Chapter 63: Caring for Clients With Orthopedic and Connective Tissue Disorders (NCLEX Review Questions/PrepU)

Which statement made by the client with RA indicates that the nurse needs to provide further instruction regarding corticosteroid therapy?

"I may develop low blood sugar and need glucose"

Which of the following statements indicates to the nurse that the client needs more information related to nutrition needs during an acute attack of gout?

"It is OK to have a glass of wine every day."

A client is undergoing diagnostic testing to determine the etiology of recent joint pain. The client asks the nurse about the difference between osteoarthritis (OA) and rheumatoid arthritis (RA). What is the best response by the nurse?

"OA is considered a noninflammatory joint disease. RA is characterized by inflamed, swollen joints."

Which of the following clients should the nurse recognize as being at the highest risk for the development of osteomyelitis?

An elderly client with an infected pressure ulcer in the sacral area

The nurse is reviewing a doctor's orders on a client admitted with SLE. Which classification of medications does the nurse expect to see on the orders?

Antimalarial

A client asks the nurse about some strategies that may be useful to slow the progression of OA in the left knee. Which suggestions from the nurse are appropriate? Select all that apply.

Apply heat to the affected knee. Lose weight. Start a progressive swimming program.

A client is suspected of having rheumatoid arthritis and her diagnostic regimen includes aspiration of synovial fluid from the knee for a definitive diagnosis. The nurse knows that which procedure will be involved?

Arthrocentesis

What is the priority intervention for a client who has been admitted repeatedly with attacks of gout?

Assess diet and activity at home

Which of the following is the first-line medication that would be used to treat and prevent osteoporosis?

Bisphosphonates

A nurse is caring for an elderly female client with osteoporosis. When teaching the client, the nurse should include information about which major complication?

Bone fracture

A nurse is reviewing the pathophysiology that may underlie a client's decreased bone density. What hormone should the nurse identify as inhibiting bone resorption and promoting bone formation?

Calcitonin

Which group is at the greatest risk for osteoporosis?

Caucasian women

A nurse is teaching a client with osteomalacia about the role of diet. What would be the best choice for breakfast for a client with osteomalacia?

Cereal with milk, a scrambled egg, and grapefruit

A has experienced increasing pain and progressing inflammation of the hands and feet. The rheumatologist has prescribed NSAID use to treat the condition. What client education is most important for the nurse to address with the use of these medications?

Common adverse effects

What clinical manifestation would the nurse expect to find in a client who has had osteoporosis for several years?

Decreased height.

A clinic nurse is caring for a client newly diagnosed with fibromyalgia. When developing a care plan for this client, what nursing diagnosis should the nurse prioritize?

Fatigue Related to Pain

A client presents at a clinic reports heel pain that impairs walking ability. The client is subsequently diagnosed with plantar fasciitis. This client's plan of care should include what intervention?

Gently stretching the foot and the Achilles tendon

When planning care for the client with RA, when will the nurse expect that the client will need more time and assistance with ADLs?

In the early morning

A patient in the early stage of rheumatoid arthritis has been admitted. What medication classification would the nurse expect to be ordered for this patient?

NSAIDs

What intervention is a priority for a client diagnosed with osteoarthritis?

Physical therapy and exercise

A nurse's plan of care for a client with rheumatoid arthritis includes several exercise-based interventions. What goal should the nurse prioritize?

Preserve or increase range of motion while limiting joint stress

The nurse knows that a patient who presents with the symptom of "blanching of fingers on exposure to cold" would be assessed for what rheumatic disease?

Raynaud's phenomenon

A nurse is caring for a client with a bone tumor. The nurse is providing education to help the client reduce the risk for pathologic fractures. What should the nurse teach the client?

Support the affected extremity with external supports such as splints.

A client with chronic osteomyelitis has undergone 6 weeks of antibiotic therapy. The wound appearance has not improved. What action would the nurse anticipate to promote healing?

Surgical debridement

The nurse teaches the client with a high risk for osteoporosis about risk-lowering strategies, including which action?

Walk or perform weight-bearing exercises outdoors

Nursing care for the client with fibromyalgia should be guided by the assumption that patients with fibromyalgia

may feel as if their symptoms are not taken seriously.

A client with systemic lupus erythematosus (SLE) is preparing for discharge. The nurse knows that the client has understood health education when the client makes what statement?

"I'll make sure to monitor my body temperature on a regular basis."

A client with rheumatoid arthritis comes into the clinic for a routine check-up. On assessment the nurse notes that the client appears to have lost some ability to function since the last office visit. What is the nurse's most appropriate action?

Arrange for the client to be assessed in her home environment.

A nurse is caring for a client who is 12 hours postoperative following foot surgery. The nurse assesses the presence of edema in the foot. What nursing measure should the nurse implement to control the edema?

Elevate the foot on several pillows.

A client with rheumatoid arthritis reports joint pain. What intervention is a priority to assist the client?

Nonsteroidal anti-inflammatory drugs