Test 3 Chpt 38,41

Which medication directly inhibits osteoclasts, thereby reducing bone loss and increasing bone mass density (BMD)?

***Calcitonin Teriparatide Vitamin D Raloxifene

A client asks the nurse how to identify rheumatoid nodules with rheumatoid arthritis. What characteristic will the nurse include?

nonmovable tender to the touch reddened ***located over bony prominence

A client with rheumatoid arthritis arrives at the clinic for a checkup. Which statement by the client refers to the most overt clinical manifestation of rheumatoid arthritis?

"I have pain in my hands." "I have trouble with my balance." "My legs feel weak." ***"My finger joints are oddly shaped."

A client asks the nurse what the difference is between osteoarthritis (OA) and rheumatoid arthritis (RA). Which response is correct?

"OA and RA are very similar. OA affects the smaller joints and RA affects the larger, weight-bearing joints." "OA is more common in women. RA is more common in men." "OA affects joints on both sides of the body. RA is usually unilateral." ***"OA is a noninflammatory joint disease. RA is characterized by inflamed, swollen joints."

A client with early stage rheumatoid arthritis asks the nurse what to do to help ease the symptoms of the disease. What would be the best response by the nurse?

"The health care provider could prescribe antipyretic drugs." "The health care provider could prescribe antineoplastic drugs." "The health care provider could prescribe antihypertensive drugs." ***"The health care provider could prescribe anti-inflammatory drugs."

Health education for a woman over age 50 includes providing information about the importance of adequate amounts of calcium and vitamin D to prevent osteoporosis. Select the daily dosage of calcium and vitamin D that the nurse should recommend.

***1,200 mg; 1,000 IU 1,600 mg; 1,400 IU 1,800 mg; 1,600 IU 1,400 mg; 1,200 IU

A clinic nurse is caring for a client diagnosed with rheumatoid arthritis (RA). The client tells the nurse that she has not been taking her medication because she usually cannot remove the childproof medication lids. How can the nurse best facilitate the client's adherence to her medication regimen?

***Encourage her to have her pharmacy replace the tops with alternatives that are easier to open. Encourage the client to store the bottles with their tops removed. Have a trusted family member take over the management of the client's medication regimen. Have the client approach her primary provider to explore medication alternatives.

A client has a serum study that is positive for the rheumatoid factor. What will the nurse tell the client about the significance of this test result?

***It is suggestive of rheumatoid arthritis. It is diagnostic for systemic lupus erythematosus. It is specific for rheumatoid arthritis. It is diagnostic for Sjögren's syndrome.

The nurse is assessing a client with decreased dexterity of the hands related to rheumatoid arthritis. The nurse knows that which process causes joint deformities?

Autoimmunity ***Inflammation Exacerbation Remission

A nurse is performing the health history and physical assessment of a client who has a diagnosis of rheumatoid arthritis (RA). What assessment finding is most consistent with the clinical presentation of RA?

Cool joints with decreased range of motion Visible atrophy of the knee and shoulder joints Signs of systemic infection ***Joint stiffness lasting longer than 1 hour, especially in the morning

The nurse is reviewing the diagnostic test findings of a client with rheumatoid arthritis. What would the nurse expect to find?

Increased C4 complement Increased red blood cell count Increased albumin levels ***Elevated erythrocyte sedimentation rate

A nurse is teaching a client about preventing osteoporosis. Which teaching point is correct?

Obtaining the recommended daily allowance of calcium requires taking a calcium supplement. Obtaining an X-ray of the bones every 3 years is recommended to detect bone loss. ***The recommended daily allowance of calcium may be found in a wide variety of foods. To prevent fractures, the client should avoid strenuous exercise.

A nurse is providing care for a client who has just been diagnosed with early-stage rheumatoid arthritis (RA). The nurse should anticipate the administration of which medication?

Prednisone ***Methotrexate Hydromorphone Allopurinol

A client is experiencing an acute exacerbation of rheumatoid arthritis. What should the nursing priority be?

Providing comprehensive client teaching; including symptoms of the disorder, treatment options, and expected outcomes Performing meticulous skin care Supplying adaptive devices, such as a zipper-pull, easy-to-open beverage cartons, lightweight cups, and unpackaged silverware ***Administering ordered analgesics and monitoring their effects

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?

Refer the client to a support group. Arrange a family meeting in order to explore assisted living options. ***Arrange for the client to be assessed in the home environment. Refer the client to social work.

A nurse is performing discharge teaching for an elderly client with osteoporosis. Which instruction about a calcium supplement should the nurse include?

Remain in an upright position 30 minutes after taking the supplement. ***Take the supplement on an empty stomach with a full glass of water. Take the supplement with meals or with orange juice. Take weekly on the same day and at the same time.

The nurse is completing a health history with a client in a clinic. What assessment finding best correlates with a diagnosis of osteoarthritis?

anorexia and weight loss fever and malaise ***joint stiffness that increases with activity erythema and edema over the affected joint

The nurse is educating a group of women on the prevention of osteoporosis. The nurse recognizes the education as being effective when the group members make which statement?

***"We need an adequate amount of exposure to sunshine." "Estrogen deficiency increases bone density." "We need to increase aerobic exercise." "We need to consume a low-calcium, high-phosphorus diet."

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

***Nonsteroidal anti-inflammatory drugs Ice packs Surgery Opioid therapy

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. Limit energy output in order to preserve strength for healing. Increase joint size and strength. Maximize range of motion while minimizing exertion.

A client's rheumatoid arthritis (RA) has failed to respond appreciably to first-line treatments and the primary provider has added prednisone to the client's drug regimen. What principle will guide this aspect of the client's treatment?

***The drug should be used for as short a time as possible. The client will need daily blood testing for the duration of treatment. The drug should be used at the highest dose the client can tolerate. The client must stop all other drugs 72 hours before starting prednisone.

A nurse is planning discharge teaching regarding exercise for a client at risk for osteoporosis. Which exercise would the nurse be most likely to suggest?

***Walking Bicycling Yoga Swimming

A client who has been diagnosed with osteoarthritis asks if he or she will eventually begin to notice deformities in the hands and fingers as the condition progresses. Which concept should the nurse include in the response?

A small percentage of osteoarthritis sufferers do eventually develop hand and arm deformities. ***Hand and finger deformities are associated with the development of rheumatoid arthritis. The client should discuss this concern with the health care provider. It's impossible to determine at the time of diagnosis how the disease will progress.

Which condition is the leading cause of disability and pain in the elderly?

Scleroderma Systemic lupus erythematous (SLE) Rheumatoid arthritis (RA) ***Osteoarthritis (OA)

A female client is at risk for developing osteoporosis. Which action will reduce the client's risk?

Taking a 300-mg calcium supplement to meet dietary guidelines Stopping estrogen therapy Living a sedentary lifestyle to reduce the incidence of injury ***Initiating weight-bearing exercise routines