39 RA
A nurse practitioner is managing the care of a patient who has gout. Choose the medication that she would prescribe as the drug of choice to prevent tophi formation and promote tophi regression. Benemid Anturane Uloric Zyloprim
Zyloprim Explanation: Allopurinol (Zyloprim), a xanthine oxidase inhibitor, is considered the drug of choice for preventing the precipitation of an attack, preventing tophi formation, and promoting the regression of existing tophi. Uricosuric agents, such as probenecid (Benemid), correct hyperuricemia and dissolve deposited urate.
Which of the following disorders is characterized by an increased autoantibody production? Systemic lupus erythematosus (SLE) Scleroderma Rheumatoid arthritis (RA) Polymyalgia rheumatic
Systemic lupus erythematosus (SLE) Explanation: SLE is an immunoregulatory disturbance that results in increased autoantibody production. Scleroderma occurs initially in the skin but also occurs in blood vessels, major organs, and body systems, potentially resulting in death. Rheumatoid arthritis results from an autoimmune response in the synovial tissue, with damage taking place in body joints. In polymyalgia rheumatic, immunoglobulin is deposited in the walls of inflamed temporal arteries.
The nurse is caring for a patient who is being treated for fibromyalgia. What intervention will best assist the patient to restore normal sleep patterns? Increasing activity during the day Administering opioids at bed time Range-of-motion exercise prior to sleeping Tricyclic antidepressants
Tricyclic antidepressants Explanation: Tricyclic antidepressants and sleep hygiene measures are used to improve or restore normal sleep patterns in patients with fibromyalgia. Increasing activity during the day or using range-of-motion exercises will not increase the patient's ability to sleep. Narcotics are generally not needed for pain control with this disorder.
The treatment of gout involves managing the acute inflammatory stage, preventing flare-ups, and controlling hyperuricemia. Select the agent of first choice when an acute inflammatory attack begins. Colchicine Benemid Anturane Aloprim
Colchicine Explanation: Colchicine, along with indomethacin, ibuprofen, or a corticosteroid is prescribed to relieve an acute attack of gout. Benemid and Anturane increase the urinary excretion of uric acid, and Aloprim breaks down purines before uric acid is formed.
A nurse assesses a client in the physician's office. Which assessment findings support a suspicion of systemic lupus erythematosus (SLE)? Facial erythema, pericarditis, pleuritis, fever, and weight loss Photosensitivity, polyarthralgia, and painful mucous membrane ulcers Weight gain, hypervigilance, hypothermia, and edema of the legs Hypothermia, weight gain, lethargy, and edema of the arms
Facial erythema, pericarditis, pleuritis, fever, and weight loss Explanation: An autoimmune disorder characterized by chronic inflammation of the connective tissues, SLE causes fever, weight loss, malaise, fatigue, skin rashes, and polyarthralgia. Nearly half of clients with SLE have facial erythema, (the classic butterfly rash). SLE also may cause profuse proteinuria (excretion of more than 0.5 g/day of protein), pleuritis, pericarditis, photosensitivity, and painless mucous membrane ulcers. Weight gain, hypervigilance, hypothermia, and edema of the legs and arms don't suggest SLE.
A patient is hospitalized with a severe case of gout. The patient has gross swelling of the large toe and rates pain a 10 out of 10. With a diagnosis of gout, what should the laboratory results reveal? Glucosuria Hyperuricemia Hyperproteinuria Ketonuria
Hyperuricemia Explanation: Gout is caused by hyperuricemia (increased serum uric acid).
The presence of crystals in synovial fluid obtained from an arthrocentesis is indicative of gout. infection. inflammation. degeneration.
gout. Explanation: The presence of crystals is indicative of gout, and the presence of bacteria is indicative of infective arthritis.
A client is experiencing an acute exacerbation of rheumatoid arthritis. What should the nursing priority be? Providing comprehensive client teaching; including symptoms of the disorder, treatment options, and expected outcomes Administering ordered analgesics and monitoring their effects Performing meticulous skin care Supplying adaptive devices, such as a zipper-pull, easy-to-open beverage cartons, lightweight cups, and unpackaged silverware
Administering ordered analgesics and monitoring their effects An acute exacerbation of rheumatoid arthritis can be very painful, and the nurse should make pain management her priority. Client teaching, skin care, and supplying adaptive devices are important, but these actions don't not take priority over pain management.
Which of the following disorders is characterized by an increased autoantibody production? Systemic lupus erythematosus (SLE) Scleroderma Rheumatoid arthritis (RA) Polymyalgia rheumatic
Systemic lupus erythematosus (SLE) Explanation: SLE is an immunoregulatory disturbance that results in increased autoantibody production. Scleroderma occurs initially in the skin but also occurs in blood vessels, major organs, and body systems, potentially resulting in death. Rheumatoid arthritis results from an autoimmune response in the synovial tissue, with damage taking place in body joints. In polymyalgia rheumatic, immunoglobulin is deposited in the walls of inflamed temporal arteries.
The treatment of gout involves managing the acute inflammatory stage, preventing flare-ups, and controlling hyperuricemia. Select the agent of first choice when an acute inflammatory attack begins. Colchicine Benemid Anturane Aloprim
Colchicine Explanation: Colchicine, along with indomethacin, ibuprofen, or a corticosteroid is prescribed to relieve an acute attack of gout. Benemid and Anturane increase the urinary excretion of uric acid, and Aloprim breaks down purines before uric acid is formed.
A nurse is assessing a client with possible osteoarthritis. The most significant risk factor for primary osteoarthritis is: congenital deformity. age. trauma. obesity.
age. Explanation: Age is the most significant risk factor for developing primary osteoarthritis. Development of primary osteoarthritis is influenced by genetic, metabolic, mechanical, and chemical factors. Secondary osteoarthritis usually has identifiable precipitating events such as trauma.
Which of the following is an appropriate nursing intervention in the care of the patient with osteoarthritis? Provide an analgesic after exercise Encourage weight loss and an increase in aerobic activity Assess for the gastrointestinal complications associated with COX-2 inhibitors Avoid the use of topical analgesics
Encourage weight loss and an increase in aerobic activity Explanation: Weight loss and an increase in aerobic activity such as walking, with special attention to quadriceps strengthening are important approaches to pain management. Patients should be assisted to plan their daily exercise at a time when the pain is least severe, or plan to use an analgesic, if appropriate, prior to their exercise session. Gastrointestinal complications, especially GI bleeding, are associated with the use of nonsteroidal anti-inflammatory drugs (NSAIDs). Topical analgesics such as capsaicin and methylsalicylate may be used for pain management.
Fibromyalgia is a common condition that -Involves chronic fatigue, generalized muscle aching, and stiffness -Involves pain, viral infection, and tremors -Involves diminished vision, chronic fatigue, and reduced appetite -Involves generalized muscle aching, mood swings, and loss of balance
Involves chronic fatigue, generalized muscle aching, and stiffness Explanation: Fibromyalgia is a common condition that involves chronic fatigue, generalized muscle aching, and stiffness. The cause is unknown and no pathological characteristics have been identified that are specific for the condition. Treatment consists of attention to the specific symptoms reported by the patient. NSAIDs may be used to treat the diffuse muscle aching and stiffness. Tricyclic antidepressants are used to improve or restore normal sleep patterns and individualized programs of exercise are used to decrease muscle weakness and discomfort and to improve the general deconditioning that occurs in these individuals.
Which of the following is the definitive diagnostic of gouty arthritis? Polarized light microscopy of the synovial fluid Synovial biopsy Arthrocentesis Radiologic studies
Polarized light microscopy of the synovial fluid Explanation: A definitive diagnosis of gouty arthritis is established by polarized light microscopy of the synovial fluid of the involved joint. Synovial biopsy, arthrocentesis, and radiological studies aid in the diagnosis of rheumatoid arthritis.
Primary gout is often caused by an inherited disorder in which type of metabolism? Purine Carbohydrate Fat Glucose
Purine Explanation: Primary gout is often caused by an inherited disorder in purine metabolism. Primary gout is not a disorder of altered carbohydrate, fat, or glucose metabolism.
Which intervention should the nurse implement to manage pain for the client with rheumatoid arthritis? Select all that apply. Support joints with splints and pillows. Assist the client to develop a sleep routine. Provide diversional activities. Provide opportunities for the client to verbalize feelings. Provide assistive devices for self-feeding.
Support joints with splints and pillows. Provide diversional activities. Provide opportunities for the client to verbalize feelings. Explanation: To manage pain, the nurse maintains normal alignment of extremities as much as possible by supporting the joints with splints and pillows. Diversional activities distract the client's focus from the pain. Providing opportunities for the client to verbalize feelings facilitates coping with pain. Assistive devices for self-feeding help the client meet nutritional needs independently. Assisting the client to develop a sleep routine promotes rest and minimizes fatigue.
