PCC Quiz 6 CH. 64 Rheumatoid Arthritis
Which clinical manifestation is associated with osteoarthritis (OA)? 1 Fever and malaise 2 Crepitation in the weight-bearing joints 3 Increased erythrocyte sedimentation rate 4 Morning stiffness of all joints that tends to last all day
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Which condition may occur if treatment for Lyme disease is delayed? 1 Sterility 2 Arthritis 3 Renal failure 4 Lung abscess
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Which activity helps to protect the joints for a patient who has osteoarthritis (OA) of the knees? 1 Use a wheelchair to avoid walking as much as possible. 2 Sit in chairs that cause the hips to be lower than the knees. 3 Eat a well-balanced diet to maintain a healthy body weight. 4 Use a walker for ambulation to relieve the pressure on the hips.
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Which arthritic disorder is transmitted by the bite of an infected deer tick? 1 Gout 2 Osteoarthritis 3 Lyme disease 4 Rheumatoid arthritis
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Which diagnosis does the nurse expect for a patient with fever who reports fatigue, joint pain, and stiffness, especially in the morning lasting approximately three hours? 1 Gout 2 Osteoarthritis 3 Rheumatoid arthritis 4 Ankylosing spondylitis
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Which stage of rheumatoid arthritis (RA) is associated with extensive cartilage loss and joint deformity? 1 I 2 II 3 III 4 IV
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Which diagnostic tests are indicative of rheumatoid arthritis (RA) and osteoarthritis (OA)? Select all that apply. 1 Elevated C-reactive protein 2 Osteoporosis on x-ray examination 3 Elevated erythrocyte sedimentation rate (ESR) 4 Narrowed joint space on x-ray examination 5 White blood cell (WBC) count of >20,000/µL in the synovial fluid
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Which symptoms are associated with Reiter's syndrome?Select all that apply. 1 Urethritis 2 Cervicitis 3 Conjunctivitis 4 Mucocutaneous lesions 5 Symmetrical joint inflammation
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Serum analysis of uric acid levels is used in the diagnosis of with which condition? 1 Gout 2 Scleroderma 3 Osteoarthritis 4 Rheumatoid arthritis
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Which activity pattern may help to manage osteoarthritis (OA)? 1 Walking and swimming regularly 2 Bed rest and walking to the restroom 3 Minimal exercise with frequent rest periods 4 Running three miles most days of the week
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Which complication from corticosteroid use can worsen the problem of decreased bone density in a patient with rheumatoid arthritis (RA)? 1 Osteopenia 2 Drug-drug interaction 3 Moon face and weight gain 4 Diabetes and mood swings
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Which diagnosis does the nurse expect for a patient who has been bitten by a tick and has a "bullseye rash" at the site? 1 Lyme disease 2 Septic arthritis 3 Psoriatic arthritis 4 Reactive arthritis
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Which intervention is beneficial for protecting the joints in a patient who has bilateral osteoarthritis of the knees? 1 Exercise regularly and maintain a well-balanced diet. 2 Use a wheelchair to avoid walking as much as possible. 3 Avoid sitting at a 90-degree angle and avoid full flexion of the knees. 4 Use a cane for ambulation to relieve the pressure on the hips.
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Which nonpharmaceutical interventions may help to manage pain for a patient with osteoarthritis?Select all that apply. 1 Use of paraffin baths or hot packs 2 Immobilization of the affected joint 3 Use of crutches or walker if required 4 Regulation of a normal body mass index (BMI) 5 Strenuous exercise to keep the joints functional
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Which interventions will the nurse include in the plan of care for a patient with septic arthritis to prevent joint destruction and bone loss? Select all that apply. 1 Explain need of antibiotics to patient. 2 Ensure adherence to corticosteroid therapy. 3 Support the patient who requires operative drainage. 4 Assist in early identification of the causative organism. 5 Assess and monitor joint inflammation, pain, and fever. 6 Suggest use of resting splints to immobilize affected joints.
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Which medication instructions does the nurse provide for a patient with osteoarthritis who is initiating treatment with celecoxib?Select all that apply. 1 Report persistent headaches. 2 Limit sodium intake. 3 Take with food or milk. 4 Monitor BP. 5 Have potassium levels checked regularly. 6 Report tarry stools or bruising.
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Which questions will the nurse ask when assessing a patient with rheumatoid arthritis? Select all that apply. 1 Are you allergic to aspirin? 2 Have you ever been hospitalized? 3 Do you feel stiffness in your joints? 4 Have you undergone any joint surgery? 5 Have you ever had a blood transfusion? 6 Are you taking any medications currently?
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The nurse reviews the diagnostic results of a patient with rheumatoid arthritis (RA) and expects which findings? Select all that apply. 1 High C-reactive protein (CRP) 2 Negative rheumatoid factor (RF) 3 Clear synovial fluid 4 Increased erythrocyte sedimentation rate (ESR) 5 Increased white blood cell (WBC) count of the synovial fluid
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Which instructions will the nurse include when teaching a group of caregivers about the home care of a patient with rheumatoid arthritis (RA)?Select all that apply. 1 Never place pillows below the knees. 2 Ensure complete bed rest for patients. 3 Apply heat for at least 30 to 60 minutes. 4 Perform aquatic exercise in warm water. 5 Use lifts and elevators instead of the stairs.
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Which interventions will the nurse include in the plan of care for a patient with gout? Select all that apply. 1 Encourage weight gain. 2 Provide warm compresses. 3 Decrease joint mobilization. 4 Encourage increased oral water intake. 5 Encourage intake of spinach, mushrooms, and cauliflower.
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How does gender factor into the prevalence of osteoarthritis (OA)? Select all that apply. 1 Women do not experience OA as often as men. 2 Men experience hip OA more often than women. 3 Men experience knee OA more often than women. 4 Women have a higher incidence of hand OA than men. 5 Women are affected by OA more often than men after age 70 years.
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Which factors contribute to an increased risk for developing osteoarthritis (OA)? Select all that apply. 1 Daily intake of multivitamins 2 History of fractured right ankle 3 Participation in yoga three times weekly 4 Played football in high school and college 5 Frequent exacerbations of chronic obstructive pulmonary disease (COPD) with steroid use
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Which activity pattern will the nurse suggest for a patient with osteoarthritis (OA)? 1 Bed rest with bathroom privileges 2 Daily high-impact aerobic exercise 3 Frequent rest periods with minimal exercise 4 Regular exercise program that involves walking
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Which actions help to reduce the risk of osteoarthritis?Select all that apply. 1 Avoiding intake of fish 2 Exercising on a hard surface 3 Increasing the intake of vitamin K 4 Avoiding forceful, repetitive movements 5 Maintaining a healthy body mass index (BMI)
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Which alternative therapies will the nurse suggest for a patient with rheumatoid arthritis? Select all that apply. 1 Hypnosis 2 Aerobic exercises 3 Use of a firm mattress 4 Vigorous range-of-motion exercises 5 Transcutaneous electrical nerve stimulation
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Which definition describes osteoarthritis (OA)? 1 Joint destruction caused by an autoimmune process 2 Degeneration of articular cartilage in synovial joints 3 Overproduction of synovial fluid resulting in joint destruction 4 Breakdown of tissue in non-weight-bearing joints by enzymes
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Which description is associated with osteoarthritis (OA)? 1 An underproduction of synovial fluid 2 Degeneration of cartilage in synovial joints 3 An autoimmune disorder that is hereditary in nature 4 Breakdown of tissue caused by a sedentary lifestyle
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Which explanation will the nurse provide about the importance of a low-purine diet for a patient with gout? 1 Purine causes the joint pain associated with gout. 2 The metabolism of purine results in the formation of uric acid. 3 Urine retention can result from a high purine level and thus increase the uric acid level. 4 Limiting purine can decrease the incidence of headaches and dizziness that occur with gout.
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Which knee assessment finding does the nurse expect for patient who is scheduled for knee arthroscopy related to osteoarthritis (OA)? 1 Ulnar drift 2 Pain with joint movement 3 Reddened, swollen, affected joints 4 Stiffness that increases with movement
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Which diagnostic tests help to determine the severity of osteoarthritis and plan the course of treatment? Select all that apply. 1 Serum uric acid 2 CT scan 3 MRI 4 Anticitrullinated protein antibody (ACPA) 5 Erythrocyte sedimentation rate (ESR) blood test
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In which order should the nurse perform interventions for a patient recently diagnosed with rheumatoid arthritis (RA)? Place the options in order of importance. 1. Educate about pharmacologic interventions. 2. Perform a careful physical assessment. 3. Coordinate a carefully planned program for rehabilitation and education. 4. Evaluate psychosocial needs and environmental concerns.
2, 4, 1, 3 perform, evaluate, educate, coordinate
Which instructions will the nurse include when teaching a 30-year-old female patient with severe rheumatoid arthritis (RA) about taking prescribed methotrexate for disease management? 1 Avoid use of contraceptives because this increases the risk for deep vein thrombosis. 2 Expect an orange-yellow urine discoloration during treatment with methotrexate. 3 Use effective contraception during and three months after treatment with methotrexate. 4 Decrease fluid intake to reduce the risk of edema-related side effects with methotrexate.
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Which knee assessment finding does the nurse expect for a patient who has osteoarthritis of the knees? 1 Evening stiffness 2 Positive Phalen's sign 3 Pain with joint movement 4 Positive anterior drawer test
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Which medication used to treat arthritis must be used at regular intervals for maximal effect? 1 Ketoprofen 2 Salicylate aspirin 3 Capsaicin cream 4 Methylprednisolone acetate
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Which type of nodules occur on the distal interphalangeal (DIP) joints of the fingers in a patient with osteoarthritis (OA)? 1 tophi nodules 2 Bouchard's nodes 3 Heberden's nodes 4 Rheumatoid nodules
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Which action will the nurse include when caring for a patient with osteoarthritis (OA) who is taking sulfasalazine and reports an orange discoloration of the urine? 1 Advise the patient to decrease fluid intake to help the urine return to normal color. 2 Report the urine discoloration to the prescriber immediately since there could be liver impairment. 3 Report the urine discoloration to the prescriber immediately since orange-colored urine could indicate renal impairment. 4 Inform the patient that orange discoloration of the urine often occurs with sulfasalazine, and there is no need for concern.
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Which assessment finding may be associated with osteoarthritis of the knees? 1 Reddened, swollen, affected joints 2 Stiffness that is worse in the evening 3 Swan-neck deformity in affected joints 4 Crepitus upon movement of knee joints
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Which condition is a complication of gout? 1 Cirrhosis 2 A gastric ulcer 3 A pulmonary embolus 4 Secondary osteoarthritis (OA)
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Which condition may be associated with dry eyes and a decrease in the amount of saliva being produced? 1 Felty syndrome 2 Down syndrome 3 Turner syndrome 4 Sjögren's syndrome
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Which findings are associated with stage III rheumatoid arthritis (RA)? 1 Subcutaneous nodules present 2 Consistent muscle strength 3 Localized disease symptoms 4 Extensive cartilage loss on x-ray
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Which term refers to the joint changes associated with osteoarthritis? 1 Malignant 2 Inflammatory 3 Immunologic 4 Degenerative
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The nurse will inform a patient who has been prescribed topical diclofenac sodium to take which precautions with its use?Select all that apply. 1 Report signs of bleeding. 2 Avoid exposure to sunlight. 3 Do not coadminister with oral aspirin. 4 Antacids should be used concomitantly. 5 Monitor BP for elevations related to fluid retention.
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Which synovial fluid analysis findings are suggestive of rheumatoid arthritis? Select all that apply. 1 Clear yellow in color 2 Presence of fibrin flecks 3 Presence of sodium urate crystals 4 Elevated white blood cell (WBC) count 5 Increased matrix metallopeptidase (MMP)-3 enzyme
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Which instruction will the nurse include when teaching a patient with osteoarthritis (OA) about taking prescribed ibuprofen 800 mg every eight hours for pain? 1 Take ibuprofen on an empty stomach. 2 Expect the stool to appear dark and tarry. 3 Do not take ibuprofen with milk products. 4 Try to take ibuprofen with food.
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Which patient condition may indicate that celecoxib should be prescribed for treatment of osteoarthritis? 1 The patient is taking warfarin. 2 The patient has hyperchlorhydria. 3 The patient has severe arthritic symptomology. 4 the patient does not tolerate traditional nonsteroidal antiinflammatory drugs (NSAIDs).
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