Chapter 39: Patients with Rheumatic Disorders
A client with rheumatoid arthritis reports joint pain. What intervention is a priority to assist the client? A) non-steroidal anti-inflammatory drugs B) ice packs C) opioid therapy D) surgery
Answer: A) non-steroidal anti-inflammatory drugs
The side effect of bone marrow depression may occur with which medication used to treat gout? A) probenecid B) allopurinol C) prednisone D) colchicine
Answer: B) allopurinol
Which condition is the leading cause of disability and pain in the elderly? A) scleroderma B) osteoarthritis (OA) C) rheumatoid arthritis (RA) D) systemic lupus erythematous (SLE)
Answer: B) osteoarthritis (OA)
Which term refers to fixation or immobility of a joint? A) Diarthrodial B) Arthroplasty C) Hemarthrosis D) Ankylosis
Answer: D) Ankylosis
Which finding is consistent with the diagnosis of rheumatoid arthritis? A) decreased ESR B) cloudy synovial fluid C) increased red blood cell count D) increased C4 complement component
Answer: B) cloudy synovial fluid
The nurse is caring for a client who has been diagnosed with a "rheumatic disease." What nursing diagnosis will most likely apply to this client's care? Select all that apply. A) fatigue B) fluid volume deficit C) alteration of self concept D) fluid and electrolyte imbalance
Answer: A) fatigue C) alteration of self concept D) fluid and electrolyte imbalance
The nurse is performing discharge teaching for a client with rheumatoid arthritis. What teachings are priorities for the client? Select all that apply. A) safe exercise B) assistive devices C) narcotic safety D) dressing changes E) medication dosages and side effects
Answer: A) safe exercise B) assistive devices E) medication dosages and side effects
The nurse teaches the client that the presence of crystals in the synovial fluid obtained from arthrocentesis confirms which disease process? A) gout B) degeneration C) infection D) inflammation
Answer: A) gout
What intervention is a priority for a client diagnosed with osteoarthritis? A) allopurinol B) physical therapy and exercise C) hydrotherapy D) colchicine
Answer: B) physical therapy and exercise
Which newer pharmacological therapy, used to treat osteoarthritis, is though to prevent the loss of cartilage and repair chondral defects, as well as have some anti-inflammatory effects? A) Glucosamine B) Chondroitin C) Capsaicin D) Viscosupplementation
Answer: D) Viscosupplementation
Which joint is most commonly affected in gout? A) ankle B) knee C) tersal area D) metatarsophalangeal
Answer: D) metatarsophalangeal
Which is an appropriate nursing intervention in the care of the client with osteoarthritis? A) avoid the use of topical analgestics B) assess for gastrointestinal complications associated with COX-2 inhibitors C) provide an analgesic after exercise D) encourage weight loss and an increase in aerobic activity
Answer: D) encourage weight loss and an increase in aerobic activity
Which points should be included in the medication teaching plan for a client taking adalimumab? A) the client should continue taking the medication if fever occurs B) the medication is given at room temperature C) the medication is administered intramuscularly D) it is important to monitor for injection site reactions
Answer: D) it is important to monitor for injection site reactions
Scleroderma typically begins with the involvement of which system? A) cardiovascular B) integumentary C) urinary D) respiratory
Answer: B) integumentary
Which is the leading cause of disability and pain in the elderly? A) scleroderma B) systemic lupus erythematosus (SLE) C) osteoarthritis (OA) D) rheumatoid arthritis (RA)
Answer: C) osteoarthritis (OA)
Which connective tissue disorder is characterized by insoluble collagen being formed and accumulating excessively in the tissues? A) Systemic lupus erythematosus B) Scleroderma C) Polymyalgia rheumatic D) Rheumatoid arthritis
Answer: B) Scleroderma
what is the priority intervention for a client who has been admitted repeatedly with attacks of gout? A) place client on bed restq B) assess diet and activity at home C) increase fluids D) insert a foley catheter
Answer: B) assess diet and activity at home
Osteoarthritis is known as a disease that A) affects the cartilaginous joints of the spine and surrounding tissues B) is the most common and frequently disabling of joint disorders C) affects young males D) requires early treatment because most of the damage seems to occur early in the course of the disease
Answer: B) is the most common and frequently disabling of joint disorders
Which disorder is characterized by a butterfly-shaped rash across the bridge of the nose and cheeks? A) rheumatoid arthritis (RA) B) systemic lupus erythematous (SLE) scleroderma C) scleroderma D) polymyositis
Answer: B) systemic lupus erythematous (SLE) scleroderma
The nurse is teaching a client about rheumatic disease. What statement best helps to explain autoimmunity? A) "You have inherited your parent's immunity to the disease." B) "You have antigens to the disease, bu they do not prevent the disease." C) "Your symptoms are a result of your body attacking itself." D) "You are not immune to the disease causing the symptoms."
Answer: C) "Your symptoms are a result of your body attacking itself."
Which term indicates an accumulation of crystalline deposition in articular surfaces, bones, soft tissue, and cartilage? A) Subchondral bone B) Joint effusion C) Tophi D) Pannus
Answer: C) Tophi
The nurse intervenes to assist the client with fibromyalgia to cope with which symptoms? A) pain, viral infection, and tremors B) diminished vision, chronic fatigue, and reduced appetite C) chronic fatigue, generalized muscle aching, and stiffness D) generalized muscle aching, mood swings, and loss of balance
Answer: C) chronic fatigue, generalized muscle aching, and stiffness
Nursing care for the client with fibromyalgia should be guided by the assumption that patients with fibromyalgia A) all have the same type of symptoms B) rarely respond to treatment C) will eventually lose their ability to walk D) may feel as if their symptoms are not taken seriously
Answer: D) may feel as if their symptoms are not taken seriously
The nurse is caring for a client who is being treated for fibromyalgia. What intervention will best assist the client to restore normal sleep patterns? A) increasing activity during the day B) administering opioids at bed time C) range-of-motion exercise before sleeping D) tricyclic antidepressants
Answer: D) tricyclic antidepressants
