Osteoarthritis (OA)

The nurse is caring for client with OA. Which factor in the client's history and physial assessment would the nurse recognize as a risk factor for developing this condition? A) BMI of 36.5 B) History of esophageal reflux disease C) Client plays tennis three times/week D) BP of 136/78 mmHg

A) BMI of 36.5 Rationale: Obesity increases the risk of developing osteoarthritis (OA), because the added weight increases stress on weight-bearing joints, causing the joints to wear down more quickly. This client has a body mass index of 36.5, which is considered obese. Moderate recreational exercise (such as tennis three times per week) has been shown to decrease the chance of developing OA and slow the progression of manifestations when OA is present. Esophageal reflux is not associated with OA. Blood pressure is not a known risk factor for the development of OA.

Which assistive device should the nurse recommend to a client with OA of the hands? SATA A) Electric an opener B) Handrails C) Large-handled toothbrush D) Zipper hook E) Reacher device

A, C, D Rationale: Zipper hooks, electric can openers, and large-handled toothbrushes can be helpful for clients with OA of the hands. Handrails can be useful for clients with OA of the hips. Reacher devices can be helpful for clients with OA of the shoulders

The nurse is planning care for a client with OA. Which nursing diagnosis is a priority for the nurse to address? A) Skin Integrity, Impaired B) Lifestyle, Sedentary C) Pain, Chronic D) Family Processes, Interrupted

C) Pain, Chronic Rationale: Chronic pain is the priority problem for the nurse to address when planning care for a client diagnosed with osteoarthritis. Sedentary lifestyle would be a concern because exercise can help to address OA but would not be a priority nursing diagnosis. Skin integrity and impaired family processes are not expected problems for the nurse to address when planning care for a client diagnosed with OA.

A client with chronic hip pain is diagnosed with OA. Which instruction regarding home safety is most appropriate for the nurse to provide to this client? A) Walk up and down the steps at home as much as possible B) Rest in a recliner C) Place scatter rugs in high-traffic areas D) Install grab bars in the bathroom near the commode and in the shower.

D) Install grab bars in the bathroom near the commode and in the shower Rationale: The client should be encouraged to install grab bars in the bathroom near the commode and in the shower. The client should be instructed not to overuse the affected joints with excessive stair climbing. Scatter rugs are a hazard to mobility and should be avoided. The client should also be instructed to sit in a straight-back chair, avoid slumping, and avoid use of a recliner.

Which of the following procedures would be most appropriate to repair a finger joint that is affected by severe OA? A) Osteotomy B) Joint resurfacing C) Joint fusion D) Internal fixation

C) Joint fusion Rationale: Joint fusion is used to permanently fuse two or more bones together at a joint using pins, plates, screws, and rods. It is often recommended for badly damaged smaller joints, such as the spine, wrist, ankle, finger, or toe. Osteotomy is usually performed on the knee and hip and entails surgical removal of a wedge of bone above or below the joint to realign the joint and shift the weight away from the damaged portion of the joint. Joint resurfacing, which involves removing a small amount of bone at the articulating surface of the joint and fitting a metal replacement over the end of the bone, is often performed for hip and shoulder joints. Internal fixation is used to fix fractures, not to address osteoarthritis.

After performing a physical assessment, the nurse suspects that a client is experiencing manifestations of OA. Which finding supports the nurse's suspicion? SATA A) Joint tenderness B) Crepitation C) Joint stiffness D) Leg tremors E) Reduced joint flexibility

A, B, C, E Rationale: Manifestations of OA include crackling sounds, or crepitation, with joint movement; joint stiffness and tenderness; and reduced joint flexibility. Leg tremors can be associated with multiple sclerosis or Parkinson disease.

The nurse is counseling a newly pregnant client with OA. Which information should the nurse include? A) "Your pain from the OA may increase due to the weight gain of pregnancy." B) "Pregnancy has no impact on OA if you keep your weight gain within the recommended limits." C) "You may continue to take your prescription NSAID drug without any risk of harm to the fetus." D) "You need to restrict your participation in low-impact aerobic exercises."

A) "Your pain from the OA may increase due to the weight gain of pregnancy." Rationale: Weight gain of pregnancy may increase the pain resulting from OA due to the increased stress on the​ joints; this would be important information to include. The impact of nonsteroidal​ anti-inflammatory drugs, such as celecoxib​ (Celebrex), on the fetus is​ unknown; the nurse would not tell the client that it is safe to use.​ Low-impact aerobic exercises are recommended for clients with OA. The recommended weight gain for pregnancy would not be changed due to the​ OA, nor is it valid to indicate that pregnancy will have no impact on the OA.

The nurse is teaching a class about the joints commonly affected by OA. Which joints should the nurse include? A) Hands, knees, hips B) Neck, shoulders, ankles C) Ankles, feet, spine D) Knees, feet, spine

A) Hands, knees, hips Rationale: Hands, knees and hips are the most commonly affected joints of OA. Feet, spine, neck, shoulders, and ankles are not the most common locations.

The nurse is teaching an older adult recently diagnosed with OA about interventions to help maintain mobility of the joints. Which should the nurse include? A) Physical therapy B) Routine NSAID use C) Glucosamine and chondroitin supplements D) Jogging three times a week

A) Physical therapy Rationale: Physical therapy is particularly important for older adults with OA to help them maintain or improve joint mobility. NSAIDs should generally not be used by older adults due to the risks associated with their use. Older adults should use acetaminophen as a​ first-line drug and narcotics as a​ second-line choice. Jogging is a​ high-impact activity that could place more stress on the joints and would not be recommended. The utility of supplements has not been supported as​ effective; additionally, the use of glucosamine and chondroitin may increase the risk of bleeding.

The nurse is planning care for a client with OA of the hip. Which intervention would be appropriate for this client? A) Provide moist heat packs to the affected joint 3 times/day B) Instruct the client on the importance of strict bedrest C) Provide NSAIDs when pain becomes severe D) Provide opioid pain medication as prescribed

A) Provide moist heat packs to the affected joint 3 times/day Rationale: Interventions appropriate for a client with osteoarthritis (OA) include NSAIDs, moist heat, active range-of-motion exercises, proper posture and body mechanics, and assistive devices to safely maintain independence with activities of daily living. Opioid medication is not typically prescribed for the treatment of OA. NSAIDs are most effective if taken before the pain is severe. The client should be encouraged to be mobile, not on strict bedrest.

A client with possible OA is scheduled for synovial fluid analysis. The nurse should explain to the client that this diagnostic test is being completed for which reason? A) To rule out inflammatory arthritis and gout B) To determine the extent of joint damage C) To evaluate for increased density of subchondral bone D) To identify irregular joint space narrowing

A) To rule out inflammatory arthritis and gout Rationale: Joint fluid analysis is used to detect​ inflammation, bacteria, and uric acid crystals to rule out inflammatory arthritis and gout. This test will not provide information on the extent of the joint damage. This test cannot identify the amount of joint space that has narrowed. This test cannot evaluate bone density.

An older adult client with bilateral OA of the knees tells the nurse, "I know I need to lose weight, but exercising makes my knees ache." What instruction should the nurse provide to this client? A) "You should discuss knee replacement surgery with your physician." B) "Exercising the muscles in your legs might be hard now, but over time, it will help protect your knees." C) "Try eating a reduced-calorie diet for several months before attempting exercise." D) "You need to stretch your muscles, because stretching is the only form of exercise that improves OA."

B) "Exercising the muscles in your legs might be hard now, but over time, it will help protect your knees." Rationale: Encouraging exercise is an important aspect of nursing care for clients with osteoarthritis (OA). Exercise can increase flexibility, improve blood flow, and help clients lose weight. Over time, these factors can help protect the joints against further deterioration and pain. The nurse should not counsel the client to follow a reduced-calorie eating plan for several months before attempting exercise. The client may or may not want to have knee replacement surgery. Stretching is just one type of exercise that will benefit clients with OA. The other components, strengthening and aerobic exercise, can be obtained through walking, swimming, and isometric, isotonic, and resistive exercises.

Which of the following treatment options would least likely be considered for a 71 year old client with OA? A) Physical therapy B) Administration of NSAIDs C) Weekly tai chi sessions D) Administration of narcotics

B) Administration of NSAIDs Rationale: Acetaminophen is a first-line medication for older adults due to its efficacy and safety. Narcotics are a second-line choice, because they are safer than NSAIDs for older adults. Mindfulness exercises and complementary health approaches such as yoga or tai chi may assist older adults in increasing mobility and reducing pain levels. Physical therapy is especially important in older adults to maintain or improve mobility of joint(s).

A nurse is teaching the parents of a client who was recently diagnosed with osteoarthritis about their child's condition. Which statement by the parents indicates the need for further instruction? A) "Our daughters OA is likely related to a joint injury sh sustained last year." B) "Most kids with OA usually have only one or two affected joints." C) "Because our daughter developed OA as a child, she is more likely to become disabled as a result of this condition." D) "Our daughter may outgrow her OA as she ages."

C) "Because our daughter developed OA as a child, she is more likely to become disabled as a result of this condition." Rationale: Juvenile OA is usually secondary to a congenital abnormality, genetic condition, or joint injury. It typically occurs only in the one or two joints affected by the abnormality or injury. Children with OA are less likely to become disabled and may outgrow the condition as they age. Thus, the parents' statement about an increased likelihood of disability indicates the need for further instruction

A client with OA tells the nurse she has difficulty walking to the bathroom first thing in the morning. Which nursing action would assist this client? A) Suggesting a family member provide the client with a bedpan B) Discussing the option of residing in an assisted-living facility C) Consulting w/physical therapy for an assistive walking device such as a walker or cane D) Suggesting the client use a bedside commode

C) Consulting w/physical therapy for an assistive walking device such as a walker or cane Rationale: Assistive devices are items used to maintain, increase, or improve function. The client describes difficulty walking to the bathroom in the morning. The best intervention to help this client would be to consult with physical therapy for an assistive walking device such as a walker or cane. The use of a bedside commode or bedpan may help with the immediate need to use the bathroom, but the client will still have difficulty ambulating in the morning. The option of residing in an assisted-living facility might be premature for this client.

The nurse is assessing an older adult who has OA. Which finding indicates the impact of OA? A) Requesting a dose of acetaminophen to address joint pain B) Sitting in a soft chair and not getting up to greet the nurse C) Leaning on furniture while walking D) Asking the nurse to retrieve items from across the room

C) Leaning on furniture while walking Rationale: When assessing the client with​ OA, the nurse should observe how the client moves and ambulates. Noting that the client leans on furniture while walking indicates possible issues related to the OA. Asking the nurse to retrieve items from across the​ room, requesting a dose of​ acetaminophen, and not getting up when the nurse arrives do not provide any direct observable data to indicate the possible impact of OA on the client.

Which clinical manifestation of OA should the nurse include when teaching about OA? SATA A) Abrupt onset B) Mild fever C) Pain and stiffness at night D) Crepitus with movement of joint E) Joint pain with activity

C, D, E Rationale: Joint pain with​ activity, grating or crepitus noted with​ movement, and pain and stiffness with prolonged inactivity are general manifestations of OA. Mild fever is associated with rheumatoid​ arthritis, not OA. Osteoarthritis is a degenerative disease that develops over​ time, although symptoms may appear suddenly.

Which of the following procedures used in the treatment of OA involves removing a small amount of bone at the articulating surface of the joint and fitting a metal replacement over the end of the knee? A) Osteotomy B) Arthroplasty C) Arthroscopy D) Joint resurfacing

D) Joint resurfacing Rationale: In joint resurfacing, a small amount of bone is removed at the articulating surface of the joint and a metal replacement is fitted over the end of the bone. Osteotomy involves surgical removal of a wedge of bone above or below the joint to realign the joint and shift the weight away from the damaged portion of the joint. Arthroscopy entails insertion of a small fiber optic light source, magnifying lens, and camera into the joint to visualize the joint structures. Arthroplasty is total joint replacement, in which a surgeon removes the damaged joint surfaces and replaces them with plastic, metal, or ceramic prostheses.

Which is a common risk factor for OA? SATA A) Overuse of joints from sports or strenuous activities B) Autoimmune disorder C) Activities affecting weight-bearing joints D) Obesity E) Ingestion of large amounts of purine

A, C, D Rationale: Common risk factors for OA include obesity, overuse of joints from sports injuries or strenuous activities, and activities affecting weight-bearing joints. Rheumatoid arthritis is thought to be an autoimmune disorder. Ingestion of large amounts of purines is a risk factor for gout.

A client diagnosed with OA asks the nurse, "If I am losing the cartilage in my knees, why do my knees look larger?" Which response should the nurse give? A) "Sometimes inflammation increases the size of your knees or fluid buildup occurs." B) "The muscle mass is increasing as a result of the exercises you must do." C) "Although the cartilage is destroyed, you may be building up more bone in the knee." D) "Your knees have developed contractures, increasing the size of the knees."

A) "Sometimes inflammation increases the size of your knees or fluid buildup occurs." Rationale: Inflammation causes swelling of the knee​ joint, which makes the joint appear larger. Joint effusion or fluid buildup may also occur. An increase in bone or muscle tissue does not occur in osteoarthritis. Flexion contractures may develop with osteoarthritis of the knee​ joint, but this will not result in an increase in the size of the joint.

The nurse is providing teaching about home care for a client with OA of the knees. Which information should the nurse include? SATA A) Encouraging heavy lifting to maintain muscle strength B) Using assistive devices to minimize stress placed on affected joint C) Continuing activity with repetitive movement D) Taking pain medications as ordered E) Installing handrails in the bathroom

B, D, E Rationale: Taking pain medications as ordered will assist with pain management and allow the client to participate in daily activities. Installing handrails in the bathroom is information that the nurse should include when educating a client to keep the client safer during activities of daily living at home. The nurse should educate the client on the importance of using assistive devices to minimize joint stress. The nurse should instruct the client to avoid repetitive movement and to avoid heavy​ lifting, because these actions will increase pain and joint degeneration and will not improve physical mobility.

The nurse is providing teaching to the client recently diagnosed with OA. Which statement by the nurse is correct? A) "Osteoarthritis is most commonly seen in thin, small-built female clients." B) "Osteoarthritis is a result of joint inflammation." C) "Osteoarthritis occurs due to erosion of cartilage in the joints." D) "Osteoarthritis is a metabolic bone disease."

C) "Osteoarthritis occurs due to erosion of cartilage joints." Rationale: Osteoarthritis is characterized by progressive erosion of the cartilage within joints. It is not a metabolic bone disease; examples of such diseases include osteoporosis, osteomalacia, and Paget disease. Thin, small-built female clients are at increased risk for osteoporosis, not osteoarthritis. In fact, osteoarthritis is more commonly associated with obesity than with slight build. Finally, joint inflammation is a characteristic of rheumatoid arthritis, not osteoarthritis.

Which surgical treatment should the nurse anticipate may be offered to clients with OA who can't be managed with traditional treatment? SATA A) Joint fusion B) Arthroplasty C) Serum hyaluronic acid D) Cortisone therapy E) Osteotomy

A, B, E Rationale: Arthroplasty,​ osteotomy, and joint fusion are all surgical interventions indicated for a client with osteoarthritis. Serum hyaluronic acid is a diagnostic blood test for knee osteoarthritis and is not a surgical treatment. Cortisone therapy is not a surgical​ treatment; it is injected into the inflamed joint.

Lab results are back for a client who has limiting joint pain. Synovial fluid analysis shows no uric acid crystals or bacteria. The client asks what the test results mean. How should the nurse respond? A) "These test results mean that your joint pain is likely not cause by gout or septic arthritis." B) "These test results mean that your joint pain is likely not related to any form of arthritis." C) "These test results mean that your joint pain is likely caused by either rheumatoid arthritis or septic arthritis." D) "These test results mean that your joint pain is likely caused by either cancer of the joint or gout."

A) "These test results mean that your joint pain is likely not cause by gout or septic arthritis." Rationale: Gout is caused by the collection of uric acid crystals in a joint. The absence of uric acid crystals in the synovial fluid (joint fluid) makes gout unlikely. Septic arthritis is caused by infection, so the absence of bacteria makes sepsis unlikely. However, this test does not rule out osteoarthritis or rheumatoid arthritis, so these are still possible diagnoses. Although the nurse may provide information related to which conditions have been ruled out, providing a medical diagnosis is outside the nurse's scope of practice.

A 32 year old client who has limited hip joint damage from OA asks the nurse why an osteotomy is being performed rather than other procedures. Which response by the nurse provides the most accurate information? A) "This procedure can be done since you are young and healthy and your hip damage is limited." B) "This procedure prepares you for joint resurfacing and a total hip replacement later in life." C) "An osteotomy is much less invasive than all of the other procedures." D) "This procedure is usually tried first; arthroplasty will be done later if this doesn't work."

A) "This procedure can be done since you are young and healthy and your hip damage is limited." Rationale: An osteotomy is performed to realign the joint or to shift the joint load toward areas of less cartilage damage. It is used instead of joint replacement surgery if the client is​ young, healthy, and damage is limited to only one side of the joint. This would provide the most accurate explanation to the client. It is not indicated as a surgery to necessarily be done first before an​ arthroplasty, nor to prepare the client for joint resurfacing surgery.

A client with OA asks the nurse how to decrease wrist swelling. Which intervention should the nurse suggest? A) Using compression cold packs to provide a deeper cold to the wrist joint B) Encouraging use of assistive devices during daily activities to decrease stress on the joint C) Increasing ROM exercises for the joint to 3X/day D) Applying a warm towel to the wrist joint 3X/day for 20 minutes at a time.

A) Using compression cold packs to provide a deeper cold to the wrist joint Rationale: The use of deep cold can best help to address swelling. Increasing ROM exercises to 3 times a day is not the best approach to decrease​ swelling; ROM helps to maintain flexibility of the joint. Heat decreases pain and increases​ flexibility; it does not address swelling. Assistive device use can decrease stress on the joint to possibly prevent​ swelling, but it would not be the best approach to address swelling once it has occurred.

The nurse is teaching older adults with OA actions to effectively manage chronic pain. Which recommendation should the nurse include? SATA A) Using firm support in chairs and mattresses to properly align the body B) Teaching proper posture and good body mechanics for activities of mobility C) Encouraging resting painful joints D) Applying cool compresses to painful joints to reduce inflammation E) Limiting isometric exercises to reduce strain on the joints

A, B, C Rationale: ​Rationale: Chronic pain is frequently associated with OA. When joints are​ painful, they should be rested. The rest should be balanced with periods of​ activity, which will reduce joint stiffness. Using proper posture and good body mechanics places the body in proper alignment and offers the joints a neutral platform to perform range of motion activities. Firm chairs and mattresses assist the body in proper alignment. Heat should be applied to painful​ joints, which will increase joint mobility. Cool compresses may increase joint pain and will limit joint mobility. Isometric exercises strengthen muscle​ groups, which is important to provide additional strength in movement. Strong muscles will reduce strain on joints.

A client with OA of the knees and hips returns for a 3 month follow-up visit with the provider. The nurse calculates that the client's BMI is now 22. The client reports starting a water aerobics and running program 3x/week. The client is also using hot packs for edema for 20 minutes and cold packs for 40 minutes daily. After evaluating the client's actions, which follow up interventions should the nurse plan? SATA A) Reinforce the correct use of hot packs B) Suggest the client replace running with a lower impact exercise C) Explain the risk of injury associated with use of cold packs D) Advise the client to continue weight loss E) Congratulate the client on starting water aerobics

A, B, C, E Rationale: The nurse should congratulate the client on starting water aerobics because it is a low-impact exercise mode. The nurse should also congratulate the client on the weight loss. Note, however, that a BMI of 22 is ideal, so continued weight loss should not be encouraged. The client should be informed that using cold packs for more than 30 minutes may cause skin injury. The nurse should also reinforce that hot packs are used to decrease pain and ice packs are used for edema (swelling). Finally, the nurse should suggest that the client replace the high impact exercise of running with a lower impact exercise such as walking or biking.

The nurse is evaluating care provided to a client with OA. Which client statement indicates to the nurse that interventions for OA have been successful? A) "I had to take early retirement and now stay at home all day and rest my legs." B) "I am sleeping throughout the night and have not missed any work because of my knee pain." C) "I am moving from my two-story house into the first floor of my daughter's home so I won't have to walk steps anymore." D) "I changed my work hours so now I work part-time and have a nursing assistant who helps me bathe twice a week at home."

B) "I am sleeping throughout the night and have not missed any work because of my knee pain." Rationale: Expected outcomes for the care of a client with OA include independence with activities of daily living, minimal lifestyle impact because of OA, and controlled pain that allows for rest and sleep. Of the client statements provided, only the one about improved sleep and pain not interfering with work indicates achievement of these outcomes. A client who changes work hours and has a nursing assistant for bathing is experiencing a reduction in activities of daily living and a significant impact in lifestyle. A client who is moving in with a daughter is experiencing significant lifestyle impact. A client who retires early and stays at home all day is also experiencing a significant impact in lifestyle.

The nurse is evaluating a client who has OA of the hips and knees. Which statement by the client indicates progress toward meeting identified activity goals? A) "I've increased my running time to 30 minutes, 3 times a week and use orthotics in my shoes." B) "I've been able to manage my pain so that I can independently complete my daily activities." C) "I've been completing ROM exercises for all joints every other day." D) "I limit the use of acetaminophen unless I absolutely need it to decrease my risk of liver toxicity."

B) "I've been able to manage my pain so that I can independently complete my daily activities." Rationale: Successful management of pain so that the client with OA can independently complete daily activities indicates progress toward an important goal. ROM should be done every day for all joints. Acetaminophen should be used regularly to help avoid severe pain from occurring. Running is a​ high-impact activity that can increase stress on joints.​ Low-activity aerobic​ exercise, not​ high-impact exercise, should be included in activity goals for the client with OA

The nurse is planning care for a client with OA. Which nursing diagnosis would have the highest priority? A) Fatigue B) Chronic Pain C) Ineffective Coping D) Disturbed body image

B) Chronic Pain Rationale: When providing care to a client diagnosed with osteoarthritis, priority diagnoses would include Chronic Pain, Impaired Physical Mobility, and Self-Care Deficit. Thus, of the diagnoses identified for this client, Chronic Pain would be the highest priority. Once this diagnosis has been addressed, the nurse and client can focus on the lower priority diagnoses of Fatigue, Ineffective Coping, and Disturbed Body Image.

A client seeking treatment for severe knee pain has worked in a factory for 30 years in a position requiring repetitive lifting and carrying of 20-40lb boxes. Based on the client's history, the nurse should anticipate which initial recommendation from the multidisciplinary healthcare team? A) Joint replacement therapy B) Pharmacologic therapy C) Referral for a disability application D) Intermittent use of a cane

B) Pharmacologic therapy Rationale: Of these options, pharmacologic therapy would be the most likely initial intervention. Acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), and joint injections are all possible options. Joint replacement should be delayed as long as possible because artificial joints often require replacement within 15-20 years. There is not enough information to determine whether applying for disability is appropriate at this time. A cane is not indicated at this time.

Which of the following terms is used to describe OA that is caused by an underlying condition, such as injury, congenital malformation, or metabolic disease? A) Idiopathic B) Secondary C) Localized D) Generalized

B) Secondary Rationale: OA can be classified as either idiopathic or secondary. Idiopathic OA has no identifiable cause. Idiopathic OA can be further divided into localized or generalized, with localized OA affecting one or two joints and generalized OA affecting three or more joints. Secondary OA is caused by an underlying condition, such as injury; congenital malformation; metabolic, endocrine, or neuropathic disease; or other medical cause

Which health promotion activity supports a healthy lifestyle for clients with OA? SATA (*shit question alert*) A) Using soft chairs and recliners for rest B) Maintaining a normal weight C) Using proper body mechanics D) Using assistive devices as needed E) Increasing dietary intake of calcium

B, D *even after reading the rationale, I don't understand why C (Using proper body mechanics) wouldn't be correct? Rationale: Maintaining a normal weight places less strain on the joints than carrying additional weight. Assistive devices such as grab​ bars, a shower​ chair, or​ long-handled grippers help the client to maintain an independent lifestyle in safety. Using proper body mechanics during activities reduces stress on joints. Although calcium intake is essential for preventing​ osteoporosis, especially in older​ adults, increasing daily calcium intake does not have a positive effect on OA. Chairs and mattresses should provide support and help to maintain normal body alignment. Soft chairs and recliners do not provide such support.

A client diagnosed with localized idiopathic osteoarthritis asks the nurse what this means. Which response by the nurse provides the most accurate information? A) "Idiopathic OA, as compared with secondary OA, is caused by some kind of underlying condition." B) "Idiopathic refers to the fact that the OA has already progressed significantly in one or two joints." C) "Idiopathic OA has no identifiable cause; when it's localized, it only affects one or two joints." D "Idiopathic describes OA overall while localized indicates that it affects one body joint only."

C) "Idiopathic OA has no identifiable cause; when it's localized, it only affects one or two joints." Rationale: There are two types of​ OA, idiopathic and secondary. Idiopathic OA has no identifiable cause and can be further subdivided as localized or​ generalized, with localized indicating that the OA only affects one or two​ joints, so stating that it has no identifiable cause and is limited to one or two joints would be the most accurate response. Idiopathic OA is not due to an underlying condition. Idiopathic refers to​ cause, not progression of the disease. Idiopathic is not a term used in general for​ OA, nor does the term localized indicate that affected joints are either in the upper or lower torso.

The parents of a child newly diagnosed with juvenile OA are concerned about their child's future ability to be disability free and remain independent. Which information should the nurse give the parents? SATA A) "OA in children is usually idiopathic, making it difficult to determine how it will affect them as adults." B) "OA in children is generalized, thus impacting all joints and increasing possible impairment." C) "Children may outgrow OA as they age." D) "The amount of disability will depend on how well the OA is managed as a child." E) "Children with OA are less likely to become disabled."

C, E Rationale: Children with OA are less likely to become disabled as adults and may outgrow the OA as they age. It's not likely that children with OA will be disabled as adults.

Clients with OA can reduce their risk of further joint damage by doing which of the following? A) Applying topical analgesic creams as prescribed B) Avoiding movement of affected joints C) Taking acetaminophen or NSAIDs before joint pain becomes severe D) Receiving cortisone injections in affected joints no more than three times/year

D) Receiving cortisone injections in affected joints no more than three times/year Rationale: Because frequent use of corticosteroids can cause joint damage, clients should receive cortisone injections in affected weight-bearing joints no more than three or four times per year. Avoiding movement of affected joints does not reduce the risk of joint damage; rather, it worsens the effects of OA. Applying topical analgesics and taking acetaminophen and NSAIDs reduces the pain of OA but does not reduce the risk of further joint damage.