Adult Health Final

A client has a diskectomy and fusion for a herniated nucleus pulposus. When getting out of the bed for the first time since surgery, the client reports feeling faint and lightheaded. What should the nurses assisting with the ambulation have the client do? 1 Sit on the edge of the bed so they can hold the client upright. 2 Slide to the floor so the client will not be injured as a result of a fall. 3 Bend forward so that blood flow to the brain is increased. 4 Lie down immediately so they can take the client's blood pressure.

1

A client is admitted via the emergency department with the tentative diagnosis of diverticulitis. Which test commonly is prescribed to assess for this problem? 1 Computed tomography (CT) scan 2 Gastroscopy 3 Colonoscopy 4 Barium enema

1

A client is diagnosed with acute gastritis secondary to alcoholism and cirrhosis. The client reports frequent nausea, pain that increases after meals, and black, tarry stools. The client recently joined Alcoholics Anonymous. The nurse should give priority to which client history item? 1 Black, tarry stools 2 Frequent nausea 3 Joining Alcoholics Anonymous 4 Pain that increases after meals

1

A client is experiencing stomatitis as a result of chemotherapy. Which action should the nurse take when caring for this client? 1 Provide frequent saline mouthwashes 2 Use karaya powder to decrease irritation 3 Increase fluid intake to compensate for accompanying diarrhea 4 Offer meticulous skin care of the abdomen with a gentle antiseptic

1

A client is scheduled for a craniotomy to remove a brain tumor. To prevent the development of cerebral edema after surgery, the nurse anticipates the use of drugs from which class? 1 Steroids 2 Diuretics 3 Anticonvulsants 4 Antihypertensives

1

A client with a brain tumor develops a urine output of 300 mL/hr, dry skin, and dry mucous membranes. Which nursing intervention is the most appropriate to perform for this client? 1 Evaluate urine specific gravity. 2 Implement fluid restrictions. 3 Provide emollients to the skin to prevent breakdown. 4 Slow down the intravenous (IV) fluids and notify the primary healthcare provider.

1

A client with diabetes asks how exercise will affect insulin and dietary needs. What information does the nurse share about insulin and exercise? 1 "Exercise increases the need for carbohydrates and decreases the need for insulin." 2 "Exercise increases the need for insulin and increases the need for carbohydrates." 3 "Regular physical activity decreases the need for insulin and decreases the need for carbohydrates." 4 "Intensive physical activity decreases the need for carbohydrates but does not affect the need for insulin."

1

A client with migraine headaches is admitted for an electroencephalogram (EEG). Which statement made by the client assures the nurse that preprocedure teaching has been effective? 1 I will need to avoid caffeine. 2 I will have a headache after the test. 3 I will need to avoid milk until the test is completed. 4 I will be able to take my sleeping pill before the test.

1

A farmer seeks medical care for a large crusty patch of skin on the cheek. The client states that even after using different remedies, it still bleeds easily and has not gotten better. From the client's history, the nurse suspects skin cancer. Which factor in the client's history helped the nurse form this conclusion? 1 Exposure to radiation 2 Location of the lesion 3 Self-treatment of lesions 4 Contact with soil contaminants

1

A nurse plans to teach a client with type 1 diabetes about the use of an insulin pump. What information will the nurse include in client teaching? 1 Insulin pumps mimic the way a healthy pancreas works. 2 The insulin pump's needle should be changed every day. 3 Pumps are implanted in a subcutaneous pocket near the abdomen. 4 The insulin pump's advantage is that it only requires glucose monitoring once a day.

1

A self-help group of clients with irritable bowel syndrome have invited a nurse to present a program on nutrition. Which substance should the nurse teach the clients to minimize in the diet to decrease gastrointestinal (GI) irritability? 1 Cola drinks 2 Gelatin 3 Fiber 4 Rice

1

The nurse is caring for a client admitted to the hospital for a rubber band ligation of internal hemorrhoids. Which action should the nurse take to reduce discomfort? 1 Offer sitz baths 2 Use water-soluble jelly 3 Use inflatable doughnut 4 Offer medicated suppository

1

The nurse is caring for a client who underwent surgery for a brain tumor. On assessment, the nurse suspects meningitis in the client. Which finding would help confirm the nurse's suspicion? 1 Positive Kernig sign 2 Glasgow coma score: 10 3 Absence of nuchal rigidity 4 Negative Brudzinski sign

1

Which nursing action is specific to the plan of care for a client with trigeminal neuralgia? t1 Be alert to prevent dehydration or starvation. 2 Initiate exercises of the jaw and facial muscles. 3 Apply ice compresses to the affected body area. 4 Emphasize the importance of brushing the teeth.

1

Which type of hepatitis virus spreads through contaminated food and water? 1 Hepatitis A virus 2 Hepatitis B virus 3 Hepatitis C virus 4 Hepatitis D virus

1

A client with gastroesophageal reflux disease (GERD) receives a prescription for an H2 receptor antagonist. Which medications are within the classification of an H2 receptor antagonist? Select all that apply. 1 Nizatidine 2 Ranitidine 3 Famotidine 4 Lansoprazole 5 Metoclopramide

1,2,3

A nurse is assessing a client with a diagnosis of psoriasis. Which clinical findings should the nurse expect to observe? Select all that apply. 1 Scaly lesions 2 Pruritic pustules 3 Reddened papules 4 Multiple petechiae 5 Erythematous macules

1,3

What is the priority of care to promote client safety directly after esophagogastroduodenoscopy? Select all that apply. 1 Preventing aspiration 2 Reminding the client not to drive 3 Monitoring for signs of perforation 4 Advising the client to use throat lozenges 5 Teaching the client about hoarseness of voice

1,3

A client is diagnosed with gastric cancer, and a subtotal gastrectomy is performed. After surgery the client begins to hemorrhage. What clinical findings support the nurse's conclusion that the client is experiencing hypovolemic shock? Select all that apply. 1 Oliguria 2 Bradypnea 3 Diaphoresis 4 Tachycardia 5 Hypertension

1,3,4

A client with gastroesophageal reflux disease (GERD) should make diet and lifestyle changes. Which instructions should the nurse include in the client's discharge teaching? Select all that apply. 1 Encourage to quit smoking 2 Elevate the foot of the bed 3 Avoid caffeine-containing products 4 Eat three large, evenly spaced meals daily 5 Avoid lying down for 2 to 3 hours after eating

1,3,5

A client with osteomyelitis has a slow rate of healing. Which factors can contribute to reduced healing in the client? Select all that apply. 1 Diabetes 2 Cataract 3 Smoking 4 Dermatitis 5 Alcoholism

1,3,5

A home care nurse is counseling a client with amyotrophic lateral sclerosis (ALS). What information should the nurse include in the discussion? Select all that apply. 1 Space activities throughout the day. 2 Engage in social interactions with large groups. 3 Request an opioid if leg pain becomes excessive. 4 Anticipate the use of alternate ways to communicate. 5 Use leg restraints to decrease the risk of physical injury.

1,4

A client is admitted to the hospital with a diagnosis of cirrhosis of the liver. For which assessment signs of hepatic encephalopathy should the nurse assess this client? Select all that apply. 1 Mental confusion 2 Increased cholesterol 3 Brown-colored stools 4 Flapping hand tremors 5 Musty, sweet breath odor

1,4,5

The nurse is providing preoperative teaching for a client who is to have cataract surgery. Which is appropriate for the nurse to include concerning what the client should do after surgery? Select all that apply. 1 Do not blow your nose. 2 Remain flat for three hours. 3 Eat a soft diet for two days. 4 Breathe and cough deeply. 5 Avoid bending from the waist

1,5

A client at the fertility clinic is being treated for hypertension and obesity with a regimen of diet and exercise. During the past month, she has lost 8 lb (3.6 kg) and her blood pressure has decreased to 154/98 mm Hg. The client states that she is using self-control strategies to reduce her blood pressure and weight. What is the nurse's most therapeutic response? 1 Explaining to the client that her current program needs revision to improve results 2 Acknowledging the client's achievement while encouraging continuation of her current program 3 Emphasizing to the client the importance of exercise in addition to reduction of sodium and caloric intake 4 Recommending that the client ask her practitioner about a prescription for an antihypertensive or a diuretic

2

A client is hospitalized with a tentative diagnosis of pancreatic cancer. On admission the client asks the nurse, "Do you think I have anything serious, like cancer?" What is the nurse's best reply? 1 "What makes you think you have cancer?" 2 "I don't know if you do; let's talk about it." 3 "Why don't you discuss this with your primary healthcare provider?" 4 "You needn't worry now; we won't know the answer for a few days."

2

A client is scheduled for skin cancer surgery and has not signed the consent form. Which situation will cause the nurse to legally delay signing the operative consent? 1 Ambivalent feelings are present and acknowledged. 2 A sedative type of medication has been given recently. 3 A complete history and physical has not been performed and recorded. 4 A discussion of alternatives with two primary healthcare providers has not occurred.

2

A client presents with extensive lesions due to psoriasis. Which intervention does the nurse anticipate from the healthcare provider? 1 Advising sunscreen and special clothing 2 Topical application of steroids 3 Potassium permanganate baths 4 Débridement of necrotic plaques

2

A client with type 1 diabetes consistently has high glucose levels on awakening in the morning. What should the nurse instruct the client to do to differentiate between the Somogyi effect and the dawn phenomenon? 1 Eat a snack before going to bed. 2 Measure the blood glucose level between 2 AM and 4 AM. 3 Identify whether morning symptoms are typical for hyperglycemia. 4 Administer the prescribed bedtime insulin immediately before going to bed.

2

A nurse administers lactulose to a client with cirrhosis of the liver. Which laboratory test change leads the nurse to determine that the lactulose is effective? 1 Decreased amylase 2 Decreased ammonia 3 Increased potassium 4 Increased hemoglobin

2

A nurse is caring for a client who just had surgery to repair an inguinal hernia. To limit a common complication associated with this surgery, which action should the nurse take? 1 Apply an abdominal binder. 2 Place a support under the scrotum. 3 Teach the client to cough several times an hour. 4 Encourage the client to eat a high-carbohydrate diet.

2

A nurse is caring for a client with quadriplegia. Which nursing intervention will decrease the occurrence of pressure ulcers? 1 Avoiding leg massages 2 Frequent repositioning of client 3 Increasing fiber content in food 4 Encouraging weight-bearing exercises

2

A nurse is caring for several clients with type 1 diabetes, and they each have a prescription for a specific type of insulin. Which insulin does the nurse conclude has the fastest onset of action? 1 NPH insulin 2 Insulin lispro 3 Regular insulin 4 Insulin glargine

2

A nurse is obtaining a health history from a client with the diagnosis of peptic ulcer disease. Which client statement provides evidence to support the identification of a possible contributory factor? 1 "My blood type is A positive." 2 "I smoke one pack of cigarettes a day." 3 "I have been overweight most of my life." 4 "My blood pressure has been high lately."

2

A registered nurse assesses a client's electronic medical record (EMR) and observes increased blood pressure, severe myopia, and blood glucose levels. Which type of eye disorder will the nurse most likely observe written in the EMR? 1 Cataract 2 Glaucoma 3 Corneal abrasions 4 Keratoconjunctivitis sicca

2

After many years of coping with ulcerative colitis, a client makes the decision to have a colectomy as advised by the primary healthcare provider. Which is most likely the significant factor that impacted on the client's decision? 1 It is temporary until the colon heals. 2 Surgical treatment cures ulcerative colitis. 3 Ulcerative colitis can progress to Crohn disease. 4 Without surgery, eating table foods is contraindicated.

2

Dexamethasone has been prescribed for a client after a craniotomy for a brain tumor. When evaluating the effectiveness of the medication, the nurse expects what physiologic response? 1 Reduced cell growth 2 Reduced cerebral edema 3 Increased renal reabsorption 4 Increased response to sedation

2

The nurse is caring for a client with a hiatal hernia. The client states that favorite beverages include ginger ale, apple juice, orange juice, and cola beverages. Of the four the client listed, which is the only beverage that should remain in the client's diet? 1 Ginger ale 2 Apple juice 3 Orange juice 4 Cola beverages

2

The nurse is caring for a client who may have Paget's disease and osteomalacia. Which laboratory tests can be conducted to confirm the nurse's suspicion? Select all that apply. 1 Aldolase 2 Serum calcium 3 Alkaline phosphatase 4 Lactic dehydrogenase 5 Aspartate aminotransferase

2,3

A client has a diagnosis of hemorrhoids. Which signs and symptoms does the nurse expect the client to report? Select all that apply. 1 Flatulence 2 Anal itching 3 Blood in stool 4 Rectal bulging 5 Pain when defecating

2,3,4,5

The nurse is caring for a client who is scheduled for a gastric bypass to treat morbid obesity. Which statement by the client indicates a good understanding of preventing dumping syndrome after meals? Select all that apply. 1 "I will eat a bland diet." 2 "I will not drink fluids when I eat meals." 3 "I will avoid artificially-sweetened foods." 4 "I will eat a low-protein, high-carbohydrate diet." 5 "I will eat small, frequent meals instead of three large meals a day."

2,3,5

A client had a gastric bypass procedure to treat morbid obesity. After surgery the client reports weakness, sweating, palpitations, and dizziness after eating. What should the nurse encourage the client to do? 1 Reduce the intake of protein-rich foods 2 Drink 8 ounces (240 mL) of water with meals 3 Divide the daily caloric intake into six smaller meals 4 Remain in an upright position for one hour after eating

3

A client has a hiatal hernia. The client is 5 feet 3 inches tall (163 cm) and weighs 160 pounds (72.6 kg). Which information should the nurse include when discussing prevention of esophageal reflux? 1 Increase your intake of fat with each meal. 2 Lie down after eating to help your digestion. 3 Reduce your caloric intake to foster weight reduction. 4 Drink several glasses of fluid during each of your meals.

3

A client is being considered for bariatric surgery. Which client health problem does the nurse identify as consistent with morbid obesity? 1 Dumping syndrome 2 Compartment syndrome 3 Hypoventilation syndrome 4 Inappropriate antidiuretic hormone syndrome (ADH)

3

A client newly diagnosed with diabetes arrives at the emergency department complaining of dizziness and weakness. The client's spouse reports that the client has been confused since this morning. The spouse reports that the client administered the morning dose of 10 units of regular insulin and 25 units of NPH insulin with difficulty and did not eat much breakfast. What does the nurse identify as the most likely cause of the client's signs and symptoms? 1 Hyperglycemia 2 Hyperlipidemia 3 Hypoglycemia 4 Hypocalcemia

3

A client with a recent history of sinusitis develops meningitis and demonstrates a positive Brudzinski sign. What is the priority nursing care? 1 Monitoring intracranial pressure 2 Adding pads to the side of the bed 3 Administering prescribed antibiotics 4 Hydrating the client with hypotonic saline

3

A client with cirrhosis is scheduled for a liver biopsy. The client asks if there are any risks after the procedure. Which response by the nurse is the best? 1 "There are relatively no risks associated with this procedure." 2 "The major risk is infection at the biopsy site." 3 "The major risk is bleeding postprocedure." 4 "The major risk is liver failure postprocedure."

3

A client with diabetes experiences tremors, pallor, and diaphoresis. What should the nurse consider is a possible cause of these clinical manifestations? 1 Overeating 2 Intestinal virus 3 Aerobic exercise 4 Missed insulin dose

3

A client with multiple sclerosis is informed that this is a chronic, progressive neurologic condition. The client asks the nurse, "Will I experience unbearable pain?" What is the nurse's best response? 1 "Tell me about your fears regarding pain." 2 "Analgesics will be prescribed to control the pain." 3 "Some clients report feeling a tingling or burning sensation but not unbearable pain." 4 "Let's make a list of the things you need to ask your healthcare provider."

3

A nurse is caring for a client who is positive for hepatitis A. Which precautions should the nurse take? 1 Wear a gown when entering the client's room. 2 Use caution when bringing in the client's food. 3 Use gloves when removing the client's bedpan. 4 Wear a protective mask when entering the client's room.

3

A nurse is caring for a client who is scheduled for a gastric bypass to treat morbid obesity. Which diet should the nurse teach the client to maintain because it will help minimize clinical manifestations of dumping syndrome? 1 Low-residue, bland diet 2 Fluid intake below 500 mL 3 Small, frequent feeding schedule 4 Low-protein, high-carbohydrate diet

3

A nurse is caring for a client with severe gastritis who vomited a large amount of blood. A lavage is prescribed by the healthcare provider. Which response does the nurse expect when using a room temperature irrigating solution? 1 Coagulation of blood 2 Neutralization of acids 3 Constriction of blood vessels 4 Stimulation of the vagus nerve

3

A nurse is caring for a group of clients with myasthenia gravis, Guillain-Barré syndrome, and amyotrophic lateral sclerosis (ALS). Which information should the nurse consider when planning care for this group of clients? 1 Progressive deterioration until death 2 Deficiencies of essential neurotransmitters 3 Increased risk for respiratory complications 4 Involuntary twitching of small muscle groups

3

A nurse provides a list of suggested food choices to a client who has peptic ulcer disease. Which foods should be included on the list? 1 Orange juice, fried eggs, and sausage 2 Tomato juice, raisin bran cereal, and tea 3 Applesauce, cream of wheat, and apple juice 4 Sliced oranges, pancakes with syrup, and coffee

3

A nurse teaches a client about limiting the discomfort associated with a hiatal hernia. Which statement from the client indicates teaching by the nurse is effective? 1 "After meals I will take a 10-minute walk." 2 "After meals I will drink 8 oz (240 mL) of water." 3 "After meals I will rest in a sitting position for one hour." 4 "After meals I will lie down in bed for at least 20 minutes."

3

A registered nurse teaches a nursing student about cluster headaches. Which statement made by the nursing student indicates a need for further teaching? 1 "Each episode of a cluster headache may last up to 3 hours." 2 "Pupillary constriction occurs during the period of cluster headaches." 3 "Pulsating pain is the characteristic type of pain that occurs in cluster headaches." 4 "Cluster headaches occur for weeks to months followed by a period of remission."

3

A thin 24-year-old woman who runs 10 miles each week asks the nurse for advice about preventing osteoporosis. Which vitamin and other dietary supplement should the nurse recommend? 1 Vitamin E and ginseng tea 2 Vitamin B and ginkgo biloba 3 Vitamin D and calcium citrate 4 Vitamin C and glucosamine/chondroitin

3

An older adult client with a low body mass index (BMI) is found to have osteoporosis. What should the nurse include in the discharge plan for this client? 1 Encouraging gradual weight gain 2 Monitoring for decreased urine calcium 3 Providing instructions relative to diet and exercise 4 Teaching about safety factors in the use of opioids and nonsteroidal antiinflammatory drugs

3

During an exacerbation of multiple sclerosis a client reports urinary urgency and frequency. What is the most appropriate initial nursing action? 1 Begin teaching self-catheterization. 2 Develop a plan to ensure high fluid intake. 3 Palpate the suprapubic area of the abdomen. 4 Initiate a regimen to monitor urinary output.

3

Six weeks after discharge, a client with a jejunoileal bypass for morbid obesity returns to the outpatient clinic reporting palpitations, abdominal cramps, diarrhea, and dizziness 30 minutes after meals. What complication should the nurse consider that the client is most likely experiencing? 1 Gastric reflux 2 Reflux gastritis 3 Dumping syndrome 4 Abdominal peritonitis

3

The nurse is administering lactulose to a client with a history of cirrhosis of the liver. The client asks the nurse why this medication is needed because the client is not constipated. How will the nurse respond? 1 "This medication helps you to stop drinking so much alcohol." 2 "This medication helps you relax and not feel anxious." 3 "This medication helps you lower the high ammonia level caused by your liver disease." 4 "This medication helps you keep your abdomen from being so distended."

3

The nurse is assessing a client experiencing diabetic ketoacidosis (DKA). Which unique response associated with DKA that is not exhibited with hyperglycemic hyperosmolar nonketotic syndrome (HHNS) should the nurse identify when assessing this client? 1 Fluid loss 2 Glycosuria 3 Kussmaul respirations 4 Increased blood glucose level

3

The nurse leader suffers from headaches, hypertension, and gastrointestinal problems. Which affirmative statement by the leader reflects an appropriate way to manage the stress? 1 "I will avoid protein." 2 "I will plan a vacation." 3 "I will get enough sleep." 4 "I will participate in support groups."

3

Which nursing intervention is the priority when a client is first admitted with hyperglycemic hyperosmolar nonketotic syndrome (HHNS)? 1 Providing oxygen 2 Encouraging carbohydrates 3 Administering fluid replacement 4 Teaching facts about dietary principles

3

A client experiences occasional right upper quadrant pain attributed to cholecystitis. The nurse is providing discharge instructions, including a list of foods that cause dyspepsia. Which foods should be on the list the nurse provided the client? 1 Nuts and popcorn 2 Meatloaf and baked potato 3 Chocolate and boiled shrimp 4 Fried chicken and buttered corn

4

A client had a craniotomy for excision of a brain tumor. After surgery, the nurse monitors the client for increased intracranial pressure. Which clinical finding supports an increase in intracranial pressure? 1 Thready, weak pulse 2 Narrowing pulse pressure 3 Regular, shallow breathing 4 Lowered level of consciousness

4

A client is admitted to the hospital with a diagnosis of acute pancreatitis. The health care provider's prescriptions include nothing by mouth and total parenteral nutrition (TPN). The nurse explains that the TPN therapy provides what benefit? 1 Is the easiest method for administering needed nutrition 2 Is the safest method for meeting the client's nutritional requirements 3 Will satisfy the client's hunger without the discomfort associated with eating 4 Will meet the client's nutritional needs without causing the discomfort precipitated by eating

4

A client is diagnosed with trigeminal neuralgia. Which medication should the nurse anticipate will be prescribed for this client? 1 Ascorbic acid (vitamin C) 2 Morphine 3 Allopurinol 4 Carbamazepine

4

A client with chronic gastritis is being treated with medication and diet. What should the nurse teach the client when discussing the therapeutic regimen? 1 Lie down after eating when possible 2 Take an antacid preparation with meals 3 Limit high-carbohydrate foods in the diet 4 Avoid using analgesics that contain aspirin

4

A client with diabetes who is receiving long-term corticosteroid therapy is admitted to the hospital with leg ulcers. What increased risk does the nurse consider when assessing this client? 1 Weight loss 2 Hypoglycemia 3 Decreased blood pressure 4 Inadequate wound healing

4

A nurse is assessing two clients. One client has ulcerative colitis, and the other client has Crohn disease. Which is more likely to be identified in the client with ulcerative colitis than in the client with Crohn disease? 1 Inclusion of transmural involvement of the small bowel wall 2 Higher occurrence of fistulas and abscesses from changes in the bowel wall 3 Pathology beginning proximally with intermittent plaques found along the colon 4 Involvement starting distally with rectal bleeding that spreads continuously up the colon

4

A nurse is teaching a client about gastroesophageal reflux disease (GERD). Which statement made by the client indicates correct understanding of GERD management? 1 "Three meals per day is the best regimen to avoid GERD symptoms." 2 "I can reduce my GERD symptoms through a high-carbohydrate, low-fat diet." 3 "A snack at bedtime will help reduce the acidity of my stomach during the night." 4 "I will place a 6-inch (15 cm) block under the head of my bed to help with digestion."

4

Steroid therapy is prescribed for a client with common signs and symptoms of multiple sclerosis. In response to the steroid therapy, what symptom does the nurse expect to decrease? 1 Emotional lability 2 Muscular contractions 3 Pain in the extremities 4 Episodes of vision loss

4

The nurse is reviewing the plan of care for a client who is scheduled for a barium swallow. What will the plan include? 1 Giving clear fluids on the day of the test 2 Asking the client about allergies to iodine 3 Administering cleansing enemas before the test 4 Administering a laxative after the procedure

4

The primary healthcare provider confirms that the client has myopia. Which type of test did the nurse perform to help the primary healthcare provider reach this conclusion? 1 Perimetry 2 Jaeger card 3 Ishihara chart 4 Snellen eye chart

4

What should the nurse instruct the client to do to limit triggering the pain associated with trigeminal neuralgia? 1 Drink iced liquids. 2 Avoid oral hygiene. 3 Apply warm compresses. 4 Chew on the unaffected side.

4

Which pulmonary risk may be increased in a postoperative client due to anesthesia? 1 Rhonchi 2 Fremitus 3 Dyspnea 4 Atelectasis

4

Which statement made by a client recently diagnosed with type 1 diabetes indicates that further education is necessary regarding the teaching plan? 1 "I will need to have my eyes and vision examined once a year." 2 "I will need to check my blood sugar at home to evaluate my response to my treatment plan." 3 "I can improve metabolic and cardiac risk factors of this disease if I follow a low-calorie diet and lose weight." 4 "Once I reach my target weight there is a good chance that I will be able to switch from insulin to an oral medication."

4

A nurse is providing instructions to a client with glaucoma. Which statements made by the client indicate the nurse needs to intervene? Select all that apply. 1 "I should take stool softeners." 2 "I can wear loose collar shirts." 3 "I should refrain from sneezing and coughing." 4 "I can lift objects that weigh more than 10 lbs (4.5 kg)." 5 "I should keep my head in a dependent position."

4,5

Which of the following structures is connective tissue? A. Lymphatic tissue B. Cartilage C. Ligaments D. Tendons E. All of the above

E

When assessing a patient who has scleroderma, the nurse recognizes which body system should be very carefully examined for evidence of impending complications? A. Pulmonary B. Integument C. Gastrointestinal D. Musculoskeletal

a

In assessing the patient with scleroderma for pending renal crisis, which findings require an intervention by the nurse? (Select all that apply.) A. Significant weight gain B. Blood pressure 174/100 mm Hg C. Creatinine 1.9 mg/dL D. Clear urine output E. BUN 15 mg/dL

a,b,c

When comparing osteoarthritis to RA, the nurse recognizes which of the following statements to be true? (Select all that apply.) A. Osteoarthritic pain tends to get worse with activity, but RA gets better with activity. B. Both RA and osteoarthritis are autoimmune diseases. C. Patients with RA are at risk for developing extraarticular manifestations such as eye inflammation and lung disease, whereas osteoarthritis affects only joints and surrounding structures. D. Patients with osteoarthritis typically have morning stiffness lasting less than 1 hour, whereas RA patients typically complain of morning stiffness lasting greater than 1 hour. E. Both RA and osteoarthritis affect joints in a symmetrical pattern.

a,c,d

The nurse includes which information in the teaching plan about the management of fibromyalgia? (Select all that apply.) A. Narcotics should be taken for pain related to fibromyalgia. B. Stress management techniques are important tools. C. Daily exercise can help control fibromyalgia symptoms. D. Antidepressant medications may decrease pain as well as depression. E. Limit exercise because that may exacerbate pain.

b,c,d

The nurse knows that which of following statements regarding laboratory values and RA are true? (Select all that apply.) A. Patients with a positive rheumatoid factor definitely have RA. B. An elevated CRP is indicative of inflammation but is not specific only for RA. C. Certain DMARD therapy may cause laboratory abnormalities such as elevated liver enzymes, thrombocytopenia, and leukocytopenia. D. Approximately 25% to 30% of patients who have RA do not have a positive rheumatoid factor. E. Patients with RA have elevated cardiac enzymes due to pharmacological therapy.

b,c,d

The nurse monitors for which clinical manifestations in the patient diagnosed with osteoarthritis? (Select all that apply.) A. Pain that improves with activity B. Joint pain C. Joint swelling D. Unsteady gait E. Increased temperature

b,c,d

The nurse monitors for which clinical manifestations in the patient diagnosed with osteoarthritis? (Select all that apply.) A. Shortness of breath B. Decreased range of motion of affected joint C. Joint pain that improves with activity D. Warmth and swelling of affected joints E. Heberden's nodes

b,d,e

The charge nurse is reviewing prescriptions for a new patient who was admitted for shortness of breath and also has RA. It is a priority for the nurse to follow up with the provider about which order? A. Oxygen per nasal cannula 2 L/min B. Prednisone 5 mg by mouth every a.m. C. Methotrexate 25 mg by mouth every p.m. D. Hydroxychloroquine 200 mg by mouth twice daily

c

The nurse recognizes which patient to be at greatest risk for developing osteoarthritis? A. A 70-year-old African American male B. A 45-year-old Caucasian female C. A 65-year-old obese African American female D. A 30-year-old Caucasian male

c

The nurse recognizes which patient to be at the highest risk for developing SLE? A. A 10-year-old Hispanic female B. An 18-year-old African American male C. A 30-year-old African American female D. A 50-year-old Caucasian male

c

The nurse recognizes which patient with scleroderma to be at the highest risk for morbidity and mortality? A. An 18-year-old Caucasian female with linear skin lesions noted on her face B. A 20-year-old Hispanic male with patches of skin on the distal portions of his arms and legs C. A 32-year-old Caucasian female presenting with thickened skin on her trunk D. A 45-year-old African American male with Raynaud's disease

c

The rheumatology nurse is screening lupus patients for the risk of developing lupus nephritis. The nurse should consider which patient at greatest risk? A. A 46-year-old Caucasian female who has been stable for many years on hydroxychloroquine (Plaquenil) 400 mg daily, complaining today of a new rash on her face, dysuria, and malodorous urine. BP 124/68 mm Hg, serum creatinine 0.9, GFR greater than 60, no protein in her urine, but she has white blood cells and bacteria present on urinalysis. She has no edema. B. A 28-year-old African American male with a history of lupus nephritis who takes hydroxychloroquine (Plaquenil) 200 mg daily and mycophenolate (CellCept) 500 mg twice daily. Serum creatinine stable at 1.9, GFR stable at 55, stable proteinuria 1+. He is taking lisinopril 10 mg daily to control his hypertension; BP is 138/88 mm Hg. C. A 22-year-old African American female presents to the clinic after missing her last two appointments. She does not regularly take her hydroxychloroquine (Plaquenil) or her BP medication. Today she complains that her feet started to swell about 2 weeks ago. Her BP is 158/90 mm Hg, +2 pedal edema. Serum creatinine 2.1, GFR 35, proteinuria 3+. D. A 50-year-old Caucasian female diagnosed with lupus in the last year. She has not been assessed in 9 months but is supposed to follow up in the rheumatology clinic every 3 months. Her BP is high even on her medications. BUN/creatinine is within normal limits. She has no edema.

c

Which structure is responsible for connecting muscles to bone? A. Ligaments B. Cartilage C. Tendons D. Synovium

c

The nurse assesses for which initial clinical manifestation in the patient diagnosed with gout? A. Pain and inflammation in the shoulder B. Pain and inflammation in the wrist C. Pain and inflammation in the knee D. Pain and inflammation in the great toe

d

Which of the following is not a function of cartilage? A. Provides joint protection B. Provides a smooth joint surface C. Disperses loads evenly across the joint D. Produces synovial fluid for joint lubrication

d

Which statement by the patient with fibromyalgia indicates that teaching has been effective? A. "Because of my fibromyalgia, I may get inflammatory arthritis, which may lead to joint damage." B. "I won't know for sure about my diagnosis until I have diagnostic tests such as x-rays and blood tests done." C. "My only option to treat my pain is narcotic analgesics." D. "It's frustrating, but I understand that fibromyalgia typically presents with a normal physical examination with no evidence of joint or muscle inflammation."

d

Which statement by the patient with gout indicates that further teaching is needed? A. "Losing weight will help to reduce further gout attacks." B. "I should report my diagnosis of gout to my cardiologist because taking some forms of diuretics may increase gout flares." C. "Avoiding foods containing purines, such as red meats, seafood, and alcoholic beverages, will help to reduce the incidence of gout flares." D. "I can drink alcohol if I limit the number of beers I drink."

d