Porth Chapter 50 RA FIXED

The parents of a child diagnosed with rheumatic disease are shocked by the diagnosis and tell the nurse that they did not think children could acquire the disease. The best response would be: - "Children can be affected with almost all of the rheumatic diseases that occur in adults." - "Children who acquire rheumatic diseases are more likely to have a higher intelligence level." - "Do not worry; a course of antibiotic therapy will cure the child." - "Your child will not be restricted with any activities and will have a normal lifestyle."

"Children can be affected with almost all of the rheumatic diseases that occur in adults."

A client has been diagnosed with rheumatoid arthritis (RA). What will the nurse tell the client about this disorder's etiology? - "Environment is the biggest contributing factor to the development of RA." - "Exposure to workplace chemicals is a causative agent." - "Genetic predisposition is very likely." - "The disease is most common in those under 30."

"Genetic predisposition is very likely."

A client presents to the orthopedic clinic for evaluation since the primary care provider thinks the client may have rheumatoid arthritis (RA). Which statement by the client correlates with the diagnosis of RA? Select all that apply. "I'm having a hard time opening doors since it hurts so bad." "Look, I didn't button all my shirt buttons....it just hurts too much and look at the swelling in my hands." "Look how my hand is deformed. My doctor calls it hyperextension." "Just look at my face. It looks like I have varicose veins on my cheeks." "Every time I get something out of the freezer, my hands turn reddish purple in color."

"I'm having a hard time opening doors since it hurts so bad." "Look, I didn't button all my shirt buttons....it just hurts too much and look at the swelling in my hands." "Look how my hand is deformed. My doctor calls it hyperextension."

A nurse is teaching a group of nursing students about the presentation of systemic lupus erythematosus (SLE). Which statement is the nurse likely to make? "Lupus is a disease of older individuals." "More women than men are affected by lupus." "Lupus is more common in white people." "Drug-induced lupus requires lifelong treatment."

"More women than men are affected by lupus."

The nurse is caring for a client diagnosed with osteoarthritis (OA). What does the nurse teach the client about the disease? "OA is a disease of the weight-bearing joints." "OA typically occurs in clients between 20 and 40 years of age." "OA is an autoimmune disorder." "OA is a genetic disorder."

"OA is a disease of the weight-bearing joints."

The nurse has just finished teaching a client newly diagnosed with rheumatoid arthritis about the disease. The nurse determines that teaching is effective when the client makes which statement? - "Rheumatoid arthritis includes joint involvement that is usually symmetric and polyarticular." - "Rheumatoid arthritis is a chronic autoimmune system disease that affects a single joint." - "Only upper extremity diarthrodial joint can be involved." - "The disease will not fluctuate in occurrence."

"Rheumatoid arthritis includes joint involvement that is usually symmetric and polyarticular."

The nurse is assessing a client's risk for osteoarthritis. Which factor places the client at greatest risk for this condition? Age Injury Social status Exposure to smoke

Age

A client with rheumatoid arthritis (RA) tells the nurse that the disease-modifying antirheumatic drug (DMARD) methotrexate does not seem to be working anymore. Which other antirheumatic medication category can the nurse relay that may be prescribed following DMARD failure? Corticosteroids Anti-TNFs like infliximab Gold salts Nonsteroidal anti-inflammatory drugs

Anti-TNFs like infliximab

A client presents with arthralgia and arthritis. Which is the priority nursing intervention? Assessing the client's pain and history of treating it Assessing the client's vital signs Assessing the client's electrocardiogram Performing range-of-motion exercises

Assessing the client's pain and history of treating it

When teaching a client with rheumatoid arthritis (RA), which factor does the nurse explain is an underlying cause of this disease? Immunocompromised host Tissue necrosis Autologous antibodies Lysosomes

Autologous antibodies

An older adult client has had mobility and independence significantly impaired by the progression of rheumatoid arthritis (RA). What is the primary pathophysiologic process that has contributed to this client's decline in health? - A mismatch between bone resorption and remodeling - Immunologically mediated joint inflammation - Excessive collagen production and deposition - Cytokine release following mechanical joint injury

Immunologically mediated joint inflammation

A nurse is caring for a client with discoid lupus. Which system does the nurse set as a priority for the nursing assessment? Integumentary assessment Hematologic assessment Peripheral vascular assessment Rheumatologic assessment

Integumentary assessment

A client has developed signs and symptoms of systemic lupus erythematosus (SLE). The nurse reviews the client's medication record for which medications that are associated with drug-induced lupus? Select all that apply. Hydralazine Ramipril Digoxin Isoniazid Procainamide

Isoniazid Procainamide Hydralazine

Which signs and symptoms should prompt a young woman's primary care provider to assess for systemic lupus erythematosus (SLE)? Chronic nausea and vomiting that is unresponsive to antiemetics Joint pain and proteinuria A history of thromboembolic events and varicose veins Dysmenorrhea and recent spontaneous abortion

Joint pain and proteinuria

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

Joint stiffness Finger and hand pain Wrist pain Limited joint mobility

A client presents with joint pain and suspected rheumatoid arthritis (RA). Which intervention is appropriate for the nurse to implement? Increase in the client's activity to provide sufficient joint stress Muscle-strengthening exercises to support joints Intravenous opioid to control pain Admission to the intensive care unit for cardiac monitoring

Muscle-strengthening exercises to support joints

The nurse is caring for a client with newly diagnosed systemic lupus erythematosus (SLE). Which over-the-counter medication does the nurse recognize is useful in treating inflammation, arthritis, and pleuritis? - Nonsteroidal anti-inflammatory drugs (NSAIDs) - Hydroxychloroquine - Cyclophosphamide - Belimumab

Nonsteroidal anti-inflammatory drugs (NSAIDs)

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

Obesity

The nurse is conducting a health promotion class on osteoarthritis (OA). Which statement should the nurse include? - Obesity is a strong risk factor for developing OA. - Young women have a higher risk than young men of developing OA. - There is no hereditary link to the development of OA. - Eating a diet low in calcium is the only contributing risk factor to OA.

Obesity is a strong risk factor for developing OA.

The client with a suspected diagnosis of osteoarthritis asks the health care provider, "How will this diagnosis be confirmed?" Which response is most appropriate? Physical examination and x-ray studies Aspiration of the joint with biopsy sent to laboratory Bone marrow aspiration of the pelvis Exercise trials to monitor angle of joint movements

Physical examination and x-ray studies

A client diagnosed with arthritis had a recent infection. Which intervention is necessary to determine if the client has bacterial arthritis? Decrease in symptoms with steroid administration Assessment of vital signs for fever Administration of antibiotics with relief of symptoms Positive culture of synovial fluid

Positive culture of synovial fluid

When teaching a group of nursing students about rheumatic disorders, a nurse emphasizes which important differences when caring for the older adult? Need for pain relief Stiffness in the morning Risk for falls Muscle weakness

Risk for falls

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

When teaching a client recently diagnosed with systemic lupus erythematosus (SLE), what does the nurse teach the client to avoid to prevent exacerbations? Raw or undercooked shellfish Ultraviolet light (UV) Corticosteroid medications Calcium supplements

Ultraviolet light (UV)

The nurse is teaching a client with rheumatoid arthritis about pannus, which develops in the affected joint area. What does the nurse include to describe pannus? Muscles in the area that atrophy from disuse Vascular granulation tissue that destroys cartilage and bone Microorganisms that attack the joint space causing stiffness Reversible calcium deposits affecting the joints

Vascular granulation tissue that destroys cartilage and bone

An older adult client has recently been diagnosed with rheumatoid arthritis. The nurse should focus assessment on which aspects? Weight and nutritional status Cognition and coping skills Sodium and potassium levels Oxygenation and respiratory status

Weight and nutritional status

Which diagnostic finding has been strongly linked to systematic lupus erythematosus (SLE)? elevated anti-nuclear antibodies (ANA) abnormal serum SLE assay decreased rheumatoid factor low red blood cell (RBC) count

elevated anti-nuclear antibodies (ANA)

A client with osteoarthritis states that every morning "it gets harder and harder to loosen up". The client's main therapy to this point is the use of over-the-counter nonsteroidal anti-inflammatories (NSAIDs). These drugs reduce the client's pain by: inhibiting prostaglandin synthesis. agonizing opioid receptors. increasing blood flow to sites of inflammation. stimulating the release of pain-reducing cytokines.

inhibiting prostaglandin synthesis.

Which assessment finding best confirms the diagnosis of systemic lupus erythematosus (SLE)? joint pain facial rash positive anti-DNA antibody test elevated antinuclear antibodies (ANA) levels

positive anti-DNA antibody test