MED 2 ARTHRITIS

1,2,3,5

The nurse is obtaining a health history from a client and is assessing for risk factors associated with osteoporosis. The nurse would be most concerned if which data were obtained? Select all that apply. 1. The client reports that she doesn't exercise much at all. 2. The client reports that she smokes a few cigarettes a day. 3. The client reports that she is taking phenytoin to treat a seizure disorder. 4. The client reports that she consumes calcium and vitamin foods and supplements daily. 5. The client reports that she takes a daily low dose of prednisone to treat a chronic respiratory condition.

3

The nurse is preparing a plan of care for a client who is scheduled to return from the recovery room after a left total knee arthroplasty. The nurse includes in the plan of care to assess the client's neurovascular status the monitoring of which parameter? 1. The pain level of the client 2. Blood pressure and respiratory rate 3. Capillary refill, sensation, color, and pulse of the left foot 4. The range of motion of the left knee when a continuous passive motion machine is used

1,2,4,5

The nurse is providing dietary instructions to a client with osteoporosis and is discussing appropriate food items to include in the diet. Which food items should the nurse recommend as being high in calcium? Select all that apply. 1. Tofu 2. Salmon 3. Peaches 4. Spinach 5. Sardines

1

The nurse provides instructions to a client diagnosed with osteoporosis. Education about prevention of which complication is the most important? 1. Fractures 2. Weight loss 3. Hypocalcemia 4. Muscle atrophy

4

The nurse provides instructions to a client with bilateral deformities of the joints of the fingers due to rheumatoid arthritis. When providing teaching about the disease process, the nurse should inform the client that the changes are most likely due to what type of response? 1. Allergic 2. Metabolic 3. Endocrine 4. Autoimmune

4

A client has had a bone scan done. The nurse determines that the client demonstrates understanding of postprocedure care when the client makes which statement? 1. "Flushing indicates a complication." 2. "I should stay on liquids for a couple of days." 3. "I need to ambulate every couple of hours faithfully for a few days." 4. "I need to drink plenty of water for 1 to 2 days after the procedure."

2

A client has had surgery to repair a fractured left hip. When repositioning the client from side to side in the bed, what should the nurse plan to use as the most important item for this maneuver? 1.Bed pillow 2.Abductor splint 3.Adductor splint 4.Overhead trapeze

1,2,3

A client is complaining of knee pain. The knee is swollen, reddened, and warm to the touch. The nurse interprets that the client's signs and symptoms are compatible with which conditions? Select all that apply. 1. Infection 2. Recent injury 3. Inflammation 4. Degenerative disease 5. Developmental retardation

4

A client who has been taking high doses of acetylsalicylic acid to relieve pain from osteoarthritis now has more generalized joint pain and an elevated temperature. The nurse should assess for which complication to determine whether the client has other signs of aspirin toxicity? 1. Diarrhea 2. Constipation 3. Double vision 4. Ringing in the ears

1

A client who has had a total knee arthroplasty tells the nurse that there is pain with extension of the knee. The nurse should perform which action? 1. Administer an analgesic. 2. Notify the health care provider. 3. Immobilize the knee temporarily. 4. Put the client's knee through full passive range of motion.

4

A client has been diagnosed with gout, and the nurse provides dietary instructions. The nurse determines that the client needs additional teaching if the client states that it is acceptable to eat which food? 1. Carrots 2. Tapioca 3. Chocolate 4. Chicken liver

2

An older client is diagnosed with osteoporosis. The nurse teaches the client about self-care measures, knowing that the client is most at risk for which problem as a result of this disorder of the bones? 1. Anemia 2. Fractures 3. Infection 4. Muscle sprains

3

The clinic nurse is performing an assessment on a client with a diagnosis of rheumatoid arthritis (RA). The nurse checks for which assessment finding that is associated with RA? 1. Age of onset is generally 65 years of age or older 2. Complaints of pain that is more severe after activity 3. Systemic symptoms such as fatigue, anorexia, and weight loss 4. Joint pain is asymmetrical and associated with past injuries to the joint

2

The community health nurse is providing a teaching session on osteoporosis to women living in the community. The nurse informs these community residents that which is a risk factor for this disorder? 1. A large skeletal frame 2. A diet low in vitamin D 3. Low thyroid hormone levels 4. A high dietary intake of calcium

1

The community health nurse is providing an educational session for community members regarding dietary measures that will assist in reducing the risk of osteoporosis. The nurse should instruct the community members to increase dietary intake of which food known to be helpful in minimizing this risk? 1. Yogurt 2. Turkey 3. Shellfish 4. Spaghetti

4

The nurse has provided instructions to a client with a diagnosis of rheumatoid arthritis about measures to protect the joints. Which statement by the client indicates a need for further instruction? 1. "I should slide objects rather than lifting them." 2. "I should try not to remain in the same position for a long period of time." 3. "I should use large joints instead of small joints when performing activities." 4. "Pain or fatigue is expected, and I should try to continue with the activity if this occurs."

2

The nurse is caring for a client with a diagnosis of gout. Which laboratory value would the nurse expect to note in the client? 1. Calcium level of 9.0 mg/dL (2.25 mmol/L) 2. Uric acid level of 9.0 mg/dL (0.54 mmol/L) 3. Potassium level of 4.1 mEq/L (4.1 mmol/L) 4. Phosphorus level of 3.1 mg/dL (1.0 mmol/L)

3,5

The nurse is caring for a client with osteoarthritis. The nurse performs an assessment knowing that which clinical manifestations are associated with the disorder? Select all that apply. 1. Elevated white blood cell count 2. A decreased sedimentation rate 3. Joint pain that diminishes after rest 4. Elevated antinuclear antibody levels 5. Joint pain that intensifies with activity

1

The home health nurse visits a client who is having an acute attack of gout. The nurse determines that the client needs further instruction regarding the treatment of gout if the client states to take which action? 1. Restricting fluids 2. Maintaining bed rest 3. Eating a low-purine diet 4. Taking nonsteroidal antiinflammatory drugs

1,2,3,4,6

The nurse is collecting data related to a client's risk factors associated with osteoporosis. Which data should the nurse include? Select all that apply. 1. Thin body build 2. Smoking history 3. Postmenopausal age 4. Chronic corticosteroid use 5. High intake of dairy products 6. Family history of osteoporosis

4

The nurse is conducting health screening for osteoporosis. Which client is at greatest risk of developing this disorder? 1. A 25-year-old woman who runs 2. A 36-year-old man who has asthma 3. A 70-year-old man who consumes excess alcohol 4. A sedentary 65-year-old woman who smokes cigarettes

1

The nurse has completed giving discharge instructions to a client after total knee arthroplasty and replacement with a prosthetic system. The nurse teaches the client about weight-bearing status. What information should the nurse include? 1. "You will use full weight bearing by discharge." 2. "You will use partial weight bearing by discharge." 3. "You will use toe-touch weight bearing by discharge." 4. "You will need to remain on bed rest even after discharge."

3

The nurse has completed giving discharge instructions to a client who has had a total joint replacement (TJR) of the knee with a metal prosthetic system. The nurse determines that the client understands the instructions if the client makes which statement? 1. "Changes in the shape of the knee are expected." 2. "Fever, redness, and increased pain are expected." 3. "All caregivers should be told about the metal implant." 4. "Bleeding gums or black stools may occur, but this is normal.

1

The nurse has provided discharge instructions to a client after a total hip replacement. Which statement by the client indicates a need for further instruction? 1. "I should sit in my recliner when I get home." 2. "I need to keep my legs apart while sitting or lying." 3. "I should try to obtain an elevated toilet seat for use at home." 4. "I should contact the health care provider if the incision becomes red or irritated or if I note any drainage."

1,2,3,4

The nurse is creating a plan of care for a client scheduled for a left total hip arthroplasty. Which interventions should the nurse include in the plan to prevent complications of the surgery? Select all that apply. 1. Keep the leg slightly abducted. 2. Teach leg exercises to the client. 3. Use aseptic technique for wound care. 4. Prevent hip flexion beyond 90 degrees. 5. Keep the client's knees flexed whenever the client is in bed. 6. Massage the legs daily to increase circulation and venous return

1,4

The nurse is gathering subjective and objective data from a client with a diagnosis of suspected rheumatoid arthritis (RA). The nurse would expect to note which early signs and symptoms of RA? Select all that apply. 1. Fatigue 2. Weight gain 3. Restlessness 4. Morning stiffness 5. Pain with movement only

1

The nurse is lecturing to a group of women who are at high risk for osteoporosis. The nurse should inform the women about which most important measure? 1. Limit caffeine intake. 2. Limit intake of vitamin D. 3. Limit participation in activities such as walking and swimming. 4. Limit protein in the diet because it contributes to the incidence of bone demineralization.

3

The nurse is performing a musculoskeletal assessment of an immobile client for disuse osteoporosis. Which should the nurse assess to obtain the best information about the bone remodeling process? 1. Vitamin C 2. Vitamin A 3. Calcitonin 4. Thyroid hormone

2,5,6

Which tests can be used to diagnose gout? Select all that apply. 1. Renal ultrasound 2. Serum uric acid level 3. Bone marrow biopsy 4. Urinalysis with culture 5. Synovial fluid aspiration 6. 24-hour urine uric acid level