Prep U's Chapter 38

The nurse is teaching a client about the characteristics of osteoarthritis. The nurse determines the client teaching was successful when the client states that which of the following may occur with osteoarthritis? A. clients may have swan neck deformity B. clients will have an ulnar deviation C. clients may develop heberden nodes D. clients will develop boutonniere deformity

clients may develop heberden nodes

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 of the following maybe the first and only physical sign of symptomatic osteoarthritis (OA)?

limited passive movement

A client with rheumatoid arthritis has experienced increasing pain and progressing inflammation of the hands and feet. What would be the expected goal of the likely prescribed treatment regimen? A. minimizing damage B. eliminating deformities C. promoting sleep D. eradicating pain

minimizing damage

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? A. I have trouble with my balance B. I have pain in my hands C. my finger joints are oddly shaped D. my legs feel weak

my finger joints are oddly shaped

Which condition is the leading cause of disability and pain in the elderly? A. systemic lupus erythematous B. scleroderma C. rheumatoid arthritis D. osteoarthritis

osteoarthritis

What intervention is a priority for a client diagnosed with osteoarthritis? A. allopurinol B. hydrotherapy C. physical therapy and exercise D. Colchicine

physical therapy and exercise

The nurse is constructing a teaching plan for the client newly diagnosed with scleroderma. What should the nurse include in the teaching plan? A. take all antibiotics until they are gone B. perform weight-bearing exercises daily C. protect the hands and feet from cold D. avoid sunlight and ultraviolet light

protect the hands and feet from cold

Which connective tissue disorder is characterized by insoluble collagen being formed and accumulating excessively in the tissues? A. scleroderma B.polymyalgia rheumatic C. rheumatoid arthritis D. systemic lupus erythematous

scleroderma

The nurse is teaching a client with osteoarthritis about the disease. What is the most important client focus for disease management? A. disease modifying antiheumatic drug therapy B. strategies for remaining active C. detection of systemic complications D. prevention of joint deformity

strategies for remaining active

The nurse is teaching a newly diagnosed client about systemic lupus erythematosus(SLE). What statement by the client indicates the teaching was successful? A. the belief is that it is an autoimmune disorder with an unknown trigger B. this disorder is more common in men in their thirties and forties than in women C. the symptoms are primarily localized to the skin but may involve the joints D. SLE has vey specific manifestations that make diagnosis relatively easy

the belief is that it is an autoimmune disorder with an unknown trigger

A nurse is preparing a client with systemic lupus erythematosus (SLE) for discharge. Which instruction should the nurse include in the teaching plan? A. monitor your body temperature B. corticosteroids may be stopped when symptoms are relieved C. exposure to sunlight will help control skin rashes D. there are no activity limitations between flare-ups

monitor your body temperature

A client with osteoarthritis expresses concerns that the disease will prevent the ability to complete daily chores. Which suggestion should the nurse offer? A. pace yourself and rest frequently, especially after activities B. do all your chores in the morning, when pain and stiffness are least pronounced C. Do all your chores after performing morning exercises to loosen up D. do all your chores in the evening, when pain and stiffness are least pronounced

pace yourself and rest frequently, especially after activities

The nurse teaches the client that the presence of crystals in the synovial fluid obtained from arthrocentesis confirms which disease process? A. Degeneration B. Gout C. Inflammation D. Infection

gout

The nurse is working with a client with systemic lupus erythematosus (SLE). What are the immune abnormalities characterized by SLE? Select all that apply. A. autoantibodies immune complexes B. susceptibility C. abnormal innate and adaptive immune responses D. damage E. inflammation

All are correct

The nurse is reviewing the medication administration record of the client. Which medication would lead the nurse to suspect that the client is suffering from an acute attack of gout? A. prednisone B. colchicine C. penicillamine D. methotrexate

B. colchicine

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? A. a weight gain of 2 pounds B. decreased joint pain C. increased fatigue D. ability to perform ADL's

C. increased fatigue

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

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? A. Etanercept (Enbrel) B. Infliximab (Remicade) C. Methotrexate (Rheumatrex) D. Methylprednisolone (Medrol)

Methotrexate (Rheumatrex)

Which of the following would a nurse encourage a client with gout to limit? A. Fluid Intake B. Purine-rich foods C. Carbohydrates D. Protein-rich foods

Purine-rich foods

Which of the following disorders is characterized by an increased autoantibody production? A. RA B. SLE C. scleroderma D. polymyalgia rheumatic

SLE

A client with rheumatoid arthritis has infiltration of the lacrimal and salivary glands with lymphocytes as a result of the disease. What does the nurse understand that this clinical manifestation is?

Sicca syndrome

Which of the following procedures involves a surgical fusion of the joint? A. arthrodesis B. osteotomy C. tenorrhaphy D. synovectomy

arthrodesis

The nurse is caring for a client with a new onset of gout. What medication does the nurse anticipate will be ordered by the health care provider? A. probenecid B. anturane C. allopurinol D. colchicine

colchicine

A client comes to the emergency department complaining of pain in the right leg. When obtaining the history, the nurse learns that the client has a history of obesity and hypertension. Based on this information the nurse anticipates the client having which musculoskeletal disorder? A. muscular dystrophy B. scoliosis C. Paget's disease D. degenerative joint disease

degenerative joint disease

Osteoarthritis is known as a disease that

is the most common and frequent disabling of joint disorders

The nurse is completing a health history with a client in a clinic. What assessment finding best correlates with a diagnosis of osteoarthritis? A. anorexia and weight loss B. fever and malaise C. erythema and edema over the affected joint D. joint stiffness that increases with activity

joint stiffness that increases with activity

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? A. after the client has a diagnostic test B. after cool compresses have been applied to the hands C. first thing in the morning when the client wakes D. after the client has had a warm paraffin hand bath

after the client has had a warm paraffin hand bath

Which of the following refers to fixation of a joint?

ankylosis

Which term refers to fixation or immobility of a joint?

ankylosis

A client with osteoarthritis asks for information concerning activity and exercise. When assisting the client, which concept should be included? A. exercising the evening before going to bed is beneficial B. the time of day when exercising is performed isn't important C. exercising immediately upon awakening allows the client to participate in activities when he has the greatest amount of energy D. delaying exercise for at least 1 hour after awakening allows the client to participate in exercise after some of the morning-related stiffness has subsided

delaying exercise for at least 1 hour after awakening allows the client to participate in exercise after some of the morning-related stiffness has subsided

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? A. high carbohydrate intake B. frequently drinking coffee C. frequently ingesting salicylates D. eating organ meats and sardines

eating organ meats and sardines

Which is an appropriate nursing intervention in the care of the client with osteoarthritis? A. assess for gastrointestinal complications associated with COX-2 inhibitors B. Avoid the use of topical analgesics C. Provide an analgesic after exercise D. Encourage weight loss and an increase in aerobic activity

encourage weight loss and an increase in aerobic activity

Which points should be included in the medication teaching plan for a client taking adalimumab? A. The medication is administered intramuscularly B. The client should continue taking the medication if fever occurs C. it is important to monitor for injection site reactions D. The medication is given at room temperature

it is important to monitor for injection site reactions

A client asks the nurse how to identify rheumatoid nodules with rheumatoid arthritis. What characteristic will the nurse include? A. tender to the touch B. reddened C. located over bony prominence D. nonmovable

located over bony prominence

The nurse is assessing a client with a history of ankylosing spondylitis. What will the nurse most commonly assess? A. low back pain B. red, butterfly shaped facial rash C. increased urine output D. patchy hair loss on the scalp

low back pain

Nursing assessment findings reveal joint swelling and tenderness and a butterfly rash on the face. The nurse suspects which of the following? A. scleroderma B. Ankylosing spondylitis C. fibromyalgia D. systemic lupus erythematous

systemic lupus erythematous

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? A. widespread chronic pain B. jaw locking C. butterfly facial rash D. heberden nodes

widespread chronic pain

A nurse is managing the care of a client with osteoarthritis. What is the appropriate treatment strategy the nurse will teach the about for osteoarthritis? A. administration of opioids for pain control B. vigorous physical therapy for joints C. administration of non steroidal anti-inflammatory drugs D. administration of monthly intra-articular injections of corticosteroids

administration of non steroidal anti-inflammatory drugs

A client was seen in the clinic for musculoskeletal pain, fatigue, mood disorders, and sleep disturbances. The physician has diagnosed fibromyalgia. What would not be a part of teaching plan for this condition? A. applications of ice B. regular exercise and stress reduction C. avoiding caffeine and alcohol D. encouraging the client to eat a healthy diet

applications of ice

The nurse intervenes to assist the client with fibromyalgia to cope with which symptoms? A. pain, viral infection, and tremors B. Generalized muscle aching, mood swings, and loss of balance C. Diminished vision, chronic fatigue, and reduced appetite D. Chronic fatigue, generalized muscle aching, and stiffness

chronic fatigue, generalized muscle aching, and stiffness

A client with rheumatoid arthritis comes to the clinic for a second dose of etanercept. The dose prescribed is 25 mg subcutaneously. The medication is available in 50 mg per milliliter. How many milliliters will the nurse administer to the client? Record your answer using one decimal place.

0.5

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? A. Pain B. Weakness C. Stiffness D. Joint Swelling

pain

Which client is most likely to develop systemic lupus erythematosus (SLE)? A. 25 yo white male B. 25 yo jewish female C. 35 yo hispanic male D. 27 yo black female

27 yo black female

Nursing care for the client with fibromyalgia should be guided by the assumption that patients with fibromyalgia A. all have the same type of symptoms B. may feel as if their symptoms are not taken seriously C. rarely respond to treatment D. will eventually lose their ability to walk

may feel as if their symptoms are not taken seriously

The client with an inflamed knee scheduled to have an arthrocentesis asks the nurse what the synovial fluid will look like. What is the best response by the nurse? A. the fluid will be straw colored B. the amount fo fluid will be scant in volume C. the fluid will be clear and pale D. the fluid will be milky, cloudy, and dark yellow

the fluid will be milky, cloudy, and dark yellow

A client is experiencing an acute exacerbation of rheumatoid arthritis. What should the nursing priority be? A. administering ordered analgesics and monitoring their effects B. providing comprehensive client teaching; including symptoms of the disorder, treatment options, and expected outcomes C. performing meticulous skin care D. 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

The nurse is gathering a health history for a client with osteoarthritis. What clinical manifestation will the nurse expect to find? A. joint pain that increases with rest B. early morning stiffness C. subcutaneous nodules D. small joint involvement

early morning stiffness

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? A. Maintain a well-balanced diet and increase fluid intake to raise energy levels and promote tissue healing B. pace activities C. if you have problems with a medication, you may stop it until your next physician visit D. avoid sunlight and ultraviolet radiation

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