Chapter 34 RA Disorders Prep U

The nurse is performing an admission interview for a client with rheumatoid arthritis. Which finding will the nurse document as abnormal for this client? Select all that apply.

- joint swelling -weakness -stiffness -pain

A nurse is teaching a client about rheumatoid arthritis. Which statement by the client indicates understanding of the disease process?

"It will get better and worse again."

A client with fibromyalgia asks why physical therapy has been prescribed. Which response will the nurse make?

"It will help with the overall deconditioning that has occurred."

An older adult with rheumatoid arthritis limits going out with others because of the need to use a cane. Which response will the nurse make to this client?

"Look at the cane as maintaining your independence."

Which client is most likely to develop systemic lupus erythematosus (SLE)?

A 27-year-old Black female

A client is being discharged from the hospital after being diagnosed with and treated for systemic lupus erythematosus (SLE). What would the nurse not say when teaching the client and family information about managing the disease?

If you have problems with a medication, you may stop it until your next physician visit.

Which points should be included in the medication teaching plan for a client taking adalimumab?

It is important to monitor for injection site reactions.

The nurse instructs a client with polymyositis rheumatica (PMR) about prescribed corticosteroids. Which statement regarding corticosteroid is correct?

"I will take the medication until my health care provider tells me to stop."

A client with rheumatoid arthritis arrives at the clinic for a checkup. Which statement by the client refers to the most overt clinical manifestation of rheumatoid arthritis?

"My finger joints are oddly shaped."

A client asks the nurse what the difference is between osteoarthritis (OA) and rheumatoid arthritis (RA). Which response is correct?

"OA is a noninflammatory joint disease. RA is characterized by inflamed, swollen joints."

The nurse is teaching a client about rheumatic disease. What statement best helps to explain autoimmunity?

"Your symptoms are a result of your body attacking itself."

The nurse is preparing a teaching tool about the pathophysiology of systemic lupus erythematosus (SLE). Which immunoregulatory disturbance factors will the nurse include in this tool? Select all that apply.

-genetic -hormonal -immunological -environmental

Which term refers to fixation or immobility of a joint?

Ankylosis

What is the priority intervention for a client who has been admitted repeatedly with attacks of gout?

Assess diet and activity at home

The nurse is educating a client about the risks of stroke related to the new prescription for a COX-2 inhibitor and what symptoms to report. Which COX-2 inhibitor is the nurse educating the client about?

Celecoxib

The nurse intervenes to assist the client with fibromyalgia to cope with which symptoms?

Chronic fatigue, generalized muscle aching, and stiffness

The nurse is preparing to educate a client with rheumatoid arthritis on long-term effects of prednisone therapy. Which topic will the nurse include in the teaching?

Eat a lower calorie diet to manage weight gain.

Which joint is most commonly affected in gout?

Metatarsophalangeal

The nurse is discussing the new medication that a client will be taking for treatment of rheumatoid arthritis. Which disease-modifying antirheumatic drug (DMARD) will the nurse educate the client about?

Methotrexate

The nurse is caring for a client with ankylosing spondylitis (AS). Which medication will the nurse expect to be prescribed for this client?

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Which is the leading cause of disability and pain in the elderly?

Osteoarthritis (OA)

The nurse is caring for a client with palindromic rheumatism. The nurse knows that this type of rheumatism can lead to which diagnosis?

Rheumatoid arthritis

A client is taking ibuprofen for the treatment of osteoarthritis. What education will the nurse give the client about the medication?

Take the medication with food to avoid stomach upset.

Which term indicates an accumulation of crystalline depositions in articular surfaces, bones, soft tissue, and cartilage?

Tophi

The nurse is caring for a client with ankylosing spondylitis. Which educational information will the nurse provide to this client?

Use of analgesics

A nurse is caring for a client with a warm and painful toe from gout. What medication will the nurse administer?

colchicine

The nurse is gathering a health history for a client with osteoarthritis. What clinical manifestation will the nurse expect to find?

early morning stiffness

A client is being treated for hyperuricemia. Part of the treatment strategy is for the client to avoid contributing factors whenever possible. Which activities might bring on an acute attack?

eating organ meats and sardines

The presence of crystals in synovial fluid obtained from arthrocentesis is indicative of

gout

The nurse is discussing life management with the client with rheumatoid arthritis in a health clinic. What assessment finding indicates the client is having difficulty implementing self-care?

increased fatigue

Nursing care for the client with fibromyalgia should be guided by the assumption that patients with fibromyalgia

may feel as if their symptoms are not taken seriously.

The nurse is performing a health history with a new client with fibromyalgia. What will the nurse expect to assess as the most common finding associated with fibromyalgia?

widespread chronic pain

A nurse is preparing a client with systemic lupus erythematosus (SLE) for discharge. Which instruction should the nurse include in the teaching plan?

"Monitor your body temperature"

An older adult with rheumatoid arthritis says exercise was not effective. Which response will the nurse make to learn the reason for the failure of this treatment approach?

"What types of exercise were you doing?"

The nurse is performing a health history with a new client in the clinic. What is the most common reason for a client to seek medical attention for arthritis?

pain

A client with rheumatoid arthritis expresses not feeling the need to take medication any longersince being in remission without symptoms. What is the best response by the nurse?

"It is important that you continue to take your medication to avoid an acute exacerbation."

A nurse assesses a client in the health care provider's office. Which assessment findings support a suspicion of systemic lupus erythematosus (SLE)?

Facial erythema, pericarditis, pleuritis, fever, and weight loss

The nurse knows that a patient who presents with the symptom of "blanching of fingers on exposure to cold" would be assessed for what rheumatic disease?

Raynaud's phenomenon

A diet plan is developed for a client with gouty arthritis. What should the nurse advise the client to limit the intake of?

organ meats

Which of the following disorders is characterized by an increased autoantibody production?

Systemic lupus erythematosus (SLE)

A client is recovering from an attack of gout. What will the nurse include in the client teaching?

Weight loss will reduce uric acid levels and reduce stress on joints.

A client with osteoarthritis expresses concerns that the disease will prevent the ability to complete daily chores. Which suggestion should the nurse offer?

"Pace yourself and rest frequently, especially after activities."

Which assessment suggests to the nurse that a client with systemic lupus erythematous is having renal involvement?

Hypertension

The nurse is reviewing the diagnostic test findings of a client with rheumatoid arthritis. What would the nurse expect to find?

Elevated erythrocyte sedimentation rate

Which is an appropriate nursing intervention in the care of the client with osteoarthritis?

Encourage weight loss and an increase in aerobic activity

A client with gout has been advised to lose weight. The client informs the nurse of plans to go on a "guaranteed rapid weight loss" plan that involves fasting and heavy exercise. Which response would be most appropriate?

"There might be some difficulties with your plan and fasting."

The nurse is teaching a newly diagnosed client about systemic lupus erythematosus(SLE). What statement by the client indicates the teaching was successful?

"The belief is that it is an autoimmune disorder with an unknown trigger."

A client suspected of having systemic lupus erythematosus (SLE) is being scheduled for testing. The client asks which of the tests ordered will determine positivity for the disorder. Which statement by the nurse is most accurate?

"The diagnosis won't be based on the findings of a single test but by combining all data found."

A client with an acute exacerbation of arthritis is temporarily confined to bed. What position will the nurse recommend to prevent flexion deformities?

prone

The nurse is teaching a client with osteoarthritis about the disease. What is the most important client focus for disease management?

strategies for remaining active

The nurse is reviewing laboratory values for a client experiencing symptoms of systemic lupus erythematosus (SLE). Which findings indicate to the nurse that the client's symptoms are consistent with this condition? Select all that apply.

- positive anti-DNA antibody - Positive antinuclear antibody

A client with rheumatoid arthritis (RA) is prescribed a topical analgesic medication to help reduce joint pain. Which information will the nurse emphasize with the client about this medication? Select all that apply.

- avoid areas of open skin - use the medication sparingly - avoid contact with mucous membranes - wash hands after applying the medication

The nurse is assessing a patient with a diagnosis of scleroderma. What clinical manifestations of scleroderma does the nurse assess? (Select all that apply.)

- decreased ventilation owing to lung scarring - dysphagia owing to hardening of the esophagus - dyspnea oing to fibrotic cardiac tissue

The nurse is planning teaching for a client with gout. Which topics will the nurse include in the teaching? Select all that apply.

-weight loss -decreasing alcohol intake -avoiding purine rich foods

The nurse is caring for a client with rheumatoid arthritis who suffers with chronic pain in the hands. When would be the best time for the nurse to perform range-of-motion exercises?

After the client has had a warm paraffin hand bath