Med Surg EAQ Ch. 44
Which is a risk factor for osteoporosis?
Fair skin
Which symptom is associated with rheumatoid arthritis (RA)?
Joint pain aggravated by movement
Which joint is the most common source of disability with osteoarthritis?
Knee
Which procedure uses special balloons inserted into the vertebra to create spaces that can be filled with cement to correct spinal deformity and restore lost height?
Kyphoplasty
Which laboratory result would be found in a patient with osteoarthritis?
Synovial fluid containing few or no leukocytes
Which connective tissue disease causes Raynaud phenomenon, painless swelling or thickening of the skin, taut and shiny skin, morning stiffness, frequent reflux of gastric acid, difficulty swallowing, weight loss, and dyspnea?
Systemic sclerosis
Which treatment options are available for a patient with rheumatoid arthritis? Select all that apply.
1. Rest 2. Surgery 3. Drug therapy 6. Physical therapy
The nurse is discussing calcium needs with a 75-year-old female patient. The patient asks how much calcium her husband, who is also 75 years old, would need. Which answer would the nurse provide?
"Men and women of your age need 1200 mg of calcium a day."
Which assessments after arthroplasty of the right knee are normal? Select all that apply.
1. Pedal pulses palpable bilaterally 2. 1+ edema noted in operative extremity 3. Capillary refill less than 3 seconds in metatarsals
The licensed practical nurse (LPN) is participating in a care planning session with the registered nurse (RN) about a patient with sudden onset of severe pain in the great toe with a diagnosis of gout. Which conditions would be included on the care plan? Select all that apply.
2. Acute, severe pain 4. Difficulty with physical mobility 5. Lack of knowledge of needed dietary changes
Which statements are true of rheumatoid arthritis? Select all that apply.
2. Anorexia and weight loss are standard features. 3. Large lesions that ulcerate may appear on the legs. 5. The distal interphalangeal and metacarpophalangeal joints are affected most often. 6. Pleural effusions and pulmonary fibrosis can lead to respiratory impairment, pulmonary hypertension, and congestive heart failure.
Which statements correctly describe medical treatment for rheumatoid arthritis? Select all that apply.
2. Janus kinase (JAK) inhibitors act on the immune system to stop the inflammatory process. 3. The maximal effect of disease-modifying antirheumatic drugs (DMARDs) can take 2 to 6 months. 5. Methotrexate sodium is a nonbiologic DMARD that is very effective for symptom relief. 6. NSAIDs, glucocorticoids, and DMARDs are often prescribed for about 3 months for aggressive prevention of deformities.
Which patient teaching would the nurse include for the patient taking alendronate sodium? Select all that apply.
2. Sit for at least 30 minutes. 3. Take with 6 to 8 ounces of water. 5. Esophageal stricture would be a contraindication to taking the medication. 6. The medication acts by increasing bone mineral density and impairing bone resorption.
Which factors relate to secondary osteoarthritis? Select all that apply.
2. Trauma 5. Infection 7. Corticosteroid therapy
During discharge planning for a patient with osteoarthritis, the nurse would include which issues that could occur at home? Select all that apply.
3. Difficulty caring for self 4. Reduced mobility in the home 5. Difficulty coping with the illness
Which statements accurately describe medical treatment for gout? Select all that apply.
3. Uricostatic agents, including allopurinol and febuxostat, prevent urate formation. 4. When a single joint is affected, prednisone might be injected directly into the joint. 6. Colchicine can be given hourly until either the symptoms ease or a patient develops diarrhea and vomiting.
Which patient needs to increase elemental calcium intake to decrease the risk for osteoporosis?
A 30-year-old patient who is postoophorectomy and taking 1000 mg per day
Which is the best description of rheumatoid arthritis (RA)?
A chronic, progressive inflammatory disease
Compression of the median nerve of the wrist is which connective tissue disorder?
Carpal tunnel syndrome
Which is the most serious complication for a postoperative patient with a hip or knee replacement?
Deep vein thrombosis
After assessing a patient with a knee replacement, the nurse notes tenderness, swelling, redness, warmth, and firm, palpable blood vessels in the operative extremity. These signs and symptoms indicate which complication?
Deep vein thrombosis (DVT)
Which occurs in osteoarthritis?
Deterioration of the articular cartilage
Which test would be ordered to confirm osteoporosis?
Dual-energy x-ray absorptiometry (DXA) of the spine and hip
Which body part is most likely to develop osteoarthritis?
Hips
Which direction would be given to a patient starting alendronate for osteoporosis?
Make sure to take the pill on an empty stomach.
Which person has the highest risk of developing osteoarthritis?
Obese
Which condition has a normal erythrocyte sedimentation rate (ESR)?
Osteoarthritis
Which assessment after arthroplasty of the right knee is abnormal?
Patient rates pain 8 out of 10, 30 minutes after receiving oxycodone
Which osteoporosis medication targets a chemical in the immune system and may cause low blood calcium levels and increased risk of infection?
Prolia
Which laboratory value would the nurse expect to be elevated in a patient with gout?
Serum uric acid
Which food would a patient with gout be advised to avoid?
Scallops
Which is the most appropriate nursing instruction to give to the nursing assistant completing basic care for a patient with progressive systemic sclerosis (PSS)?
Use a bed cradle to keep linens off the patient's body while in bed.
Which measure lowers the risk of the formation of a deep vein thrombosis after hip or knee replacement surgery?
Wearing antiembolic stockings
The nurse explains that pain relief and joint flexibility are goals of the process of therapy for rheumatoid arthritis (RA). Which exercises would be beneficial?
Yoga, cycling, aquatics, aerobics, and walking
