Prep U: Disorders of Musculoskeletal Fx: Rheumatic Disorders

A nurse is caring for a client who has systemic lupus erythematosus (SLE). Which of the following causes the disease?

Autoimmune process

The nurse is teaching the client about the management of primary gout. Which medications will the nurse include as indicated to control uric acid levels? Select all that apply.

Allopurinol Febuxostat Probenecid

The parents of a child diagnosed with rheumatic disease are shocked by the diagnosis and tell the nurse that they did not think children could acquire the disease. The best response would be:

Children can be affected with almost all of the rheumatic diseases that occur in adults.

Which statement best describes the pathogenesis of systemic lupus erythematosus (SLE)?

Formation of autoantibodies and immune complexes (type III hypersensitivity)

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

Corticosteroids

When a nurse assesses a client with scleroderma (systemic sclerosis), which manifestation does the nurse recognize is part of the CREST variant syndrome rather than the systemic type of this disorder?

Dermal thickening proximal to wrists

When educating the client with ankylosing spondylitis, the nurse should emphasize which treatment interventions? Select all that apply.

Encourage sleeping supine on an extra firm mattress if possible. Try using the heating pad prior to exercise to help stretching and improve movement.

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

Generalized stunted growth can occur

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

Gentle exercise

A 64-year-old man was diagnosed 19 months ago with bilateral osteoarthritis (OA) in his knees, and has come to his family physician for a checkup. The client and his physician are discussing the effects of his health problem and the measures that the man has taken to accommodate and treat his OA in his daily routines. Which statement by the client would necessitate further teachin

I've been avoiding painkillers because I know they can mask damage that I might be inflicting on my knees

An older adult client has had mobility and independence significantly impaired by the progression of rheumatoid arthritis (RA). What is the primary pathophysiologic process that has contributed to this client's decline in health?

Immunologically mediated joint inflammation

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

Kyphosis

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

Due to her progressing osteoarthritis (OA), an 80-year-old woman is no longer able to perform her activities of daily living without assistance. Which phenomenon most likely underlies the woman's situation?

Loss of articular cartilage and synovitis has resulted from inflammation caused when joint cartilage attempted to repair itself.

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

Lower back pain

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

Raynaud's phenomenon.

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

During assessment of a client with systemic lupus erythematosus (SLE), the nurse hears a friction rub when the stethoscope is placed over the heart. Which complication of SLE will the nurse document in the medical records and report to the health care provider?

Pericarditis

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 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

Following a progressive onset of fatigue, aching, and joint stiffness over the last two years, a 69-year-old male has recently been diagnosed with rheumatoid arthritis (RA). Which teaching point should his primary care physician include during the office visit in which this diagnosis is communicated to the client?

Steroids and anti-inflammatory drugs that I'll prescribe will likely bring some relief to your symptoms

While reviewing the following diagnostic findings on a group of clients with joint complaints, which finding would be a priority for further investigation and possible medical intervention?

Synovial fluid aspiration indicates the presence of monosodium urate crystals

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.

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.

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

Weight and nutritional status

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.

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

elevated anti-nuclear antibodies (ANA)