Musculoskeletal EAQ

A patient is experiencing osteoarthritis. Which finding on the x-ray report of a patient experiencing osteoarthritis indicates that the patient is developing a permanent limitation of motion?

Joint-space narrowing

The nurse is assessing a patient suspected of having fibromyalgia. Which sites should the nurse assess for tenderness? Select all that apply.

Knee Low cervical area

When reinforcing health teaching about the management of osteoarthritis, the nurse determines that the patient needs additional instruction after making which statement?

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

The nurse suspects that a patient is at a high risk of developing osteoporosis. The nurse made this conclusion based on which statement made by the patient?

"I do not perform any weight-bearing exercises."

The nurse is completing an admission history for a patient with osteoarthritis who has been admitted for a knee arthroplasty. When the nurse asks the patient why the procedure is being performed, what does the nurse anticipate the patient will state?

"I have chronic knee pain."

A patient with systemic lupus erythematosus (SLE) reports a low-grade fever and malaise. What response by the nurse would be the most appropriate?

"Please schedule a sick visit with the healthcare provider."

As a part of discharge teaching, the nurse has explained to a patient with osteoarthritis about the disease and its treatment. Which statements by the patient indicate the need for furthering education? 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."

The patient with fibromyalgia has pain at 12 of the 18 identification sites, including the neck and upper back and the knees. The patient also reports nonrefreshing sleep, depression, and being anxious when dealing with multiple tasks. About what treatments should the nurse teach this patient? Select all that apply.

-Antiseizure drug pregabalin -Low-impact aerobic exercise -Relaxation strategy (biofeedback) -Serotonin reuptake inhibitor (e.g. sertraline)

The nurse is reviewing the laboratory results for a patient to differentiate between rheumatoid arthritis and osteoarthritis. What findings does the nurse anticipate will correlate with both? Select all that apply.

-Elevated erythrocyte sedimentation rate -Narrowed joint space on x-ray examination

A patient is admitted to the hospital with Boutonnière deformity. What are the signs and symptoms that the nurse is likely to find during assessment? Select all that apply.

-Flexion of proximal interphalangeal joint -Hyperextension of the distal interphalangeal joint

The nurse is planning the discharge teaching for a patient with rheumatoid arthritis. Which alternative therapies should the nurse suggest? Select all that apply.

-Hypnosis -Use of a firm mattress -Transcutaneous electrical nerve stimulation

A patient recently diagnosed with osteoporosis is concerned about getting a bone fracture. On what preventive measures would the nurse educate the patient? Select all that apply.

-Increase exposure to sunlight to at least 20 minutes a day -Conduct weight-bearing exercises, such as tennis or walking -Eat foods such as cottage cheese, sardines, and turnip greens

A nurse is reviewing subjective and objective data from the examination of a patient with rheumatoid arthritis. Which assessment findings indicate rheumatoid arthritis? Select all that apply.

-Joint stiffness -Rheumatoid nodules -High white blood cell (WBC) count

A nurse caring for a patient with osteoarthritis instructs the patient about the various nonpharmaceutical interventions for the management of pain. Which information should the nurse include in these instructions? Select all that apply. <p>A nurse caring for a patient with osteoarthritis instructs the patient about the various nonpharmaceutical interventions for the management of pain. Which information should the nurse include in these instructions? <b>Select all that apply.</b> </p>

-Use of paraffin baths or hot packs -Use of crutches or walker if required -Regulation of a normal body mass index (BMI)

When caring for a patient with systemic lupus erythematosus, the nurse recognizes which major and serious complication of the disorder?

Renal failure

During a health screening event, which assessment finding would alert the nurse to the possible presence of osteoporosis?

A measurable loss of height

The nurse is educating a patient about the prevention of osteoarthritis. What information would be most beneficial for the nurse to discuss with the patient? Select all that apply.

Avoiding smoking Maintaining a healthy weight Promptly treating any joint injury

The nurse teaches a patient with osteoporosis about dietary modifications to improve calcium intake. Which patient food choices indicate the need for additional teaching?

Boiled egg, carrot and lettuce salad, and a fresh cut apple

The nurse is performing an assessment for a patient with suspected systemic lupus erythematosus (SLE). Which finding would the nurse determine is due to Raynaud's phenomenon?

Cyanosis of fingers

A patient with osteoporosis has a history of multiple fractures. Which prescription should the nurse question the health care provider about that is contraindicated in this patient?

Corticosteroids

A nurse is assessing a patient with osteoarthritis. What finding would be expected with this disorder?

Crepitation in the weight-bearing joints

The nurse is caring for a patient with osteoarthritis. What statement made by the patient demonstrates accurate knowledge of the disorder?

Degeneration of cartilage in synovial joints

The community health nurse is teaching a group of adults about prevention of osteoarthritis (OA). What important teaching points should the nurse include? Select all that apply.

Eat a balanced diet. Avoid cigarette smoking. Maintain a healthy weight.

The nurse is caring for a patient diagnosed with fibromyalgia. What action should the nurse consider while caring for this patient?

Encouraging the patient to reduce the intake of coffee and alcohol

The nurse is reinforcing health teaching about osteoporosis with a patient admitted to the hospital. In reviewing this disorder, what should the nurse explain to the patient?

Even with a family history of osteoporosis, the calcium loss from bones can be slowed by increased calcium intake and exercise.

A patient reports to a rheumatology clinic with a swan neck deformity of the fingers of the left hand and is referred for laboratory testing for systemic lupus erythematosus (SLE). The patient calls back several days later saying, "The healthcare provider must be wrong. This has to be arthritis like my mother has." What is the nurse's best response?

Explain that arthritis is not the only medical condition that can cause joint deformities.

A common diagnostic feature of systemic lupus erythematosus (SLE) is the malar rash, which is characterized by what features?

Fixed erythema, flat or raised, usually in a butterfly pattern

the nurse reviews the laboratory reports of an obese patient who is diagnosed with gout. Which finding does the nurse associate with the patient's condition?

Hyperuricemia

The nurse is reinforcing health teaching about osteoporosis with a patient admitted to the hospital. Which risk factors for osteoporosis should the nurse include in the discussion? Select all that apply.

Smoking Asian descent Sedentary lifestyle

Which stage of rheumatoid arthritis does the nurse determine a patient is in who has extensive muscle atrophy and joint deformity?

Stage III

A patient is receiving alendronate for treatment of osteoporosis. The nurse should provide education after noting which action by the patient?

Takes the medication immediately before bed

A patient with gout asks the nurse why a low-purine diet is recommended. What explanation should the nurse provide?

The metabolism of purine results in the formation of uric acid.

The nurse is creating a plan of care for a patient with osteoarthritis. What would the nurse plan as an appropriate short-term goal for this patient?

The patient will participate in physical therapy activities.

A patient with osteoarthritis of the knees has been taking celecoxib 200 mg every 12 hours. The patient states that the drug does not seem to work as well as it used to in controlling the pain. What does the nurse infer from the patient's statement?

This patient may respond better to an alternate nonsteroidal antiinflammatory drug (NSAID).

A nurse provides instructions to a caregiver of an 88-year-old with severe osteoporosis. What should the nurse include in the education about how to reduce the risk of falls in the home? Select all that apply.

Use night-lights. Use toilet grab bars. Use colored step strips. Use railings on the stairway.