Chapter 50 Pathophysiology NCLEX-Style Review Questions

Which disease in children presents with an inflammatory myopathy primarily involving skin and muscle with a heliotrope rash around the eyes? -Systematic lupus erythematous -Juvenile spondyloarthropathies -Juvenile dermatomyositis -Juvenile arthritis

Juvenile dermatomyositis

When a nurse is assessing a client with osteoarthritis, which factor poses a risk for the disease? -Obesity -Smoking -Hypertension -Sedentary life style

Obesity

When planning care for the client with severe osteoarthritis (OA) of the hip, the nurse includes which statement in a teaching session with the client? Select all that apply. -"A walker may be helpful to avoid excess pressure on your hips." -"Avoid nonsteroidal anti-inflammatory medications." -"Try to balance your rest and exercise." -"Using heat or cold to relieve pain may be helpful." -"Losing weight or maintaining your ideal weight reduces stress on your joints."

"A walker may be helpful to avoid excess pressure on your hips.", "Try to balance your rest and exercise.", "Using heat or cold to relieve pain may be helpful.", "Losing weight or maintaining your ideal weight reduces stress on your joints."

When administering a corticosteroid to a client with rheumatoid arthritis, a nurse includes which education about the medication? Select all that apply. -"These drugs are for short-term use." -"Pain is relieved with use of corticosteroid medications." -"Corticosteroids may be given to inhibit tumor necrosis factor." -"Corticosteroids are taken for life to reduce inflammation." -"Corticosteroids do not prevent joint destruction."

"These drugs are for short-term use.", "Pain is relieved with use of corticosteroid medications.", "Corticosteroids do not prevent joint destruction."

The nurse determines that additional client education is needed when a client with gout makes which statement? -"I will plan to eat more white meat rather than red meat." -"Increasing my intake of water each day will help stop the symptoms." -"When I have an exacerbation of my symptoms, a glass of red wine will be helpful." -"I should avoid eating shellfish to decrease the risk of an episode."

"When I have an exacerbation of my symptoms, a glass of red wine will be helpful."

A nurse is caring for an adolesecnt female who is undergoing diagnostic studies for systemic lupus erythematosus (SLE). Which assessment findings does the nurse recognize as being consistent with childhood SLE? Select all that apply. -Child is fatigued and generally feels "under the weather." -Child is of Asian descent. -Child has increased serum creatinine. -Child is between 8 and 15 years of age. -Child has gained 20 lb (9.1 kg).

Child is fatigued and generally feels "under the weather.", Child has increased serum creatinine., Child is between 8 and 15 years of age.

The nurse is assessing a client for osteoarthritis (OS) of the knee. Which should the nurse consider to be expected findings? Select all that apply. -Crepitus -Shuffling gait -Quadricep atrophy -Localized pain -Limitation of motion

Crepitus, Quadricep atrophy, Localized pain, Limitation of motion

Which diagnostic finding has been strongly linked to systematic lupus erythematosus (SLE)? -Decreased rheumatoid factor -Low red blood cell count -An abnormal serum SLE assay -Elevated anti-nuclear antibodies (ANA)

Elevated anti-nuclear antibodies (ANA)

The nurse is assessing a client in early stage of rheumatoid arthritis. Which assessment findings would the nurse expect to find? Select all that apply. -Erythema -Crepitus -Tenderness -Warmth -Swelling

Erythema, Tenderness, Warmth, Swelling

Which symptoms are required for a diagnosis of psoriatic arthritis? Select all that apply. -A prominent butterfly-shaped rash on the face -Bone biopsy -Evidence of nail changes -Characteristic skin changes are evident

Evidence of nail changes, Characteristic skin changes are evident

Which statement is true regarding the development of juvenile idiopathic arthritis? -Surgical intervention can stop the decline associated with the arthritis. -The condition will resolve in adulthood. -A diagnosis will be made when two joints are affected. -Generalized stunted growth can occur.

Generalized stunted growth can occur.

When a nurse is caring for a client with gout, which medications will the nurse likely administer? Select all that apply. -Indomethacin -Ibuprofen -Simvastatin -Cyclosporine -Colchicine

Indomethacin, Ibuprofen, Colchicine

The nurse is assessing a client with ankylosing spondylitis (AS). What does the nurse expect to find? -Facial butterfly rash -Bruises on the lower extremities -Joint contractures -Lower back pain

Lower back pain

A child, diagnosed with juvenile idiopathic arthritis, should receive education about commonly prescribed medications. Which other priority aspect(s) of care should the nurse assess during regular clinic visits? Select all that apply. -Nutiritonal status/issues -Appearance of calcifications at pressure points -Pain and swelling in the first metatarsophalangeal in the joint -Development of hip dysplasia -Achieving growth and development milestones

Nutiritonal status/issues, Achieving growth and development milestones

Giant cell arteritis is a comorbid condition of: -Gout -Pseudogout -Polymyalgia rheumatica -Systemic lupus erythematosus

Polymyalgia rheumatica

The nurse assessing a client with scleroderma with CREST variant would include an assessment for: -Raynaud's phenomenon. -leukocytosis. -thrombocytopenia. -butterfly rash.

Raynaud's phenomenon.

What are the criteria categories required for the diagnosis of early-onset rheumatoid arthritis (RA)? Select all that apply. -Serology -Acute phase reactants -Existence of comorbid conditions -Joint involvement -Duration of symptoms

Serology, Acute phase reactants, Joint involvement, Duration of symptoms

A client is experiencing an episode of gout. The nurse recognizes that the condition is a result of: -Serum calcitonin levels -Serum blood urea nitrogen (BUN) -Serum calcium levels -Serum uric acid levels

Serum uric acid levels

The nurse is providing client education related to intra-articular corticosteroid injections. Which instruction should the nurse include? -The client or a family member will be taught to administer the injections daily. -There will be minimal discomfort because the injections are placed in the subcutaneous tissue. -The injections will be given only 3 to 4 times per year because they can increase joint destruction. -There will be immediate relief with one injection and daily running can be resumed.

The injections will be given only 3 to 4 times per year because they can increase joint destruction.

Which assessment findings will help the nurse to confirm the diagnosis of rheumatoid arthritis? Select all that apply. -Wrist pain -Asymmetrical joint involvement -Limited joint mobility -Finger and hand pain -Joint stiffness

Wrist pain, Limited joint mobility, Finger and hand pain, Joint stiffness