Chapter 20

The nurse is completing a health screening for a school-age child with rheumatoid arthritis (RA). The parents ask the nurse to recommend activities that will promote exercise for their child. Which recommendation by the nurse is the most appropriate? 1) Running 2) Softball 3) Football 4) Swimming

4) Swimming

The nurse is assessing a patient with significant joint pain. Which characteristic of pain and body alteration make the nurse suspect rheumatoid arthritis (RA)? Select all that apply. A. Frequent fatigue B. Pain that worsens after a long rest C. Swelling in both ankle joints D. Pain mostly in the left knee joint E. Joint stiffness in the morning for half an hour

A, B, C

A patient arrives at the hospital with joint pain and morning stiffness. Which laboratory value may indicate the presence of inflammation? A. Elevation of C-reactive protein (CRP) B. Decreased white blood cells (WBCs) C. Decreased erythrocyte sedimentation rate (ESR) D. Positive anticyclic citrullinated peptides level

A. Elevation of C-reactive protein (CRP)

The patient with systemic lupus erythematosus (SLE) is experiencing pancytopenia. What would be the cause of this? A. Immunosuppression B. Medications used for treatment C. Failing kidney function D. Bone marrow failure

A. Immunosuppression

The nurse knows that which of following statements regarding laboratory values and RA are true? (Select all that apply.) A. Patients with a positive rheumatoid factor definitely have RA. B. An elevated CRP is indicative of inflammation, but is not specific only for RA. C. Certain DMARD therapy may cause laboratory abnormalities such as elevated liver enzymes, thrombocytopenia, and leukocytopenia. D. Approximately 25% to 30% of patients who have RA do not have a positive rheumatoid factor. E. Patients with RA have elevated cardiac enzymes due to pharmacological therapy.

B, C, D

The nurse monitors for which clinical manifestations in the patient diagnosed with osteoarthritis? (Select allthat apply.) A. Pain that improves with activity B. Joint pain C. Joint swelling D. Unsteady gait E. Increased temperature

B, C, D

Which conditions are treated with high dose oral glucocorticoids in a patient with systemic lupus erythematosus (SLE)? Select all that apply. A. Oral and nasal ulcers B. Pneumonitis C. Chronic cutaneous lupus D. Systemic vasculitis E. Hematologic abnormalities

B, D, E

The registered nurse is providing discharge teaching to a patient who is diagnosed with rheumatoid arthritis and was prescribed methotrexate. Which statement made by the patient indicates the need for further teaching? A. "I should avoid alcohol." B. "I will avoid taking folic acid tablets." C. "I should perform weight-bearing exercises regularly." D. "I should notify the primary health-care provider for any sign of breathing difficulty."

B. "I will avoid taking folic acid tablets."

The nurse recognizes which patient to be at the highestrisk for developing SLE? A. A 10-year-old Hispanic female B. An 18-year-old African American male C. A 30-year-old African American female D. A 50-year-old Caucasian male

C. A 30-year-old African American female

A patient who was diagnosed with systemic lupus erythematosus (SLE) 6 months ago arrived at the hospital for a regular checkup. The nurse anticipates the priority assessment would be performing the eye examination. Which medication in the treatment leads the nurse to this decision? A. Capsaicin B. Naproxen C. Hydrocodone D. Hydroxychloroquine

D. Hydroxychloroquine

Arrange the sequence of pathophysiological events of rheumatoid arthritis. 1. Production of collagenase 2. Formation of immune complexes 3. Proliferation of synovial membrane 4. Activation of monocyte and T lymphocytes 5. Production of leukotrienes and prostaglandins

4, 2, 5, 1, 3

The patient enters the outpatient clinic and states to the triage nurse, "I think I have the flu. I'm so tired, I have no appetite, and everything hurts." The triage nurse assesses the patient and finds a butterfly rash over the bridge of nose and on the cheeks. Then nurse correlates this data with the clinical manifestations of which disorder? 1. Gout 2. Lyme disease 3. Fibromyalgia 4. Systemic lupus erythematosus

4. Systemic lupus erythematosus

When comparing osteoarthritis to RA, the nurse recognizes which of the following statements to be true? (Select all that apply.) A. Osteoarthritic pain tends to get worse with activity,but RA gets better with activity. B. Both RA and osteoarthritis are autoimmune diseases. C. Patients with RA are at risk for developing extra articular manifestations such as eye inflammation and lung disease, whereas osteoarthritis affects only joints and surrounding structures. D. Patients with osteoarthritis typically have morning stiffness lasting less than 1 hour, whereas RA patients typically complain of morning stiffness lasting greater than 1 hour. E. Both RA and osteoarthritis affect joints in asymmetrical pattern.

A, C, D

The nurse is caring for a patient diagnosed with osteoarthritis. Which clinical manifestations does the nurse suspect in the patient? Select all that apply. A. Severe joint pain B. Swan neck fingers C. Stiffness of the joints D. Severe bone deformity E. Formation of edema at the joints

A, C, E

What is the purpose of using an echocardiogram as a diagnostic tool in a patient with systemic lupus erythematosus (SLE)? A. To assess for pericardial involvement and elevated pulmonary artery pressure B. To access neurological defects and cognitive dysfunction C. To assess the kidney size if there is any sign of renal impairment D. To assess joint pain, swelling, and stiffness

A. To assess for pericardial involvement and elevated pulmonary artery pressure

Upon assessment, the nurse recognizes hyperextension of the proximal interphalangeal joint of the thumb finger in a patient. What does the nurse suspect? A. Osteopenia B. Ulnar deviation C. Swan neck deformity D. Boutonnière deformity

C. Swan neck deformity

Which diagnostic tool is most likely used to assess for joint damage in an older adult with systemic lupus erythematosus (SLE)? A. Ultrasound B. Computed tomography (CT) C. X-ray D. Magnetic resonance imaging (MRI)

C. X-ray

A patient with systemic lupus erythematosus (SLE) is being treated with immunosuppressant drugs and corticosteroids. Which patient statement indicates the need for further education after teaching? 1) "I can go to events with large crowds." 2) "I should avoid getting the flu shot." 3) "I will use contraception to avoid pregnancy." 4) "I will report any symptoms of infection immediately."

1) "I can go to events with large crowds."

The nurse is providing care for a newly married woman with systemic lupus erythematosus (SLE). Which patient statement indicates an appropriate understanding of the plan of care? 1) "I will take birth control pills while I am taking cytotoxic medications." 2) "I do not need to contact the doctor if I develop a fever or rash." 3) "I plan to go to the movies this weekend so that I get out of the house." 4) "I can take aspirin as indicated for pain."

1) "I will take birth control pills while I am taking cytotoxic medications."

The nurse is providing care to a patient who is receiving nonsteroidal anti-inflammatory drugs (NSAIDs) for the treatment of rheumatoid arthritis. When providing care to this patient, which actions by the nurse are appropriate? Select all that apply. 1. Assessing for an allergic reaction 2. Monitoring for signs of renal problems 3. Advising against abrupt discontinuation of drugs 4. Assuring the patient that there is no relationship between NSAIDs and heart disease 5. Encouraging the patient to take NSAIDs with water, milk, or a small snack to help avoid stomach distress

1, 2, 3, 5

Which clinical manifestations does the nurse assess for in the patient diagnosed with gout? Select all that apply. 1. Presence of tophi 2. Raynaud's phenomenon 3. Reports of severe pain in the great toe 4. Redness and swelling of great toe 5. Ulnar deviation

1, 3, 4

A patient with systemic lupus erythematosus (SLE) is being treated with immunosuppressant drugs and corticosteroids. Which patient statement indicates the need for further teaching? 1. "I am relieved that I can still attend concerts with my friends." 2. "I should avoid getting the flu shot." 3. "I will use contraception to avoid pregnancy." 4. "I will report any symptoms of infection immediately."

1. "I am relieved that I can still attend concerts with my friends."

Which information should the nurse include when teaching a patient information regarding limited systemic scleroderma? Select all that apply. 1) A rapid onset is anticipated. 2) An insidious onset is anticipated. 3) Affects internal organs several years prior to onset 4) Can be preceded by a diagnosis of Raynaud's phenomenon 5) Skin of extremities distal to the elbows and knees are affected

2, 4, 5

The nurse identifies the nursing diagnosis of Chronic Pain for a patient with fibromyalgia. Which manifestation supports this nursing diagnosis? 1. Chest pain 2. Pain from eye strain 3. Tender points in the knees 4. Pain from a severe skin rash

3. Tender points in the knees

The nurse is providing health education to a diverse group at a neighborhood community center. The nurse includes information about signs and symptoms of systemic lupus erythematosus (SLE) for which of the following reasons? 1. The neighborhood is composed of many young female children. 2. The neighborhood has a large number of older adult women. 3. The audience is mainly composed of Caucasian women. 4. The audience is mainly females of Asian-American descent.

4. The audience is mainly females of Asian-American descent.

The nurse is collecting a health history for a patient in an outpatient clinic who reports joint pain and swelling for the last two months. The patient is diagnosed with rheumatoid arthritis (RA). When planning care for this patient, which statement supports the nursing diagnosis of Activity Intolerance? 1) "I seem to get tired early in the day and require a nap." 2) "My joints are stiffest at night before I go to sleep." 3) "I find it difficult to move when I first get up in the morning." 4) "I take ibuprofen for the pain as needed."

1) "I seem to get tired early in the day and require a nap."

A patient recently diagnosed with rheumatoid arthritis (RA) asks the nurse if the disease is caused by ethnicity. Which response by the nurse is the most appropriate? 1) "RA affects all races at the same rate." 2) "RA is most prevalent in Caucasian females." 3) "RA affects those of German descent most often." 4) "RA is most prevalent in men under the age of 20 years."

1) "RA affects all races at the same rate."

A nurse is caring for a patient who is newly diagnosed with rheumatoid arthritis (RA). The patient asks the nurse what the difference is between RA and osteoarthritis (OA). Which response by the nurse is most appropriate? 1) "The onset of OA is gradual while the onset of RA may be rapid." 2) "With OA, multiple joints are symmetrically affected; RA affects one joint at a time." 3) "The affected joints in RA feel cold to the touch while the joints affected by OA are warm or hot to the touch." 4) "The pain and stiffness with RA is with activity; OA pain and stiffness is predominant upon arising."

1) "The onset of OA is gradual while the onset of RA may be rapid."

The nurse is caring for a patient who is hospitalized due to an exacerbation of systemic lupus erythematosus (SLE). The nurse is reviewing the patient's lab work and finds the white blood cell count (WBC) is shifted to the left. Based on this information, which is a priority nursing diagnosis for this patient? 1) Risk for Infection 2) Ineffective Individual Coping 3) Risk for Impaired Skin Integrity 4) Ineffective Health Maintenance

1) Risk for Infection

A nurse is caring for a patient with systemic lupus erythematosus (SLE). The patient begins to cry stating, "I am afraid I will be disfigured because of all of these lesions." Which intervention does the nurse plan to teach this patient to minimize skin infections associated with SLE? 1) Use sunscreen with an SPF of 15 or greater 2) Remain indoors on sunny days 3) Avoid swimming in a pool or the ocean 4) Decrease sun exposure between 3:00 p.m. and 5:00 p.m.

1) Use sunscreen with an SPF of 15 or greater

A patient, recently diagnosed with rheumatoid arthritis (RA), asks the nurse whether RA will affect her in other ways. When responding to the patient, which systems will the nurse include as possibly being affected by the diagnosis? Select all that apply. 1) Exocrine 2) Respiratory 3) Hematologic 4) Reproductive 5) Cardiovascular

1, 2, 3, 5

The nurse is caring for a patient who has recently been diagnosed with fibromyalgia. The nurse correlates which prescriptions as part of the patient's treatment plan? Select all that apply. 1. Ibuprofen (Advil) 2. Aerobic exercise 3. Pregabalin (Lyrica) 4. Fentanyl (Sublimaze) 5. Cognitive behavioral therapy

1, 2, 3, 5

The nurse is providing care to a patient who is receiving nonsteroidal anti-inflammatory drugs (NSAIDs) in the treatment of rheumatoid arthritis. When providing care to this patient, which actions by the nurse are appropriate? Select all that apply. 1) Assessing for an allergic reaction 2) Monitoring for signs of renal problems 3) Advising against abrupt discontinuation of drugs 4) Assuring the patient that there is no relationship between NSAIDs and heart disease 5) Encouraging the patient to take with water, milk, or small snack to help avoid stomach distress

1, 2, 3, 5

The nurse monitors for which of the following clinical manifestations in the patient diagnosed with systemic lupus erythematosus? Select all that apply. 1. Alopecia 2. Fever 3. Elevated uric acid 4. Thrombocytosis 5. Leukopenia

1, 2, 5

The nurse monitors for which of the following clinical manifestations in the patient diagnosed with osteoarthritis? Select all that apply. 1. Bouchard's nodes 2. Butterfly rash 3. Crepitus 4. Heberden's nodes 5. Raynaud's phenomenon

1, 3, 4

The nurse provides education to a patient with rheumatoid arthritis who is prescribed methotrexate by the healthcare provider. Which patient statement indicates to the nurse the need for further teaching? 1. "I can have a glass of wine each night with dinner." 2. "I will take folic acid each day to decrease my risk of mouth ulcers." 3. "I will continue to take my oral contraception to prevent pregnancy." 4. "I didn't have to decrease my medication dose because my kidney tests came back okay."

1. "I can have a glass of wine each night with dinner."

The nurse is providing care for a newly married woman with systemic lupus erythematosus (SLE). Which patient statement indicates an appropriate understanding of the plan of care? 1. "I will need to use birth control methods while I am taking cytotoxic medications." 2. "I do not need to be concerned with a fever or rash because these are expected with this disorder." 3. "I plan to go to the movies this weekend so that I get out of the house." 4. "I can take aspirin as indicated for pain."

1. "I will need to use birth control methods while I am taking cytotoxic medications."

A patient recently diagnosed with rheumatoid arthritis (RA) asks the nurse if the disease is caused by ethnicity. Which response by the nurse is the most appropriate? 1. "RA affects females more often than males" 2. "RA affects about 10% of the population." 3. "The onset of RA is usually in the sixth decade." 4. "RA is most prevalent in men younger than age 20 years."

1. "RA affects females more often than males"

A nurse is caring for a patient who is newly diagnosed with rheumatoid arthritis (RA). The patient asks the nurse what the difference is between RA and osteoarthritis (OA). Which response by the nurse is most appropriate? 1. "The onset of OA is gradual, whereas the onset of RA may be rapid." 2. "With OA, multiple joints are symmetrically affected; RA affects one joint at a time." 3. "The affected joints in RA feel cold to the touch, whereas the joints affected by OA are warm or hot to the touch." 4. "The pain and stiffness with RA is with activity; OA pain and stiffness is predominant on arising."

1. "The onset of OA is gradual, whereas the onset of RA may be rapid."

Which of the following medications prescribed for a patient with acute gout requires an intervention by the nurse? 1. Allopurinol 2. Colchicine 3. Cortisone 4. Indocin

1. Allopurinol

The nurse develops the nursing diagnosis "Altered Comfort related to inflammation and pain secondary to urate crystals in the joints and tissues." For which disorder is this nursing diagnosis most relevant? 1. Gout 2. Osteoarthritis 3. Rheumatoid arthritis 4. Scleroderma

1. Gout

The nurse provides care for a patient who is admitted to the cardiac care unit for a coronary artery bypass graft (CABG). The patient has a history of osteoarthritis. Which medication does the nurse question if prescribed by the healthcare provider? 1. Ibuprofen (Advil) 2. Fentanyl (Duragesic) 3. Morphine (MS Contin) 4. Acetaminophen (Tylenol)

1. Ibuprofen (Advil)

A nurse is caring for a patient with systemic lupus erythematosus (SLE). Which intervention does the nurse plan to teach this patient to minimize skin infections associated with SLE? 1. Use sunscreen with an SPF of 50 or greater 2. Remain indoors on sunny days 3. Avoid swimming in a pool or the ocean 4. Decrease sun exposure between 3:00 p.m. and 5:00 p.m.

1. Use sunscreen with an SPF of 50 or greater

An adult patient is diagnosed with fibromyalgia. The patient asks the nurse whether a recent of infection with the Coxsackie B virus could have caused fibromyalgia. Which response by the nurse is the most appropriate? 1) "The Coxsackie B virus has nothing to do with fibromyalgia." 2) "The Coxsackie B virus may have triggered the fibromyalgia." 3) "The Coxsackie virus definitely caused the fibromyalgia." 4) "Fibromyalgia is a psychiatric disorder."

2) "The Coxsackie B virus may have triggered the fibromyalgia."

The nurse is caring for a patient diagnosed with discoid lupus erythematosus. The nurse is collaborating with the patient to set goals for the nursing plan of care. Which is an appropriate goal for this patient? 1) Work through the stages of death and dying 2) Compliance with a sun protection plan 3) Gain weight to within 10 pounds of normal for height 4) Report pain no higher than 4 on a scale of 1-10

2) Compliance with a sun protection plan

The nurse is planning care for an adolescent patient who has systemic lupus erythematosus (SLE). Which action by the patient indicates the implemented plan of care is appropriate? 1) Refusing to attend school 2) Discussing skin changes with a good friend 3) Refraining from attending any social functions 4) Discussing skin changes with the health-care provider

2) Discussing skin changes with a good friend

A nurse is caring for a patient with systemic lupus erythematous (SLE) who is taking hydroxychloroquine (Plaquenil). When providing care for this patient, the nurse monitors for which adverse effect associated with the prescribed medication? 1) Renal toxicity 2) Retinal toxicity 3) Cushingoid effects 4) Pulmonary fibrosis

2) Retinal toxicity

A patient recently diagnosed with rheumatoid arthritis (RA) asks the nurse if RA always causes crippling deformities. Which teaching topics will the nurse include as ways to decrease the likelihood of crippling deformities? Select all that apply. 1) Ignore pain as a warning signal 2) Use stronger joints for most activity 3) Avoid stress to any current area of deformity 4) Type instead of handwriting items if possible 5) Stop an activity if it is beyond your ability to perform

2, 3, 4, 5

The nurse correlates which clinical manifestations to the diagnosis of rheumatoid arthritis? Select all that apply. 1. Bouchard's nodes 2. Boutonniere deformity 3. Swan-neck deformity 4. Tophi 5. Ulnar deviation

2, 3, 5

Which information should the nurse include when teaching a patient information regarding limited systemic scleroderma? Select all that apply. 1. A rapid onset is anticipated. 2. An insidious onset is anticipated. 3. It affects internal organs several years before onset. 4. It can be preceded by a diagnosis of Raynaud's phenomenon. 5. Skin of extremities distal to the elbows and knees are affected.

2, 4, 5

In providing care to a patient who is being evaluated for a possible connective tissue disease, the nurse correlates which finding to the definitive diagnosis of gout? 1. Boutonniere deformity 2. Crystals in synovial fluid 3. Elevated uric acid levels 4. Joint erosions

2. Crystals in synovial fluid

A nurse is caring for a patient with systemic lupus erythematous (SLE) who is taking hydroxychloroquine (Plaquenil). When providing care for this patient, the nurse monitors for which adverse effect associated with the prescribed medication? 1. Renal toxicity 2. Retinal toxicity 3. Cushingoid effects 4. Pulmonary fibrosis

2. Retinal toxicity

A patient with rheumatoid arthritis (RA) is being seen in the outpatient clinic for a progress check-up. The nurse is reviewing the patient's plan of care and determines that the patient has met a goal of treatment when the patient makes which statement? 1) "I sleep for 10 hours at night." 2) "I have increased pain in my joints all the time now." 3) "I have delegated many household chores to my children and spouse." 4) "I do not perform household chores at all anymore."

3) "I have delegated many household chores to my children and spouse."

A patient asks the nurse if there are any conditions that can exacerbate systemic lupus erythematosus (SLE). Which response by the nurse is the most appropriate? 1) "Conditions causing hypotension can often exacerbate SLE." 2) "GI upset is often associated with SLE exacerbation." 3) "Pregnancy is often associated with an SLE exacerbation." 4) "Fever is a known trigger for an SLE exacerbation."

3) "Pregnancy is often associated with an SLE exacerbation."

An Asian male accompanies his spouse to the clinic and states, "I want you to fix my wife and tell her that there is nothing wrong with her." The patient reports pain, sleep disorders, and stiffness. Which would be most appropriate for the nurse to include in a plan of care for this family? 1) Medications used to treat fibromyalgia 2) An exercise program to increase energy 3) Information and literature on fibromyalgia 4) Suggested dietary changes to help with the pain

3) Information and literature on fibromyalgia

The nurse identifies the nursing diagnosis of chronic pain as being appropriate for a patient with fibromyalgia. Which manifestation did the patient most likely report that caused the nurse to select this diagnosis? 1) Acute chest pain 2) Pain from eyestrain 3) Tender points in the knees 4) Pain from a severe skin rash

3) Tender points in the knees

Which statement by the patient diagnosed with gout indicates the need for further teaching by the nurse related to dietary guidelines? 1. "I should drink at least 8 glasses of water daily." 2. "I need to avoid red meats." 3. "I am not allowed to drink wine but can drink beer." 4. "It is okay to eat chicken."

3. "I am not allowed to drink wine but can drink beer."

A patient with rheumatoid arthritis (RA) is being seen in the outpatient clinic for a progress checkup. The nurse is reviewing the patient's plan of care and determines that the patient has met a goal of treatment when the patient makes which statement? 1. "I sleep for 10 hours at night." 2. "My joint pain is still severe in the morning." 3. "I get help with household tasks from my children and spouse." 4. "I try not to be too active because of the pain."

3. "I get help with household tasks from my children and spouse."

The nurse correlates an increased risk of osteoarthritis in which of the following patients? 1. 40-year-old obese female who works as an administrative assistant 2. 45-year-old obese male who is a construction worker 3. 55-year-old obese female with works as a machine operator 4. 60-year-old obese male who works as an accountant

3. 55-year-old obese female with works as a machine operator

The nurse is caring for a patient who was diagnosed with rheumatoid arthritis (RA) last year. The patient has recently been placed on prednisone for treatment. Which patient statement indicates that the medication teaching was successful? 1) "I will not have to limit my consumption of canned vegetables." 2) "I will take this medication on a full stomach to enhance absorption." 3) "I will not need to monitor my blood sugar more frequently while on this medication." 4) "I will take the ordered dose at the same time every day."

4) "I will take the ordered dose at the same time every day."

A nurse is caring for a pregnant patient who has rheumatoid arthritis (RA). Based on this data, which does the nurse anticipate when providing care to this patient? 1) A higher risk for preterm delivery 2) An increased need for medication 3) An acute exacerbation of symptoms 4) A continued risk for anemia

4) A continued risk for anemia

The nurse is discussing goals to relieve pain and fatigue with a patient newly diagnosed with fibromyalgia. Which goal statement would be realistic for this patient to achieve within 30 days? 1) Join an exercise group 2) Get a job outside the home 3) Walk her son to school daily 4) Cook dinner five nights a week

4) Cook dinner five nights a week

During a home visit, the family of a patient with fibromyalgia asks the nurse what they can do to help the patient with painful episodes. What should the nurse suggest to the patient and family? 1) Plan a family reunion 2) Keep the patient in bed 3) Protect the patient from injury 4) Divide household chores among each member of the family

4) Divide household chores among each member of the family

The mother of three teenagers is diagnosed with fibromyalgia and asks the nurse how to keep up with all of the children's activities. Which suggestion by the nurse is the most appropriate? 1) Ask the children to limit their activities. 2) Attempt to attend the all the functions of the children. 3) Avoid attending any afterschool functions for the children. 4) Negotiate with the children to alternate attending their functions.

4) Negotiate with the children to alternate attending their functions.

The patient enters the outpatient clinic and states to the triage nurse, "I think I have the flu. I'm so tired, I have no appetite, and everything hurts." The triage nurse assesses the patient and finds a butterfly rash over the bridge of nose and on the cheeks. Based on this data, which diagnosis does the nurse anticipate? 1) Gout 2) Lyme disease 3) Fibromyalgia 4) Systemic lupus erythematosus

4) Systemic lupus erythematosus

The nurse is counseling an adult patient with fibromyalgia. What are some elements of counseling that can help this patient develop effective coping skills? 1) Remind the patient that the patient has a progressive disease. 2) Suggest to the patient that some symptoms may be psychosomatic. 3) Inform the patient that the patient does not need to see a specialist. 4) Teach the patient strategies including distractions, relaxation techniques, or journaling.

4) Teach the patient strategies including distractions, relaxation techniques, or journaling.

The nurse is providing health education to a diverse group at a neighborhood community center. Why does the nurse plan to include signs and symptoms of systemic lupus erythematosus (SLE)? 1) The neighborhood is composed of many young female children. 2) The audience has asked the nurse to include the information. 3) The audience is mainly composed of Caucasian women. 4) The audience is mainly females of Asian-American descent.

4) The audience is mainly females of Asian-American descent.

The nurse provides care to a patient diagnosed with osteoarthritis who is prescribed daily acetaminophen. Which patient statement requires an intervention? 1. "I am not experiencing as much pain as I was before." 2. "I joined a gym to learn muscle-strengthening exercises." 3. "I lost 10 lbs. since my last visit by modifying my diet." 4. "I only drink a couple of beers when I get home from work."

4. "I only drink a couple of beers when I get home from work."

The nurse is caring for a patient who was diagnosed with rheumatoid arthritis (RA) last year who has a history of type 2 diabetes mellitus. The patient has recently been placed on prednisone for treatment. Which patient statement indicates that the medication teaching was successful? 1. "I can eat canned vegetables." 2. "I can take this medication on an empty stomach." 3. "I do not need to monitor my blood sugar more frequently while on this medication because I take pills for my diabetes." 4. "I will take the ordered dose at the same time every day."

4. "I will take the ordered dose at the same time every day."

Which statement by the patient with rheumatoid arthritis indicates the need for further teaching? 1. "I can use analgesics to help decrease the pain." 2. "It is okay to take ibuprofen for the pain." 3. "I may have to take steroids if I have a rheumatoid arthritis (RA) flare." 4. "My immunosuppressive medications need to be increased if I get an infection."

4. "My immunosuppressive medications need to be increased if I get an infection."

The nurse collects assessment data for a patient diagnosed with limited systemic scleroderma. The nurse monitors for which data based on the current diagnosis? 1. Rapid onset of symptoms 2. Internal organ involvement 3. Trunk and extremity skin involvement 4. Previous diagnosis of Raynaud's phenomenon

4. Previous diagnosis of Raynaud's phenomenon

In planning care for a patient admitted for treatment of a connective tissue disorder, the nurse formulates the nursing diagnosis, "Self-care deficit related to decreased joint mobility secondary to an autoimmune response resulting in Boutonniere deformities" is most relevant for which disorder? 1. Fibromyalgia 2. Gout 3. Osteoarthritis 4. Rheumatoid arthritis

4. Rheumatoid arthritis

In providing care to a patient admitted for evaluation of a connective tissue disorder, the nurse formulates the nursing diagnosis "Self-Care Deficit related to joint deformities and pain secondary to pathological accumulation of collagen." This is most relevant to which disorder? 1. Fibromyalgia 2. Osteoarthritis 3. Rheumatoid arthritis 4. Scleroderma

4. Scleroderma

The registered nurse is teaching about the risk factors for developing osteoarthritis. Which risk factor is a modifiable risk factor? A. Obesity B. Increased age C. History of joint injury D. Genetic predisposition

A. Obesity

The nurse monitors for which clinical manifestations in the patient diagnosed with osteoarthritis? (Select all that apply.) A. Shortness of breath B. Decreased range of motion of affected joint C. Joint pain that improves with activity D. Warmth and swelling of affected joints E. Heberden's nodes

B, D, E

Which is a biological response modifier used to treat patients with systemic lupus erythematosus (SLE)? A. Clobetasol B. Belimumab C. Azathioprine D. Cyclophosphamide

B. Belimumab

The nurse is assessing a patient diagnosed with osteoarthritis who has been taking nonsteroidal anti-inflammatory drugs (NSAIDs) for 2 months. Which findings may indicate a complication due to NSAID use? Select all that apply. A. Elevated uric acid level B. Low albumin level C. Elevated creatinine level D. Low hemoglobin level E. Low blood urea nitrogen level

C, D

The registered nurse is teaching about systemic lupus erythematosus (SLE). Which statement by the nurse is incorrect? A. "It is important to avoid prolonged exposure to sun." B. "It is important to avoid immunizations with live vaccines." C. "It is important to perform vigorous exercises regularly." D. "If you have a history of phlebitis it is important to avoid the use of oral contraceptives."

C. "It is important to perform vigorous exercises regularly."

The nurse recognizes which patient to be at greatest risk for developing osteoarthritis? A. A 70-year-old African American male B. A 45-year-old Caucasian female C. A 65-year-old obese African American female D. A 30-year-old Caucasian male

C. A 65-year-old obese African American female

The charge nurse is reviewing prescriptions for anew patient who was admitted for shortness of breath and also has RA. It is a priority for the nurse to follow up with the provider about which order? A. Oxygen per nasal cannula 2 L/min B. Prednisone 5 mg by mouth every a.m. C. Methotrexate 25 mg by mouth every p.m. D. Hydroxychloroquine 200 mg by mouth twice daily

C. Methotrexate 25 mg by mouth every p.m.

A nurse is educating about the medications that can be administered to a patient with lupus. Which statement indicates a need for further teaching? A. Hydroxychloroquine B. Glucocorticoids C. Oral contraceptives D. Methotrexate

C. Oral contraceptives

A registered nurse is teaching about cyclophosphamide treatment in patients with systemic lupus erythematosus. Which complication or disease indicates a need for further teaching? A. Lupus nephritis B. Pulmonary hemorrhage C. Pneumonitis D. Systemic vasculitis

C. Pneumonitis