Ch. 51, 52

Characteristics of gout include which features? (Select all that apply.) - Disturbed uric acid metabolism - Crystalline deposits in bony and connective tissue - Onset before menopause in women - Cardiac involvement - Renal involvement

- Disturbed uric acid metabolism, - Crystalline deposits in bony and connective tissue, - Cardiac involvement - Renal involvement

For which signs/symptoms of Lyme disease would the nurse assess? (Select all that apply.) - Fever and chills - Migratory rash - Arthritic pain - Headache - Myalgia

- Fever and chills, - Arthritic pain, - Headache, - Myalgia

Characteristics of scoliosis include which of the following? (Select all that apply.) - Involvement of lateral curvature of the spine -Increase during periods of rapid growth -More common in boys -Identifiable by uneven shoulders or scapular prominence -Possibility of leading to respiratory complications

- Involvement of lateral curvature of the spine, - Increase during periods of rapid growth -Identifiable by uneven shoulders or scapular prominence - Possibility of leading to respiratory complications

Which drugs are considered Disease Modifying Antirheumatic Drugs (DMARDs)? (Select all that apply.) - Methotrexate - Leflunomide - Hydroxychloroquine - Prednisone - Gold

- Methotrexate, - Leflunomide, - Hydroxychloroquine

Which of the following are manifestations of osteoarthritis? (Select all that apply.) - Nodules on joints of the hands - Crepitus with joint movement - Pain that is worse upon arising in the morning - Stiffness that worsens with joint use - Narrowing of joint spaces

- Nodules on joints of the hands, - Crepitus with joint movement, - Narrowing of joint spaces

Which are signs and symptoms of Sjogren syndrome? (Select all that apply.) - Xerophthalmia - Xerostomia - Candida vaginal infections - Annular erythema - Increased dental caries

- Xerophthalmia - Xerostomia - Annular erythema - Increased dental caries

Manifestations of fibromyalgia often include which of the following? (Select all that apply.) -Generalized pain -Sensitivity to Heat -Headaches -Fatigue -Sleep disturbances

-Generalized pain, -Headaches -Fatigue -Sleep Disturbances

The person at highest risk of a greenstick fracture from falling off a tall ladder is age a. 68 b. 44 c. 8 d. 23

8

Most muscle strains are caused by a. a tear in an adjoining tendon. b. abnormal muscle contraction. c. muscle asymmetry. d. bleeding into the muscle.

abnormal muscle contraction.

Myasthenia gravis is an autoimmune disease in which a. neuronal demyelination disrupts nerve transmission. b. muscles become increasingly bulky but weakened. c. acetylcholine receptors are destroyed or dysfunctional. d. acetylcholine release from motor neurons is disrupted.

acetylcholine receptors are Destroyed or Dysfunctional.

The complication which is not likely to result from an open, transverse fracture of the tibia and fibula is a. bone infection. b. fat emboli. c. air embolus. d. compartment syndrome.

air embolus

Rheumatoid arthritis is commonly associated with the presence of rheumatoid factor autoantibodies in the bloodstream. This indicates that rheumatoid arthritis is likely to be a. caused by bacterial infection. b. an autoimmune process. c. an infective process. d. because of an enzymatic defect.

an autoimmune process

The most common source of osteomyelitis is a. an infection that migrates via the bloodstream. b. direct invasion from a fracture. c. surgical contamination. d. a joint prosthesis.

an infection that migrates via the bloodstream.

Rheumatoid arthritis involves joint inflammation caused by a. bacterial infection. b. trauma. c. autoimmune injury. d. congenital hypermobility.

autoimmune injury

Systemic lupus erythematosus (SLE) is a rheumatic disease attributed to a. wear and tear on weight-bearing joints. b. septic joint inflammation and necrosis. c. unknown etiologic factors. d. autoimmune mechanisms.

autoimmune mechanisms.

To avoid the progression of cutaneous lesions, a patient diagnosed with systemic lupus erythematosus (SLE) should a. avoid sun exposure. b. avoid excessive use of moisturizers. c. refrain from washing the affected areas. d. apply warm, wet compresses daily.

avoid sun exposure.

The most common type of osteomyelitis is a. hematogenous. b. contiguous focus. c. Brodie abscess. d. direct invasion.

Hematogenous

People who have osteoporosis are at risk for a. rhabdomyolysis. b. osteomyelitis. c. osteomalacia. d. bone fractures

bone fractures

The most common symptom of multiple myeloma is a. pathologic fracture. b. fever. c. bone pain. d. osteomyelitis

bone pain

A Type I open fracture is best described as a bone that is a. broken in two or more pieces. b. cracked but not completely separated. c. broken along the long axis. d. broken and protruding through the skin.

broken and protruding through the skin

Inflammation of the sacs that overlie bony prominences is called a. epicondylitis. b. arthritis. c. tendinitis. d. bursitis.

bursitis

Anticholinesterase inhibitors may be used to manage a. muscular dystrophy. b. myasthenia gravis. c. fibromyalgia. d. rheumatoid arthritis.

myasthenia gravis.

Bone healing may be impaired by a. excessive vitamin C. b. nicotine use. c. a high-protein diet. d. immobilization.

nicotine use

A bone disorder that results from insufficient vitamin D is referred to as a. rickets. b. osteoporosis. c. osteomalacia. d. subluxation.

OsteoMALACIA

Which disorder usually causes skeletal pain and involves significant bone demineralization from vitamin D deficiency? a. Osteomalacia b. Osteopenia c. Osteomyelitis d. Osteoporosis

OsteoMALACIA

A malignant bone-forming tumor is referred to as a(n) a. rhabdosarcoma. b. liposarcoma. c. osteosarcoma. d. chondrosarcoma.

Osteosarcoma

27. The disorder characterized by softening and then enlargement of bones is referred to as a. osteomyelitis. b. osteoporosis. c. Paget disease. d. rickets.

Paget Disease

Pain with passive stretching of a muscle is indicative of a. noncontractile tissue injury. b. contractile tissue injury. c. vascular insufficiency. d. skeletal muscle damage.

noncontractile tissue injury

The most common presenting sign/symptom with rheumatic fever is a. cardiac murmur. b. polyarthritis. c. rash. d. painless nodules.

Polyarthritis

A laboratory test result that helps confirm the diagnosis of systemic lupus erythematosus (SLE) is a. elevated serum calcium level. b. elevated monoclonal antibody titer. c. positive antinuclear antibodies. d. positive microsomal antibodies.

Positive Antinuclear Antibodies.

The earliest manifestation of scleroderma is a. thick, tight, shiny skin. b. skin hyper/hypopigmentation. c. renal impairment. d. Raynaud phenomenon.

Raynaud Phenomenon

The disease that is similar to osteomalacia and occurs in growing children is a. rickets. b. osteosarcoma. c. Paget disease. d. osteopenia.

Rickets

Compartment syndrome occurs secondary to a. bone infarction. b. soft-tissue damage. c. muscle necrosis. d. breakdown of RBCs.

Soft-tissue damage

The displacement of two bones in which the articular surfaces partially lose contact with each other is called a. subluxation. b. subjugation. c. sublimation. d. dislocation.

subluxation

In contrast to osteoarthritis, rheumatoid arthritis may be associated with a. debilitating joint pain and stiffness. b. improvement in symptoms with aspirin therapy. c. changes in activities of daily living. d. systemic aching in the musculoskeletal system.

systemic aching in the musculoskeletal system.

The final stage of gout, characterized by crystalline deposits in cartilage, synovial membranes, and soft tissue, is called a. tophaceous gout. b. gouty arthritis. c. complicated gout. d. asymptomatic hyperuricemia.

Tophaceous Gout

"Tell me again the name of that chemical that makes crystals when my gout flares up," asks the client. The nurse's best response is a. calcium phosphate. b. urea. c. uric acid. d. β-hydroxybutyric acid.

Uric Acid

Although skin manifestations may occur in numerous locations, the classic presentation of systemic lupus erythematosus (SLE) includes a. lesions affecting the palms of hands and the soles of feet. b. dry, scaly patches in the antecubital area and behind the knees. c. cracked, scaly areas in the webs of fingers. d. a butterfly pattern rash on the face across the bridge of the nose.

a butterfly pattern rash on the face across the bridge of the nose.

Pain in fibromyalgia involves a. muscle inflammation. b. autoimmune destruction of muscle tissue. c. nerve inflammation. d. changes in pain transmission in the spinal cord.

changes in pain transmission in the spinal cord

A fracture in which bone breaks into two or more fragments is referred to as a. comminuted. b. open. c. greenstick. d. stress.

comminuted

The chief pathologic features of osteoarthritis are a. stress fractures of the epiphysis, inflammation of the diaphysis, and accumulation of excessive synovial fluid. b. autoimmune damage to the synovium, destruction of articular cartilage by pannus, and thickening of synovial fluid. c. degeneration of articular cartilage, destruction of the bone under the cartilage, and thickening of the synovium. d. thinning of the joint capsule, resorption of bone, excessive formation of new bone, and formation of bone spurs.

degeneration of articular cartilage, destruction of the bone under the cartilage, and thickening of the synovium.

A patient diagnosed with diabetes smokes a pack of cigarettes daily and eats very few green leafy vegetables. After experiencing a fractured toe, this patient is at risk for a. delayed healing. b. malunion. c. nonunion. d. dysunion.

delayed healing.

Tophi are a. renal calculi composed of uric acid. b. deposits of urate crystals in tissues. c. painful edematous joints. d. spots that coalesce in a malar rash.

deposits of urate crystals in tissues

Following a bone fracture, the earliest likely event to occur is a. development of a blood clot beneath the periosteum. b. leukocyte infiltration into bone tissue. c. blood vessel growth at the fracture site. d. migration of osteoblasts to the fracture site.

development of a blood clot beneath the periosteum.

The pain of nonarticular rheumatism ("growing pain") is worse a. during activity. b. following strenuous exercise. c. upon awakening. d. during the night.

during the night

A risk factor for osteoporosis is a. endometriosis. b. early menopause. c. late menopause. d. ovarian cysts.

early menopause

In older women, osteoporosis is thought to be primarily because of a. dietary inadequacies. b. estrogen deficiency. c. malabsorption syndrome. d. inactivity.

estrogen deficiency

Paget disease is characterized by a. overactivity of osteoblasts leading to multiple bone tumors. b. excessive bone resorption followed by excessive formation of fragile bone. c. inflammatory disorder resulting in fusion of spine joints. d. failure of resorption by osteoclasts resulting in hard bones.

excessive bone resorption followed by excessive formation of fragile bone.

Muscular dystrophy includes a number of muscle disorders that are a. genetically transmitted. b. easily prevented and managed. c. autoimmune in nature. d. demyelinating focused.

genetically transmitted

What type of fracture generally occurs in children? a. Greenstick b. Stress c. Oblique d. Colles

greenstick

Prosthetic joint infection is most often because of a. defective replacement material. b. injury to the joint. c. hematogenous transfer. d. arthritis.

hematogenous transfer

The pathophysiology of rheumatoid arthritis involves a. immune cells accumulating in pannus and destroying articular cartilage. b. free radicals attaching to the synovial membrane and tunneling into articular cartilage. c. excessive wear and tear and microtrauma that damage articular cartilage. d. cysts developing in subchondral bone and creating fissures in articular cartilage.

immune cells accumulating in pannus and destroying articular cartilage.

Individuals diagnosed with systemic lupus erythematosus (SLE) are at risk for developing numerous complications of various organs because of a. excessive production of connective tissue. b. formation of osteophytes in tissues. c. immune injury to basement membranes. d. impaired tissue oxygen transport.

immune injury to basement membranes.

The pathophysiology of osteomalacia involves a. increased osteoclast activity. b. collagen breakdown in the bone matrix. c. crowding of cells in the osteoid. d. inadequate mineralization in the osteoid.

inadequate mineralization in the osteoid.

Gouty arthritis is a complication of a. group A streptococcal infection. b. autoimmune destruction of joint collagen. c. excessive production of urea. d. inadequate renal excretion of uric acid.

inadequate renal excretion of uric acid.

It is true that scleroderma involves a. inflammation and fibrosis of connective tissue. b. autoantibodies against acetylcholine receptors. c. infection by β-hemolytic streptococcus. d. inflammation caused by antigenic fragments of dead organisms.

inflammation and fibrosis of connective tissue.

Ankylosing spondylitis is characterized by a. inflammation, stiffness, and fusion of spinal joints. b. loss of articular cartilage in weight-bearing joints. c. excessive bone remodeling leading to soft bone. d. immune mechanisms leading to widespread joint inflammation.

inflammation, stiffness, and fusion of spinal joints.

Enteropathic arthritis is associated with a. irritable bowel syndrome. b. inflammatory bowel disease. c. chronic constipation. d. chronic diarrhea.

inflammatory bowel disease

Assessment of an extremity six hours after surgical alignment and casting demonstrates pulselessness and pallor. The priority action to take is to a. increase the administration his pain medication. b. initiate action to have the cast split or removed. c. note the increase in pain in the chart, and recheck the extremity in 30 minutes. d. elevate the extremity to relieve swelling.

initiate action to have the cast split or removed.

Ankylosing spondylitis causes a. intervertebral joint fusion. b. instability of synovial joints. c. costal cartilage degeneration. d. temporomandibular joint degeneration.

intervertebral joint fusion.

The most common site affected in Paget disease is the a. lower spine. b. skull. c. pelvis. d. joints.

lower spine

Healing of a fractured bone with a poor alignment is called a. malunion. b. nonunion. c. disunion. d. delayed union.

malunion

A clinical finding consistent with a diagnosis of rheumatoid arthritis would be a. systemic manifestations of inflammation. b. localized pain in weight-bearing joints. c. reduced excretion of uric acid by the kidney. d. firm, crystallized nodules or "tophi" at the affected joints.

systemic manifestations of inflammation.

A unique characteristic feature of fibromyalgia is the presence of a. tender point pain. b. head pain. c. contractures. d. muscle atrophy.

tender point pain

Complete healing of a bone fracture occurs when a. no movement of the break is detectable. b. the callus has been completely replaced with mature bone. c. the fracture site and surrounding soft tissue are pain free. d. a cast is no longer required to stabilize the break.

the callus has been completely replaced with mature bone

Rickets is characterized by soft, weak bones resulting from a deficiency of a. calcium. b. estrogen. c. phosphate. d. vitamin D.

vitamin D