Chp. 64: Arthritis and Connective Tissue Diseases

What is most likely to cause the pain experienced in the later stages of OA? A) Crepitation B) Bouchard's nodes C) Heberden's nodes D) Bone surfaces rubbing together

D) Bone surfaces rubbing together

***MISSING QUESTION***

***MISSING QUESTION***

A patient who had arthroscopic surgery of the right knee 7 days ago is admitted with a red, swollen, and hot knee. Which assessment finding by the nurse should be reported to the health care provider immediately? A) The blood pressure is 86/50 mm Hg B) The white blood cell count is 11,500/L C) The patient is taking ibuprofen (Motrin) D) The patient says the knee pain is severe

A) The blood pressure is 86/50 mm Hg

The nurse suggests that a patient recently diagnosed with rheumatoid arthritis (RA) plan to start each day with? A) A warm bath followed by a short rest B) A short routine of isometric exercises C) Active range-of-motion (ROM) exercises D) Stretching exercises to relieve joint stiffness

A) A warm bath followed by a short rest

Patient-Centered Care: A patient taking ibuprofen for treatment of OA has good pain relief but reports increased dyspepsia and nausea. What should the nurse discuss with the patient's health care provider (HCP) about these side effects? A) Adding misoprostol to the patient's drug regimen B) Substituting naproxen (Naprosyn) for the ibuprofen C) Returning to the use of acetaminophen at a dose of 5 g per day instead of 4g per day D) Administering the ibuprofen with antacids to decrease the gastrointestinal (GI) irritation

A) Adding misoprostol to the patient's drug regimen

Which action will the nurse include in the plan of care for a 40-year-old with newly diagnosed ankylosing spondylitis? A) Advise the patient to sleep on the back with a flat pillow B) Emphasize that application of heat may worsen symptoms C) Schedule annual laboratory assessment for the HLA-B27 antigen D) Assist patient to choose physical activities that allow the spine to flex

A) Advise the patient to sleep on the back with a flat pillow

Which finding for a patient who is taking hydroxychloroquine (Plaquenil) to treat rheumatoid arthritis is likely to be an adverse effect of the medication? A) Blurred vision B) Joint tenderness C) Abdominal cramping D) Elevated blood pressure

A) Blurred vision

A 28-year-old with psoriatic arthritis and back pain is receiving etanercept (Enbrel). Which finding is most important for the nurse to report to the health care provider? A) Crackles are heard in both lung bases B) Red, scaly patches are noted on the arms C) Hemoglobin level is 11.1g/dL and hematocrit is 35% D) Patient reports continued back pain after a week of etanercept therapy

A) Crackles are heard in both lung bases

During an acute exacerbation, a patient with SLE is treated with corticosteroids. The nurse should expect the corticosteroids to begin to be tapered when which serum laboratory results are evident? A) Decreased anti-DNA B) Increased complement C) Increased red blood cells (RBCs) D) Decreased erythrocyte sedimentation rate (ESR)

A) Decreased anti-DNA

What characterizes the pathophysiology of systemic lupus erythematosus (SLE)? A) Destruction of nucleic acids and other self-proteins by autoantibodies B) Overproduction of collagen that disrupts the functioning of internal organs C) Formation of abnormal IgG that attaches to cellular antigens, activating complement D) Increased activity of T suppressor cells with B-cell hypoactivity, resulting in an immunodeficiency

A) Destruction of nucleic acids and other self-proteins by autoantibodies

Which finding will the nurse expect when assessing a 58-year-old patient who has osteoarthritis (OA) of the knee? A) Discomfort with joint movement B) Heberden's and Bouchard's nodes C) Redness and swelling of the knee joint D) Stiffness that increases with movement

A) Discomfort with joint movement

The nurse cares for the client with a 10 year history of osteoarthritis. Which assessment would the nurse expect to find? A) Increased joint pain and stiffness after periods of activity B) Weight loss and decreased appetite C) Upper an lower extremity joints warm to touch and reddened in appearance D) Increased erythrocyte sedimentation rate (ESR)

A) Increased joint pain and stiffness after periods of activity

Which description is most characteristic of osteoarthritis (OA) when compared to rheumatoid arthritis (RA)? A) Not systemic or symmetric B) Rheumatoid factor (RF) positive C) Most commonly occurs in women D) Morning joint stiffness lasts 1 to several hours

A) Not systemic or symmetric

The nurse determines that colchicine has been effective for a patient with an acute attack of gout upon finding? A) Relief of joint pain B) Increased urine output C) Elevated serum uric acid D) Increased white blood cells (WBC)

A) Relief of joint pain

A patient with OA asks the nurse if he could try glucosamine and chondroitin for symptom management. What is the best response by the nurse? A) Results of research have been mixed and most medical groups do not recommend their use B) Most patients find these supplements helpful for relieving arthritis pain and improving mobility C) These supplements are a fad that have not been shown to reduce pain or increase joint mobility D) High dosages of these supplements are needed for the patient to receive any benefit in treating OA

A) Results of research have been mixed and most medical groups do not recommend their use

A 63-year-old patient hospitalized with polymyositis has joint pain, an erythematosus facial rash, eyelid edema, and a weak, hoarse voice. The priority nursing diagnosis for the patient is? A) Risk for aspiration related to dysphagia B) Disturbed visual perception related to swelling C) Acute pain related to generalized inflammation D) Risk for impaired skin integrity related to scratching

A) Risk for aspiration related to dysphagia

A 37-year-old patient with 2 school-age children who has recently been diagnosed with rheumatoid arthritis (RA) tells the nurse that home life is very stressful. Which response by the nurse is most appropriate? A) Tell me more about situations that are causing you stress B) You need to see a family therapist for some help with stress C) Your family should understand the impact of your rheumatoid arthritis D) Perhaps it would be helpful for your family to be involved in a support group

A) Tell me more about situations that are causing you stress

During assessment of the patient with scleroderma, what should the nurse expect to find? A) Thickening of the skin of the fingers and hands B) Cool, cyanotic fingers with thinning skin over the joints C) Swan neck deformity or ulnar drift deformity of the hands D) Low back pain, stiffness, and limitation of spine movement

A) Thickening of the skin of the fingers and hands

Patient-Centered Care: What should the nurse include in the teaching plan for the patient with SLE? A) Ways to avoid exposure to sunlight B) Ways to increase dietary protein and carbohydrate intake C) The need for genetic counseling before planning a family D) The use of nonpharmacologic pain interventions instead of analgesics

A) Ways to avoid exposure to sunlight

During assessment of the patient with fibromyalgia, the nurse would expect the patient to report which of the following (select all that apply)? A) Sleep disturbances B) Multiple tender points C) Cardiac palpitations and dizziness D) Multi joint pain with inflammation and swelling E) Widespread bilateral, burning musculoskeletal pain

A, B, E

A patient with debilitating fatigue has been diagnosed with SEID. Which criteria are considered the 3 major symptoms and the 1 additional manifestation that must be present for this diagnosis to be made (select all that apply)? A) Unrefreshing sleep B) Unexplained muscle pain C) Cognitive impairment ("brain fog") D) Profound fatigue lasting for 6 months E) Tender cervical or axillary lymph nodes F) Headaches of a new type, pattern, or severity G) Total exhaustion after minor physical or mental exertion

A, C, D, G

Which information will the nurse include when preparing teaching materials for patients with exacerbations of rheumatoid arthritis? A) Affected joints should not be exercised when pain is present B) Application of cold packs before exercise may decrease joint pain C) Exercises should be performed passively by someone other than the patient D) Walking may substitute for range-of-motion (ROM) exercises on some days

B) Application of cold packs before exercise may decrease joint pain

What laboratory findings should the nurse expect to be present in the patient with RA? A) Polycythemia B) Increased immunoglobulin G (IgG) C) Decreased white blood cell (WBC) count D) Antibodies to citrullinated peptide (anti-CCP)

D) Antibodies to citrullinated peptide (anti-CCP)

After teaching a patient with RA about the prescribed therapeutic regimen, which patient statement indicates that further instruction is needed? A) "It is important for me to perform my prescribed exercises every day." B) "I should do most of my daily chores in the morning when my energy level is highest." C) "An ice pack to a joint for 10 minutes may help relieve pain when I have an acute flare." D) "I can use assistive devices, like padded utensils and elevated toilet seats, to protect my joints."

B) "I should do most of my daily chores in the morning when my energy level is highest."

Priority Decision: A patient with newly diagnosed SLE asks the nurse how the disease will affect her life. What is the best response by the nurse? A) "You can plan to have a near-normal life, since SLE rarely causes death." B) "It is hard to say because the disease is so variable in its severity and progression." C) "Life span is shortened in people with SLE, but the disease can be controlled with long-term corticosteroid use." D) "Most people with SLE have alternating periods of remissions and exacerbations that rapidly progress to permanent organ damage."

B) "It is hard to say because the disease is so variable in its severity and progression."

The health care provider has prescribed the following collaborative interventions for a patient who is taking azathioprine (Imuran) for systemic lupus erythematosus. Which order will the nurse question? A) Draw anti-DNA blood titer B) Administer varicella vaccine C) Naproxen (Aleve) 200 mg BID D) Famotidine (Pepcid) 20 mg daily

B) Administer varicella vaccine

Patient-Centered Care: A patient recovering from an acute exacerbation of RA tells the nurse that she is too tired to bathe. What should the nurse do for this patient? A) Give the patient a bed bath to conserve her energy B) Allow the patient a rest period before showering with the nurse's help C) Tell the patient that she can skip bathing if she will walk in the hall later D) Teach the patient that it is important for her to maintain self-care activities

B) Allow the patient a rest period before showering with the nurse's help

A patient with gout is treated with drug therapy to prevent future attacks. What should the nurse should teach the patient? A) Have periodic testing of serum uric acid levels B) Avoid all foods high in purine, such as organ meats C) Increase the dose of medication with the onset of an acute attack D) Perform active range of motion (ROM) of all joints that are affected by gout

B) Avoid all foods high in purine, such as organ meats

A patient with gout has a new prescription for losartan (Cozaar) to control the condition. The nurse will plan to monitor? A) Blood glucose B) Blood pressure C) Erythrocyte count D) Lymphocyte count

B) Blood pressure

The patient has had RA for some time but has not had success with previous medications. Although there is an increased risk for tuberculosis, which tumor necrosis factor (TNF) inhibitor may be used with methotrexate to treat symptoms? A) Parenteral gold B) Certolizumab (Cimzia) C) Tocilizumab (Actemra) D) Hydroxychloroquine (Plaquenil)

B) Certolizumab (Cimzia)

During treatment of the patient with an acute attack of gout, which drug should the nurse expect to administer first? A) Aspirin B) Colchicine C) Probenecid D) Allopurinol

B) Colchicine

Which information will the nurse include when teaching a 38-year-old male patient with newly diagnosed ankylosing spondylitis (AS) about the management of the condition? A) Exercise by taking long walks B) Do daily deep-breathing exercises C) Sleep on the side with hips flexed D) Take frequent naps during the day

B) Do daily deep-breathing exercises

Which nursing action can the registered nurse (RN) delegate to unlicensed assistive personnel (UAP) who are assisting with the care of a patient with scleroderma? A) Monitor for difficulty in breathing B) Document the patients oral intake C) Check finger strength and movement D) Apply capsaicin (Zostrix) cream to hands

B) Document the patients oral intake

During the acute phase of dermatomyositis, what is an appropriate patient outcome? A) Relates improvement in pain B) Does not experience aspiration C) Performs active ROM 4 times daily D) Maintains absolute rest of affected joints

B) Does not experience aspiration

Which result for a 30-year-old patient with systemic lupus erythematosus (SLE) is most important for the nurse to communicate to the health care provider? A) Decreased C-reactive protein (CRP) B) Elevated blood urea nitrogen (BUN) C) Positive antinuclear antibodies (ANA) D) Positive lupus erythematosus cell prep

B) Elevated blood urea nitrogen (BUN)

Which drug that prevents binding of the tumor necrosis factor and inhibits the inflammatory response is used in the management of RA? A) Anakinra (Kineret) B) Entanercept (Enbrel) C) Leflunomide (Arava) D) Azathioprine (Imuran)

B) Entanercept (Enbrel)

Which extraarticular manifestation of RA is most likely to be seen in the patient with rheumatoid nodules? A) Lyme disease B) Felty syndrome C) Sjögren's syndrome D) Spondyloarthropathies

B) Felty syndrome

The nurse cares for the client with a 15 yr. history of SLE. The client's BP is 158/94 and pretibial edema is present. The client's serum potassium levels are increased and the serum hemoglobin level is low. Which process best describes the reason for these findings? A) Degranulation of mast cells and release of histamine and serotonin B) Formation of immune complexes and trigger inflammation C) Release of massive amounts of IgE and leukotrienes D) Lysis of the antibody molecules and release of sensitized T cells

B) Formation of immune complexes and trigger inflammation

The nurse determines that additional instruction is needed when a patient diagnosed with scleroderma says which of the following? A) Paraffin baths can be used to help my hands B) I should lie down for an hour after each meal C) Lotions will help if I rub them in for a long time D) I should perform range-of-motion exercises daily

B) I should lie down for an hour after each meal

After the nurse has taught a 28-year-old with fibromyalgia, which statement by the patient indicates a good understanding of effective self-management? A) I am going to join a soccer team to get more exercise B) I will need to stop drinking so much coffee and soda C) I will call the doctor every time my symptoms get worse D) I should avoid using over-the-counter medications for pain

B) I will need to stop drinking so much coffee and soda

After the nurse has finished teaching a 68-year-old patient with osteoarthritis (OA) of the right hip about how to manage the OA, which patient statement indicates a need for more teaching? A) I can take glucosamine to help decrease my knee pain B) I will take 1 g of acetaminophen (Tylenol) every 4 hours C) I will take a shower in the morning to help relieve stiffness D) I can use a cane to decrease the pressure and pain in my hip

B) I will take 1 g of acetaminophen (Tylenol) every 4 hours

Which statement by a patient with systemic lupus erythematosus (SLE) indicates that the patient has understood the nurses teaching about the condition? A) I will exercise even if I am tired B) I will use sunscreen when I am outside C) I should take birth control pills to keep from getting pregnant D) I should avoid aspirin or nonsteroidal anti-inflammatory drugs

B) I will use sunscreen when I am outside

A 40-year-old African American patient has scleroderma manifested by CREST (calcinosis, Raynaud's phenomenon, esophageal dysfunction, sclerodactyly, and telangiectasia) syndrome. Which action will the nurse include in the plan of care? A) Avoid use of capsaicin cream on hands B) Keep environment warm and draft free C) Obtain capillary blood glucose before meals D) Assist to bathroom every 2 hours while awake

B) Keep environment warm and draft free

During assessment of the patient diagnosed with fibromyalgia, what should the nurse expect the patient to report in addition to widespread pain? A) Generalized muscle twitching and spasms B) Nonrestorative sleep with resulting fatigue C) Profound and progressive muscle weakness that limits ADLs D) Widespread musculoskeletal pain that is accompanied by inflammation and fever

B) Nonrestorative sleep with resulting fatigue

Patient-Centered Care: To preserve function and the ability to perform activities of daily living (ADLs), what should the nurse teach the patient with OA? A) Avoid exercise that involves the affected joints B) Plan and organize task performance to be less stressful to joints C) Maintain normal activities during an acute episode to prevent loss of function D) Use mild analgesics to control symptoms when performing tasks that cause pain

B) Plan and organize task performance to be less stressful to joints

Which action will the nurse include in the plan of care for a 33-year-old patient with a new diagnosis of rheumatoid arthritis? A) Instruct the patient to purchase a soft mattress B) Suggest that the patient take a nap in the afternoon C) Teach the patient to use lukewarm water when bathing D) Suggest exercise with light weights several times daily

B) Suggest that the patient take a nap in the afternoon

A patient with rheumatoid arthritis (RA) complains to the clinic nurse about having chronically dry eyes. Which action by the nurse is most appropriate? A) Teach the patient about adverse effects of the RA medications B) Suggest that the patient use over-the-counter (OTC) artificial tears C) Reassure the patient that dry eyes are a common problem with RA D) Ask the health care provider about discontinuing methotrexate (Rheumatrex)

B) Suggest that the patient use over-the-counter (OTC) artificial tears

Which assessment finding about a patient who has been using naproxen (Naprosyn) for 6 weeks to treat osteoarthritis is most important for the nurse to report to the health care provider? A) The patient has gained 3 pounds B) The patient has dark-colored stools C) The patients pain has become more severe D) The patient is using capsaicin cream (Zostrix)

B) The patient has dark-colored stools

A 46-year-old male patient with dermatomyositis is receiving long-term prednisone (Deltasone) therapy. Which assessment finding by the nurse is most important to report to the health care provider? A) The blood glucose is 112 mg/dL B) The patient has painful hematuria C) Acne is noted on the patients face D) The patient has an increased appetite

B) The patient has painful hematuria

A 31-year-old woman is taking methotrexate (Rheumatrex) to treat rheumatoid arthritis. Which information from the patients health history is important for the nurse to report to the health care provider about the methotrexate? A) The patient had a history of infectious mononucleosis as a teenager B) The patient is trying to get pregnant before her disease becomes more severe C) The patient has a family history of age-related macular degeneration of the retina D) The patient has been using large doses of vitamins and health foods to treat the RA

B) The patient is trying to get pregnant before her disease becomes more severe

Which assessment information obtained by the nurse indicates that a patient with an exacerbation of rheumatoid arthritis (RA) is experiencing a side effect of prednisone (Deltasone)? A) The patient has joint pain and stiffness B) The patient's blood glucose is 165 mg/dL C) The patient has experienced a recent 5-pound weight loss D) The patient's erythrocyte sedimentation rate (ESR) has increased

B) The patient's blood glucose is 165 mg/dL

Which statements describe reactive arthritis (select all that apply)? A) Methotrexate is an initial treatment of choice B) Symptoms include urethritis and conjunctivitis C) Diagnosed by finding of hypersensitive tender points D) Increased risk in persons with decreased host resistance E) Infection of a joint often caused by hematogeneous route F) Self-limiting arthritis following genitourinary or GI tract infections

B, F

The nurse determines that teaching about management of osteoarthritis of the feet and hands has been effective when the patient says? A) "I should exercise my hands every day, especially if they are painful and inflamed." B) "I will be careful to avoid crowds and people with infections." C) "I can use heat to relieve the stiffness when I wake up in the morning." D) "I should avoid the use of glucosamine as it has been shown to have no therapeutic value."

C) "I can use heat to relieve the stiffness when I wake up in the morning."

Which patient seen by the nurse in the outpatient clinic is most likely to require teaching about ways to reduce risk for osteoarthritis (OA)? A) A 38-year-old man who plays on a summer softball team B) A 56-year-old man who is a member of a construction crew C) A 56-year-old woman who works on an automotive assembly line D) A 49-year-old woman who is newly diagnosed with diabetes mellitus

C) A 56-year-old woman who works on an automotive assembly line

Which information will the nurse include when teaching a patient with newly diagnosed chronic fatigue syndrome about self-management? A) Avoid use of over-the-counter antihistamines or decongestants B) A low-residue, low-fiber diet will reduce any abdominal distention C) A gradual increase in your daily exercise may help decrease fatigue D) Chronic fatigue syndrome usually progresses as patients become older

C) A gradual increase in your daily exercise may help decrease fatigue

A new clinic patient with joint swelling and pain is being tested for systemic lupus erythematosus. Which test will provide the most specific findings for the nurse to review? A) Rheumatoid factor (RF) B) Antinuclear antibody (ANA) C) Anti-Smith antibody (Anti-Sm) D) Lupus erythematosus (LE) cell prep

C) Anti-Smith antibody (Anti-Sm)

The nurse teaches the patient with RA that which exercise is the most effective methods of aerobic exercise? A) Ballet dancing B) Casual walking C) Aquatic exercises D) Low-impact aerobic exercises

C) Aquatic exercises

The nurse notices a circular lesion with a red border and clear center on the arm of an 18-year-old summer camp counselor who is in the camp clinic complaining of chills and muscle aches. Which action should the nurse take next? A) Palpate the abdomen B) Auscultate the heart sounds C) Ask the patient about recent outdoor activities D) Question the patient about immunization history

C) Ask the patient about recent outdoor activities

A patient with rheumatoid arthritis being seen in the clinic has rheumatoid nodules on the elbows. Which action will the nurse take? A) Draw blood for rheumatoid factor analysis B) Teach the patient about injections for the nodules C) Assess the nodules for skin breakdown or infection D) Discuss the need for surgical removal of the nodules

C) Assess the nodules for skin breakdown or infection

Which laboratory result will the nurse monitor to determine whether prednisone (Deltasone) has been effective for a 30-year-old patient with an acute exacerbation of rheumatoid arthritis? A) Blood glucose test B) Liver function tests C) C-reactive protein level D) Serum electrolyte levels

C) C-reactive protein level

The nurse will anticipate the need to teach a 57-year-old patient who has osteoarthritis (OA) about which medication? A) Adalimumab (Humira) B) Prednisone (Deltasone) C) Capsaicin cream (Zostrix) D) Sulfasalazine (Azulfidine)

C) Capsaicin cream (Zostrix)

A 29-year-old patient reporting painful urination and knee pain is diagnosed with reactive arthritis. The nurse will plan to teach the patient about the need for several months of therapy with? A) Anakinra (Kineret) B) Etanercept (Enbrel) C) Doxycycline (Vibramycin) D) Methotrexate (Rheumatrex)

C) Doxycycline (Vibramycin)

A 70-year-old patient is being evaluated for symptoms of RA. What should the nurse recognize as the major problem in the management of RA in the older adult? A) RA is usually more severe in older adults B) Older patients are not as likely to comply with treatment regimens C) Drug interactions and toxicity are more likely to occur with multidrug therapy D) Laboratory and other diagnostic tests are not effective in identifying RA in older adults

C) Drug interactions and toxicity are more likely to occur with multidrug therapy

What is an ominous sign of advanced SLE? A) Proteinuria from early glomerulonephritis B) Anemia from antibodies against blood cells C) Dysrhythmias from fibrosis of the atrioventricular node D) Cognitive dysfunction from immune complex deposit in the brain

C) Dysrhythmias from fibrosis of the atrioventricular node

A 19-year-old patient hospitalized with a fever and red, hot, and painful knees is suspected of having septic arthritis. Information obtained during the nursing history that indicates a risk factor for septic arthritis is that the patient? A) Had several knee injuries as a teenager B) Recently returned from South America C) Is sexually active with multiple partners D) Has a parent who has rheumatoid arthritis

C) Is sexually active with multiple partners

When the nurse brings medications to a patient with rheumatoid arthritis, the patient refuses the prescribed methotrexate (Rheumatrex). The patient tells the nurse, "My arthritis isn't that bad yet. The side effects of methotrexate are worse than the arthritis". The most appropriate response by the nurse is? A) You have the right to refuse to take the methotrexate B) Methotrexate is less expensive than some of the newer drugs C) It is important to start methotrexate early to decrease the extent of joint damage D) Methotrexate is effective and has fewer side effects than some of the other drugs

C) It is important to start methotrexate early to decrease the extent of joint damage

Anakinra (Kineret) is prescribed for a 49-year-old patient who has rheumatoid arthritis (RA). When teaching the patient about this drug, the nurse will include information about? A) Avoiding concurrently taking aspirin B) Symptoms of gastrointestinal (GI) bleeding C) Self-administration of subcutaneous injections D) Taking the medication with at least 8 oz of fluid

C) Self-administration of subcutaneous injections

During the physical assessment of the patient with early to moderate RA, what should the nurse expect to find? A) Hepatomegaly B) Heberden's nodes C) Spindle-shaped fingers D) Crepitus on joint movement

C) Spindle-shaped fingers

What is 1 criterion identified by the American College of Rheumatology for a diagnosis of fibromyalgia? A) Fiber atrophy found on muscle biopsy B) Elimination of all other causes of musculoskeletal pain C) The elicitation of pain on palpation of at least 11 of 18 identified tender points D) The presence of manifestations of systemic exertion intolerance disease (SEID)

C) The elicitation of pain on palpation of at least 11 of 18 identified tender points

A patient with an acute attack of gout in the right great toe has a new prescription for probenecid (Benemid). Which information about the patients home routine indicates a need for teaching regarding gout management? A) The patient sleeps about 8 to 10 hours every night B) The patient usually eats beef once or twice a week C) The patient takes one aspirin a day to prevent angina D) The patient usually drinks about 3 quarts water daily

C) The patient takes one aspirin a day to prevent angina

Which laboratory data is important to communicate to the health care provider for a patient who is taking methotrexate (Rheumatrex) to treat rheumatoid arthritis? A) The blood glucose is 90 mg/dL B) The rheumatoid factor is positive C) The white blood cell (WBC) count is 1500/L D) The erythrocyte sedimentation rate is elevated

C) The white blood cell (WBC) count is 1500/L

The nurse is planning care for a patient with hypertension and gout who has a red and painful right great toe. Which nursing action will be included in the plan of care? A) Gently palpate the toe to assess swelling B) Use pillows to keep the right foot elevated C) Use a footboard to hold bedding away from the toe D) Teach patient to avoid use of acetaminophen (Tylenol)

C) Use a footboard to hold bedding away from the toe

The nurse teaching a support group of women with rheumatoid arthritis (RA) about how to manage activities of daily living suggests that they? A) Stand rather than sit when performing household and yard chores B) Strengthen small hand muscles by wringing sponges or washcloths C) Protect the knee joints by sleeping with a small pillow under the knees D) Avoid activities that require repetitive use of the same muscles and joints

D) Avoid activities that require repetitive use of the same muscles and joints

After teaching a patient with RA to use heat and cold therapy to relieve symptoms, which patient statement indicates to the nurse that teaching has been effective? A) "Heat treatments should not be used if muscle spasms are present." B) "Cold applications can be applied for 25 to 30 minutes to relieve joint stiffness." C) "I should use heat applications for 25 minutes to relieve the symptoms of an acute flare." D) "When my joints are painful, using a bag of frozen corn for 10 to 15 minutes may relieve the pain."

D) "When my joints are painful, using a bag of frozen corn for 10 to 15 minutes may relieve the pain."

A 60-year-old woman has pain on motion in her fingers and asks the nurse if this is just a result of aging. What information is the best response by the nurse? A) Joint pain with functional limitation is a normal change that affects all people to some extent B) Joint pain that develops with age is usually related to previous trauma or infection of the joints C) This is a symptom of a systemic arthritis that eventually affects all joints as the disease progresses D) Changes in the cartilage and bones of joints may cause symptoms of pain and loss of function in some people as they age

D) Changes in the cartilage and bones of joints may cause symptoms of pain and loss of function in some people as they age

Etanercept (Enbrel) is prescribed for a patient with stage II rheumatoid arthritis. The nurse monitors the patient's laboratory results with the knowledge that a positive response to the drug is reflected by? A) Increased serum immunoglobulin G B) Decreased lymphocyte count C) Absence of Rh factor in the blood D) Decreased C-reactive protein (CRP)

D) Decreased C-reactive protein (CRP)

A 71-year-old patient who takes multiple medications develops acute gouty arthritis. The nurse will consult with the health care provider before giving the prescribed dose of? A) Sertraline (Zoloft) B) Famotidine (Pepcid) C) Oxycodone (Roxicodone) D) Hydrochlorothiazide (HydroDIURIL)

D) Hydrochlorothiazide (HydroDIURIL)

After the nurse assesses a 78-year-old who uses naproxen (Aleve) daily for hand and knee osteoarthritis management, which information is most important to report to the health care provider? A) Knee crepitation is noted with normal knee range of motion B) Patient reports embarrassment about having Heberden's nodes C) Patient's knee pain while golfing has increased over the last year D) Laboratory results indicate blood urea nitrogen (BUN) is elevated

D) Laboratory results indicate blood urea nitrogen (BUN) is elevated

What best describes the manifestations of OA? A) Smaller joints are typically affected first B) There is joint stiffness after periods of inactivity C) Joint stiffness is accompanied by fatigue, anorexia, and weight loss D) Pain and immobility may be aggravated by falling barometric pressure

D) Pain and immobility may be aggravated by falling barometric pressure

What should the nurse teach the patient with ankylosing spondylitis? A) Wear roomy shoes with good orthotic support B) Sleep on the side with the knees and hips flexed C) Keep the spine slightly flexed while sitting, standing, or walking D) Perform back, neck, and chest stretches and deep-breathing exercises

D) Perform back, neck, and chest stretches and deep-breathing exercises

A patient is seen at the outpatient clinic for a sudden onset of inflammation and severe pain in the great toe. What establishes a definitive diagnosis of gouty arthritis? A) A family history of gout B) Elevated urine uric acid levels C) Elevated serum uric acid levels D) Presence of monosodium urate crystals in synovial fluid

D) Presence of monosodium urate crystals in synovial fluid

When caring for the patient with CREST syndrome (calcinosis, Raynaud's phenomenon, esophageal dysfunction, sclerodactyly, and telangiectasia) associated with scleroderma, what should the nurse teach the patient to do? A) Maintain a fluid intake of at least 3000 mL per day B) Avoid exposure to the sun or other ultraviolet light C) Monitor and keep a log of daily BP D) Protect the hands and feet from cold exposure and injury

D) Protect the hands and feet from cold exposure and injury

What characteristics are common in spondyloarthropathies associated with human leukocyte antigen (HLA)-B27? A) Presence of RF B) Symmetric polyarticular arthritis C) Absence of extraarticular disease D) Sacroiliac and peripheral joint involvement

D) Sacroiliac and peripheral joint involvement

A 25-year-old female patient with systemic lupus erythematosus (SLE) who has a facial rash and alopecia tells the nurse, "I never leave my house because I hate the way I look". An appropriate nursing diagnosis for the patient is? A) Activity intolerance related to fatigue and inactivity B) Impaired social interaction related to lack of social skills C) Impaired skin integrity related to itching and skin sloughing D) Social isolation related to embarrassment about the effects of SLE

D) Social isolation related to embarrassment about the effects of SLE

The nurse assesses a patient with a diagnosis of osteoarthritis. The nurse expects to observe which of the following signs/symptoms? A) Swollen, reddened, painful joint with limitation of motion B) Fever, rash, and nodules over bony prominences C) Pain on abduction of the hips, waddling gait D) Stiffness of the hips, knees, vertebrae, and fingers

D) Stiffness of the hips, knees, vertebrae, and fingers

The home health nurse is doing a follow-up visit to a 41-year-old patient with recently diagnosed rheumatoid arthritis (RA). Which assessment made by the nurse indicates that more patient teaching is needed? A) The patient takes a 2-hour nap each day B) The patient has been taking 16 aspirins daily C) The patient sits on a stool while preparing meals D) The patient sleeps with two pillows under the head

D) The patient sleeps with two pillows under the head

What should the nurse teach the patient with fibromyalgia? A) Rest the muscles as much as possible to avoid triggering pain B) Plan nighttime sleep and naps to obtain 12 to 14 hours of sleep a day C) Try using food supplements, such as glucosamine and chondroitin, for pain relief D) Use techniques, such as meditation and cognitive behavioral therapy, to manage stress

D) Use techniques, such as meditation and cognitive behavioral therapy, to manage stress