corticosteroid injections. Which of the following should the nurse include?

The injections will be given only 3 to 4 times per year because they can increase joint destruction

Although the client's primary care provider has downplayed the symptoms, a geriatrician suspects that an 82-year-old female has polymyalgia rheumatica. Which characteristic symptomatology would most likely have led the specialist to suspect this health problem?

The woman complains of aching and morning stiffness in her neck, shoulder, and pelvis.

The "CREST" variant of which disease is associated with the presence of an anticentromere antibody?

progressive systemic sclerosis (scleroderma)

A physician is attempting a differential diagnosis of a 30-year-old female who is suspected of having systemic lupus erythematosus (SLE). Which of the following aspects of the physician's assessment and the client's history would be considered potentially indicative of SLE? Select all that apply.

- The client has a "butterfly rash" on her nose and cheeks. - She complains of intermittent joint pain. - The client has been hospitalized twice in the past for pleural effusions. - Blood work indicates low red cells, white cells, and platelets.

When educating the patient with ankylosing spondylitis, the nurse should emphasize which of the following treatment interventions? Select all that apply.

- Encourage sleeping supine on an extra firm mattress if possible. - Try using a heating pad prior to exercise to help stretching and improve movement.