Ch 50 patho

A client has been diagnosed with rheumatoid arthritis (RA). What will the nurse tell the client about this disorder's etiology? "Environment is the biggest contributing factor to the development of RA." "Exposure to workplace chemicals is a causative agent." "Genetic predisposition is very likely." "The disease is most common in those under 30."

"Genetic predisposition is very likely."

A nurse is teaching a newly-diagnosed client with rheumatoid arthritis (RA) about pharmacologic therapy with disease-modifying antirheumatic drug (DMARD) therapy. Which statement should the nurse include in the teaching? "Ideally, DMARDs should be started at time of diagnosis." "Corticosteroids are first-line medications, followed by nonsteroidal anti-inflammatory drugs (NSAIDs)." "NSAIDs should be avoided early in the course of the disease." "Surgery is used as a first-line treatment, rather than regular drug therapy."

"Ideally, DMARDs should be started at time of diagnosis."

A client sought care because of increasing pain and inflammation in the toe and ankle of one foot. Diagnostic testing has resulted in a diagnosis of gouty arthritis. When educating the client about the treatment and management of the disease, what should the nurse teach the client? "Your doctor will likely prescribe acetaminophen with codeine to manage your pain." "Losing some weight and reducing your alcohol intake will likely be beneficial." "In a lot of cases, clients with gout are able to control their symptoms through physiotherapy." "It's important that you have your bloodwork drawn weekly and that you adjust your diet."

"Losing some weight and reducing your alcohol intake will likely be beneficial."

A nurse is teaching a group of nursing students about the presentation of systemic lupus erythematosus (SLE). Which statement is the nurse likely to make? "Lupus is a disease of older individuals." "More women than men are affected by lupus." "Lupus is more common in white people." "Drug-induced lupus requires lifelong treatment."

"More women than men are affected by lupus."

The nurse is caring for a client diagnosed with osteoarthritis (OA). What does the nurse teach the client about the disease? "OA is a disease of the weight-bearing joints." "OA typically occurs in clients between 20 and 40 years of age." "OA is an autoimmune disorder." "OA is a genetic disorder."

"OA is a disease of the weight-bearing joints."

The nurse has just finished teaching a client newly diagnosed with rheumatoid arthritis about the disease. The nurse determines that teaching is effective when the client makes which statement? "Rheumatoid arthritis includes joint involvement that is usually symmetric and polyarticular." "Rheumatoid arthritis is a chronic autoimmune system disease that affects a single joint." "Only upper extremity diarthrodial joint can be involved." "The disease will not fluctuate in occurrence."

"Rheumatoid arthritis includes joint involvement that is usually symmetric and polyarticular."

A nurse is caring for a client with a fractured elbow. Which instruction is important to give the client to prevent cartilage degeneration while the elbow is immobilized? "It is important to begin with vigorous exercise of the affected area as soon as the cast is removed." "To prevent cartilage atrophy, slowly and gradually resume exercising." "Once the elbow has been casted, you will not be able to exercise that joint for 3-6 months." "If you take a nonsteroidal anti-inflammatory medication prior to exercise, you will be able regain mobility faster."

"To prevent cartilage atrophy, slowly and gradually resume exercising."

The nurse determines that additional client education is needed when a client with gout makes which statement? "When I have an exacerbation of my symptoms, a glass of red wine will be helpful." "Increasing my intake of water each day will help stop the symptoms." "I will plan to eat more white meat rather than red meat." "I should avoid eating shellfish to decrease the risk of an episode."

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

A nurse is caring for a client who has systemic lupus erythematosus (SLE). Which of the following causes the disease? Infectious process Autoimmune process Genetic disorder Ischemic response

Autoimmune process

Juvenile dermatomyositis is a chronic inflammatory myopathy that commonly manifests systemically. What is the treatment of choice for this myopathy? Muscle relaxants Corticosteroids IgG Nonsteroidal anti-inflammatory drugs (NSAIDs)

Corticosteroids

When a nurse is caring for a client with systemic sclerosis (scleroderma), which condition does the nurse instruct the client causes symptoms of the disease? Autoimmune arthritis Deposits of collagen in the skin and organs Neurologic disorder with hardening of the neurons Dermatologic disorder with lesions on the face and hands

Deposits of collagen in the skin and organs

A rheumatology nurse is teaching a client about extra-articular signs and symptoms of rheumatoid arthritis (RA). Which item does the nurse include in the teaching session? Select all that apply. Weight gain Fatigue Loss of appetite Temperature 99.3°F (37.4°C) Wheezing Steady, chronic decline of health

Fatigue Loss of appetite Temperature 99.3°F (37.4°C)

When caring for a client with ankylosing spondylitis, the nurse tells the client that stiffness may be relieved by which intervention? Bed rest Gentle exercise Calcium supplements Acetaminophen

Gentle exercise

Which signs and symptoms should prompt a young woman's primary care provider to assess for systemic lupus erythematosus (SLE)? Chronic nausea and vomiting that is unresponsive to antiemetics Joint pain and proteinuria A history of thromboembolic events and varicose veins Dysmenorrhea and recent spontaneous abortion

Joint pain and proteinuria

The nurse is assessing a client with ankylosing spondylitis (AS). What does the nurse expect to find? Joint contractures Facial butterfly rash Lower back pain Bruises on the lower extremities

Lower back pain

A client presents with joint pain and suspected rheumatoid arthritis (RA). Which intervention is appropriate for the nurse to implement? Increase in the client's activity to provide sufficient joint stress Muscle-strengthening exercises to support joints Intravenous opioid to control pain Admission to the intensive care unit for cardiac monitoring

Muscle-strengthening exercises to support joints

The nurse is conducting a health promotion class on osteoarthritis (OA). Which statement should the nurse include? Obesity is a strong risk factor for developing OA. Young women have a higher risk than young men of developing OA. There is no hereditary link to the development of OA. Eating a diet low in calcium is the only contributing risk factor to OA.

Obesity is a strong risk factor for developing OA.

When teaching a group of nursing students about rheumatic disorders, a nurse emphasizes which important differences when caring for the older adult? Need for pain relief Stiffness in the morning Risk for falls Muscle weakness

Risk for falls

A client's presentation and recent health history are suggestive of systemic lupus erythematosus (SLE). Which findings would support this diagnosis? Select all that apply. The client states that she experiences seasonal allergies. The client reports being "really sensitive to sunshine." The client states that she is highly prone to mouth sores. The client is known to have arthritis in her knees. The client has elevated creatinine and blood urea nitrogen (BUN) levels.

The client reports being "really sensitive to sunshine." The client states that she is highly prone to mouth sores. The client is known to have arthritis in her knees. The client has elevated creatinine and blood urea nitrogen (BUN) levels.

The nurse is teaching a client with rheumatoid arthritis about pannus, which develops in the affected joint area. What does the nurse include to describe pannus? Muscles in the area that atrophy from disuse Vascular granulation tissue that destroys cartilage and bone Microorganisms that attack the joint space causing stiffness Reversible calcium deposits affecting the joints

Vascular granulation tissue that destroys cartilage and bone

The nurse is caring for clients with autoimmune conditions. Which client will the nurse assess first? client with rheumatoid arthritis reporting joint pain client with rheumatoid arthritis and vasculitis reporting numbness and tingling client with systemic lupus erythematosus reporting chest pain client with systemic lupus erythematosus reporting a rash on the face

client with systemic lupus erythematosus reporting chest pain

Which diagnostic finding has been strongly linked to systematic lupus erythematosus (SLE)? elevated anti-nuclear antibodies (ANA) abnormal serum SLE assay decreased rheumatoid factor low red blood cell (RBC) count

elevated anti-nuclear antibodies (ANA)