PrepU Chapter 38

The client with rheumatoid arthritis has a red blood cell count of 3.2 cells/cu mm. Which nursing diagnosis has the highest priority for the client?

Fatigue

Which of the following would the nurse most commonly assess in a client with ankylosing spondylitis?

Low back pain

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

Osteoarthritis (OA)

Which of the following is the most common cause for a patient to seek medical attention for arthritis?

Pain

A nurse is assigned to a client with polymyositis. Which expected outcome in the care plan relates to a potential problem associated with polymyositis?

"Client will exhibit no signs or symptoms of aspiration."

A client suspected of having systemic lupus erythematosus (SLE) is being scheduled for testing. She asks which of the tests ordered will determine if she is positive for the disorder. Which statement by the nurse is most accurate?

"The diagnosis won't be based on the findings of a single test but by combining all data found."

Which term indicates an accumulation of crystalline depositions in articular surfaces, bones, soft tissue, and cartilage?

Tophi

A diet plan is developed for a client with gouty arthritis. The nurse should advise the client to limit his intake of:

organ meats.

A nurse is teaching a client about rheumatoid arthritis. Which statement by the client indicates understanding of the disease process?

"It will get better and worse again."

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

"OA is a noninflammatory joint disease. RA is characterized by inflamed, swollen joints."

A client with gout has been advised to lose weight. She informs the nurse that she plans to go on a "guaranteed rapid weight loss" plan that involves fasting and heavy exercise. Which response would be most appropriate?

"There might be some difficulties with your plan and fasting."

The nurse is caring for a client with rheumatoid arthritis who suffers with chronic pain in the hands. When would be the best time for the nurse to perform range-of-motion exercises?

After the client has had a warm paraffin hand bath

Which of the following classifications are considered antiarthritic drugs? Select all that apply.

Anti-inflammatory Disease-modifying antirheumatics (DMARDs) Glucocorticoids

What is the priority intervention for a client who has been admitted repeatedly with attacks of gout?

Assess diet and activity at home

The treatment of gout involves managing the acute inflammatory stage, preventing flare-ups, and controlling hyperuricemia. Select the agent of first choice when an acute inflammatory attack begins

Colchicine

A client comes to the emergency department complaining of pain in the right leg. When obtaining the history, the nurse learns that the client has a history of obesity and hypertension. Based on this information the nurse anticipates the client having which musculoskeletal disorder?

Degenerative joint disease

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

Elevated erythrocyte sedimentation rate

Which is an appropriate nursing intervention in the care of the client with osteoarthritis?

Encourage weight loss and an increase in aerobic activity

When developing a care plan for a client newly diagnosed with scleroderma, which nursing diagnosis has the highest priority?

Impaired skin integrity

Which of the following statements is accurate regarding osteoarthritis?

It is a noninflammatory disorder and the most common and frequently disabling of joint disorders.

Which points should be included in the medication teaching plan for a client taking adalimumab?

It is important to monitor for injection site reactions.

Which findings best correlate with a diagnosis of osteoarthritis?

Joint stiffness that decreases with activity

Which joint is most commonly affected in gout?

Metatarsophalangeal

The nurse is discussing the new medication that a client will be taking for treatment of rheumatoid arthritis. Which disease-modifying antirheumatic drug (DMARD) will the nurse educate the client about?

Methotrexate (Rheumatrex)

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

Nonsteroidal anti-inflammatory drugs

The client with rheumatoid arthritis is seen in the clinic. Which assessment finding indicates the client is having difficulty implementing self-care?

Reports increased fatigue

A nurse is poviding care for a client with progressive systemic sclerosis. For a client with this disease, the nurse is most likely to formulate which nursing diagnosis?

Risk for impaired skin integrity

In teaching clients with osteoarthritis about their condition, it would be important for the nurse to focus on:

Strategies for remaining active

The nurse is gathering objective data for a client at the clinic complaining of arthritic pain in the hands. The nurse observes that the fingers are hyperextended at the proximal interphalangeal joint with fixed flexion of the distal interphalangeal joint. What does the nurse recognize this deformity as?

Swan neck deformity

Which of the following disorders is characterized by an increased autoantibody production?

Systemic lupus erythematosus (SLE)

Which disorder is characterized by a butterfly-shaped rash across the bridge of the nose and cheeks?

Systemic lupus erythematous (SLE)

A patient is taking NSAIDs for the treatment of osteoarthritis. What education should the nurse give the patient about the medication?

Take the medication with food to avoid stomach upset.

What intervention will best help a client with ankylosing spondylitis (AS)?

Teach the client to use a walker or cane.

After teaching a group of students about systemic lupus erythematosus, the instructor determines that the teaching was successful when the students state which of the following?

The belief is that it is an autoimmune disorder with an unknown trigger.

A client was seen in the clinic for musculoskeletal pain, fatigue, mood disorders, and sleep disturbances. The physician has diagnosed fibromyalgia. What would not be a part of teaching plan for this condition?

applications of ice

Fibromyalgia is a common condition that involves

chronic fatigue, generalized muscle aching, and stiffness.

Osteoarthritis is known as a disease that

is the most common and frequently disabling of joint disorders.

The nurse teach the client that osteoarthritis is

the most common and frequently disabling of joint disorders.

Which of the following would a nurse encourage a client with gout to limit?

Purine-rich foods

The nurse is educating the patient with gout about ways to prevent reoccurrence of an attack. What foods should the nurse encourage the patient to avoid?

Liver.

A client is being discharged from the hospital after being diagnosed with and treated for systemic lupus erythematosus (SLE). What would the nurse not include when teaching the client and family information about managing the disease?

If you have problems with a medication, you may stop it until your next physician visit.

When caring for a client experiencing an acute gout attack, the nurse anticipates administering which medication?

Colchicine

Which of the following would the nurse expect to assess as the most common finding associated with fibromyalgia?

Widespread chronic pain

A client with osteoarthritis tells the nurse she is concerned that the disease will prevent her from doing her chores. Which suggestion should the nurse offer?

"Pace yourself and rest frequently, especially after activities."

A client is being treated for hyperuricemia. Part of the treatment strategy is for the client to avoid contributing factors whenever possible. Which activities might bring on an acute attack?

eating organ meats and sardines

A client is recovering from an attack of gout. Client teaching should include the need to lose weight because:

weight loss will reduce uric acid levels and reduce stress on joints.

The nurse is educating a patient about the risks of stroke related to the new prescription for a COX-2 inhibitor and what symptoms they should report. Which COX-2 inhibitor is the nurse educating the patient about?

Celecoxib (Celebrex)

The treatment of gout involves managing the acute inflammatory stage, preventing flare-ups, and controlling hyperuricemia. Select the agent of first choice when an acute inflammatory attack begins.

Colchicine

The nurse teaches the client that the presence of crystals in the synovial fluid obtained from arthrocentesis confirms which disease process?

Gout

A nursing student asks the instructor how to identify rheumatoid nodules in a client with rheumatoid arthritis. Which of the following characteristics would the instructor include?

Located over bony prominence

Nursing care for the client with fibromyalgia should be guided by the assumption that patients with fibromyalgia

may feel as if their symptoms are not taken seriously.