CH 50 PREP U

A nurse is assessing a client with rheumatoid arthritis (RA). What does the nurse expect to find when evaluating the client's joints? Select all that apply.

Joint pain lasting for 30 minutes to several hours Decreased joint motion Nodules on joints

The nurse is conducting a health promotion class on osteoarthitis (OA). Which statement should the nurse include?

Obesity is a strong risk factor for developing OA.

A client recently diagnosed with rheumatoid arthritis (RA) tells the nurse she is glad there is nothing "really wrong with her" besides some joint swelling. Which information should the nurse tell the client about RA?

"Extra-articular manifestations may include anemia and deformities of the affected joints."

A client sought care because of increasing pain and inflammation in the toe and ankle of one foot. Diagnostic testing has resulted in a diagnosis of gouty arthritis. When educating the client about the treatment and management of the disease, what should the nurse teach the client?

"Losing some weight and reducing your alcohol intake will likely be beneficial."

A nurse is teaching a group of nursing students about the presentation of systemic lupus erythematosus (SLE). Which statement is the nurse likely to make?

"More women than men are affected by lupus."

The nurse is caring for a client diagnosed with osteoarthritis (OA). What does the nurse teach the client about the disease?

"OA is a disease of the weight-bearing joints."

A nurse is caring for a client with a fractured elbow. Which instruction is important to give the client to prevent cartilage degeneration while the elbow is immobilized?

"To prevent cartilage atrophy, slowly and gradually resume exercising."

The nurse determines that additional client education is needed when a client with gout makes which statement?

"When I have an exacerbation of my symptoms, a glass of red wine will be helpful."

The nurse is caring for several clients on an orthopedic unit. Place the clients listed in the order in which the nurse should assess them. Use all options.

77-year-old with osteoarthritis who has just returned from total knee arthroplasty. 56-year-old with rheumatoid arthritis with a temperature of 101.3°F (38.5°C). 24-year-old with ankylosing spondylitis with acute pain radiating from spine to thigh. 89-year-old with polymyalgia rheumatica who currently has corticosteroids infusing.

A client with a history of ankylosing spondylitis is admitted to the hospital. Which interventions will best assist this client while in the hospital? Select all that apply.

Assist the client to ambulate in the morning. Medicate the client for muscle spasms. Provide nonsteroidal anti-inflammatory drugs.

Despite differences in onset, involvement, and symptomatology, all of the spondyloarthropathies involve which pathogenesis etiology?

Autoimmune etiology

Which clients with rheumatoid arthritis (RA) will the nurse prioritize to assess first?

Client with systemic lupus erythematosus (SLE) and chest pain

Which diagnostic finding has been strongly linked to systematic lupus erythematosus (SLE)?

Elevated anti-nuclear antibodies (ANA)

When assessing a client with rheumatoid arthritis, which statement about joint involvement is most accurate?

Involvement is symmetric and polyarticular, initially starting in the fingers, hands, and wrists.

A nurse is caring for a client with ankylosing spondylitis. For which associated symptom does the nurse assess?

kyphosis

The nurse is caring for a client with newly diagnosed systemic lupus erythematosus (SLE). Which over-the-counter medication does the nurse recognize is useful in treating inflammation, arthritis, and pleuritis?

Nonsteroidal anti-inflammatory drugs (NSAIDs)

The client with a suspected diagnosis of osteoarthritis asks the health care provider, "How will this diagnosis be confirmed?" Which response is most appropriate?

Physical examination and x-ray studies

The nurse assessing a client with scleroderma with CREST variant would include an assessment for:

Raynaud's phenomenon

When assessing a child for clinical manifestations of oligoarticular arthritis, the health care provider will base the diagnosis on which clinical findings?

Right knee is warm and painful when putting it through normal range of motion.

A nurse is caring for a client admitted with a malar rash on the nose and cheeks. The nurse recognizes that this rash is characteristic of which disease process?

Systemic lupus erythematosus (SLE)

The nurse is providing client education related to intra-articular corticosteroid injections. Which instruction should the nurse include?

The injections will be given only 3 to 4 times per year because they can increase joint destruction.

The nurse is assessing a client with ankylosing spondylitis (AS). What does the nurse expect to find?

lower back pain

The nurse is teaching a client with rheumatoid arthritis about pannus, which develops in the affected joint area. What does the nurse include to describe pannus?

Vascular granulation tissue that destroys cartilage and bone

Which signs and symptoms should prompt a young woman's primary care provider to assess for systemic lupus erythematosus (SLE)?

joint pain and proteinuria

Juvenile dermatomyositis is a chronic inflammatory myopathy that commonly manifests systemically. What is the treatment of choice for this myopathy?

corticosteroids

Which statement is true regarding the development of juvenile idiopathic arthritis?

generalized stunted growth

When caring for a client with ankylosing spondylitis, the nurse tells the client that stiffness may be relieved by which intervention?

gentle exercise

An older adult client has history of benign prostatic hyperplasia (BPH), osteoarthritis, loss of height by 1 in (2.5 cm), and presbycusis. Which disorder is not commonly attributed to age-related changes?

osteoarthritis

When teaching a group of nursing students about rheumatic disorders, a nurse emphasizes which important differences when caring for the older adult?

risk for falls

The health care provider is assessing a client with a history of ankylosing spondylitis to note progression of the disease. On which area of the body will the provider focus the assessment?

spine

Which substance helps maintain a smooth surface in joint cartilage?

synovial fluid

When teaching a client recently diagnosed with systemic lupus erythematosus (SLE), what does the nurse teach the client to avoid to prevent exacerbations?

ultraviolet light

A client has been diagnosed with rheumatoid arthritis (RA). What will the nurse tell the client about this disorder's etiology?

"Genetic predisposition is very likely."

An older adult client has recently been diagnosed with rheumatoid arthritis. The nurse should focus assessment on which aspects?

weight and nutritional status