osteoarthritis and rheumatoid arthritis eaq quiz

Which nonpharmaceutical interventions may help to manage pain for a patient with osteoarthritis? Select all that apply.

- use of paraffin baths or hot packs - use of crutches or walked if required - regulation of a normal body mass index (BMI)

Which instructions will the nurse include when teaching a group of caregivers about the home care of a patient with rheumatoid arthritis (RA)? Select all that apply.

- never place pillows below the knees - perform aquatic exercise in warm water - use lifts and elevators instead of the stairs

In which order should the nurse perform interventions for a patient recently diagnosed with rheumatoid arthritis (RA)? Place the options in order of importance.

1. perform a careful physical assessment 2. evaluate psychosocial needs and environmental concerns 3. educate patient about pharmacologic interventions 4. coordinate a carefully planned program for rehabilitation and education

Which medication therapy may be initiated for a patient receiving long-term nonsteroidal antiinflammatory drug (NSAID) therapy for osteoarthritis who develops gastrointestinal bleeding and erosion?

chloroquine

The nurse will chart which score according to rheumatoid arthritis classification criteria for a patient who reports joint pain in six small joints going on for four weeks and has a high positive rheumatoid factor (RF) and abnormal erythrocyte sedimentation rate (ESR)?

7

Which stage of rheumatoid arthritis (RA) is associated with extensive cartilage loss and joint deformity?

III

Which condition may occur if treatment for Lyme disease is delayed?

arthritis

Which definition describes osteoarthritis (OA)?

degeneration of articular cartilage in synovial joints

Which actions help to reduce the risk of osteoarthritis? Select all that apply.

- avoiding forceful, repetitive movements - maintaining a healthy body mass index (BMI)

For which parameters will the nurse monitor in a patient who is taking systemic hydrocortisone for the treatment of arthritis? Select all that apply.

- body weight - BP - potassium level

Which instructions will the nurse include when teaching a patient with arthritis about ways to protect the small joints? Select all that apply.

- carry your laundry basket in both arms - slide objects instead of picking them up - use doorknobs that pushed rather than turned

Which instructions will the nurse include when teaching a group of adults about prevention of osteoarthritis (OA)? Select all that apply.

- eat a balanced diet - avoid cigarette smoking - maintain a healthy weight

Which diagnostic tests are indicative of rheumatoid arthritis (RA) and osteoarthritis (OA)? Select all that apply.

- elevated erythrocyte sedimentation rate (ESR) - narrowed joint space on x-ray examination

Which patient statement indicates the need for further teaching about the management of osteoarthritis (OA)?

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

Which patient statement indicates understanding of teaching about osteoarthritis of the knees?

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

Which patient statement indicates the need for further teaching about the management of osteoarthritis?

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

Which patient statements indicate the need for furthering teaching about osteoarthritis (OA) and its treatment? 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."

Which diagnostic tests help to determine the severity of osteoarthritis and plan the course of treatment? Select all that apply.

- CT scan - MRI

Which questions will the nurse ask when assessing a patient with rheumatoid arthritis? 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 will inform a patient who has been prescribed topical diclofenac sodium to take which precautions with its use? Select all that apply.

- avoid exposure to sunlight - do not coadminister with oral aspirin

Which interventions will the nurse include in the plan of care for a patient with septic arthritis to prevent joint destruction and bone loss? Select all that apply.

- explain need of antibiotics to patient - support the patient who requires operative drainage - assist in early identification of the causative organism - assess and monitor joint inflammation, pain, and fever - suggest use of resting splints to immobilize affected joints

The nurse reviews the diagnostic results of a patient with rheumatoid arthritis (RA) and expects which findings? Select all that apply.

- high C-reactive protein (CRP) - increased erythrocyte sedimentation rate (ESR) - increased white blood cell count of the synovial fluid

Which factors contribute to an increased risk for developing 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

Which alternative therapies will the nurse suggest for a patient with rheumatoid arthritis? Select all that apply.

- hypnosis - use of a firm mattress - transcutaneous electrical nerve stimulation

Which medications may be prescribed for a patient with mucocutaneous lesions, urethritis, and conjunctivitis? Select all that apply.

- ibuprofen - methotrexate - sulfasalazine

Which assessment findings may be associated with rheumatoid arthritis (RA)? Select all that apply.

- joint stiffness - dry, itchy eyes - rheumatoid nodules - mouth infection and dental caries - high white blood cell count (WBC) count

How does gender factor into the prevalence of osteoarthritis (OA)? Select all that apply.

- men experience hip OA more often than women - women have a higher incidence of hand OA than men

Which synovial fluid analysis findings are suggestive of rheumatoid arthritis? Select all that apply.

- presence of fibrin checks - elevated white blood cell count - increased MMP-3 enzyme

Which interventions will the nurse include in the plan of care for a patient with gout? Select all that apply.

- provide warm compresses - decrease joint mobilization - encourage increased oral water intake

Which medication instructions does the nurse provide for a patient with osteoarthritis who is initiating treatment with celecoxib? Select all that apply.

- report persistent headaches - take with food or milk - monitor BP - report tarry stools or bruising

Which symptoms are associated with Reiter's syndrome? Select all that apply.

- urethritis - cervicitis - conjuntivitis - mucocutaneous lesions

Which action will the nurse include when caring for a patient with osteoarthritis (OA) who is taking sulfasalazine and reports an orange discoloration of the urine?

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

Which instructions will the nurse include when teaching a 30-year-old female patient with severe rheumatoid arthritis (RA) about taking prescribed methotrexate for disease management?

Use effective contraception during and three months after treatment with methotrexate.

Which assessment finding may be related to osteoarthritis (OA)?

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

Which arthritic disorder is transmitted by the bite of an infected deer tick?

lyme disease

Which diagnosis does the nurse expect for a patient who has been bitten by a tick and has a "bullseye rash" at the site?

lyme disease

Which instruction will the nurse include when teaching a patient with osteoarthritis (OA) about taking prescribed ibuprofen 800 mg every eight hours for pain?

try to take ibuprofen with food

Which medication used to treat arthritis must be used at regular intervals for maximal effect?

capsaicin cream

Which clinical manifestation is associated with osteoarthritis (OA)?

crepitation in the weight-bearing joints

Which assessment finding may be associated with osteoarthritis of the knees?

crepitus upon movement of knee joints

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

crepitus with knee movement

Which activity pattern may help to manage osteoarthritis (OA)?

walking and swimming regularly

Which type of nodules occur on the distal interphalangeal (DIP) joints of the fingers in a patient with osteoarthritis (OA)?

herberden's nodes

Which description is associated with osteoarthritis (OA)?

degeneration of cartilage in synovial joints

Which activity helps to protect the joints for a patient who has osteoarthritis (OA) of the knees?

eat a well-balanced diet to maintain a healthy body weight

Which intervention is beneficial for protecting the joints in a patient who has bilateral osteoarthritis of the knees?

exercise regularly and maintain a well-balanced diet

Which findings are associated with stage III rheumatoid arthritis (RA)?

extensive cartilage loss on x-ray

Serum analysis of uric acid levels is used in the diagnosis of with which condition?

gout

Which complication from corticosteroid use can worsen the problem of decreased bone density in a patient with rheumatoid arthritis (RA)?

osteopenia

Which knee assessment finding does the nurse expect for a patient who has osteoarthritis of the knees?

pain with joint movement

Which knee assessment finding does the nurse expect for patient who is scheduled for knee arthroscopy related to osteoarthritis (OA)?

pain with joint movement

The nurse will suggest which action for a patient with osteoarthritis?

participate in physical therapy activities

Which activity pattern will the nurse suggest for a patient with osteoarthritis (OA)?

regular exercise program that involves walking

Which diagnosis does the nurse expect for a patient with fever who reports fatigue, joint pain, and stiffness, especially in the morning lasting approximately three hours?

rheumatoid arthritis

Which condition is a complication of gout?

secondary osteoarthritis (OA)

Which condition may be associated with dry eyes and a decrease in the amount of saliva being produced?

sjogren's syndrome

Which explanation will the nurse provide about the importance of a low-purine diet for a patient with gout?

the metabolism of purine results in the formation of uric acid

Which patient condition may indicate that celecoxib should be prescribed for treatment of osteoarthritis?

the patient does not tolerate traditional NSAIDs

Which explanation will the nurse provide for a patient with osteoarthritis of the knees who tells the nurse that the celecoxib 200 mg they have been taking every 12 hours does not seem to work as well as it used to in controlling the pain?

you may respond better to an alternate NSAID