Lewis med-surg, chapter 69:Assessment, Diagnosis, Pharmacologic Management, Nonpharmacologic Interventions, Patient Education, Risk Factors, Pain Control, Joint Protection, Exercise Therapy, Range-of-Motion, Mobility, Functional Independence, Self-Care St

Lewis med-surg, chapter 69:Assessment, Diagnosis, Pharmacologic Management, Nonpharmacologic Interventions, Patient Education, Risk Factors, Pain Control, Joint Protection, Exercise Therapy, Range-of-Motion, Mobility, Functional Independence, Self-Care Strategies, Disease-Modifying Antirheumatic Drugs (DMARDs), Corticosteroid Therapy, Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), Biologic Agents, Autoimmune Disorders, Osteoarthritis, Rheumatoid Arthritis, Gout, Systemic Lupus Erythematosus, Extraarticular Manifestations, Laboratory Monitoring, Renal Function, Infection Prevention, Skin Integrity, Psychosocial Support, Patient Safety, Activity Pacing, Lifestyle Modifications, Weight Management Exam Questions Verified and Provided with Complete A+ Graded Rationales Latest Updated 2026 1. A 60-year-old patient has osteoarthritis (OA) of the left knee. A finding that the nurse would expect to be present on examination of the patient's knee is a. Heberden's nodules. b. redness and swelling of the knee joint. c. pain upon joint movement. d. stiffness that increases with movement. Answer: C Rationale: Initial symptoms of OA include pain with joint movement. Heberden's nodules occur on the fingers. Redness of the joint is more strongly associated with rheumatoid arthritis (RA), and stiffness in OA is worse right after the patient rests and decreases with joint movement. 2. When screening patients at a community center, the nurse will plan to teach ways to reduce risk factors for osteoarthritis to a a. 24-year-old man who participates in a summer softball team. b. 36-year-old woman who is newly diagnosed with diabetes mellitus. c. 49-year-old woman who works on an automotive assembly line. d. 56-year-old man who is a member of a construction crew. Answer: C Rationale: OA is more likely to occur in women as a result of estrogen reduction at menopause and in individuals whose work involves repetitive movements and lifting. Moderate exercise, such as softball, reduces risk for OA. Diabetes is not a risk factor for OA. Working on a construction crew would involve nonrepetitive work and thus would not be as risky. 3. The health care provider has prescribed naproxen (Naprosyn) twice daily for a patient with osteoarthritis (OA) of the hands. The patient tells the nurse after 3 weeks of use that the drug does not seem to be effective in controlling the pain. The nurse should teach the patient that a. another type of nonsteroidal antiinflammatory drug (NSAID) may be indicated because of variations in individual response to the drugs. b. it may take up to 4 to 6 weeks for NSAIDs to reach therapeutic levels in the blood. c. if NSAIDs are not effective in controlling symptoms, corticosteroids are the next drug of choice. d. adding a twice-daily aspirin to the naproxen may improve the effectiveness of the drug. Answer: A Rationale: Individual responses to NSAIDs can vary, so the health care provider may prescribe a different NSAID. Full effectiveness of NSAIDs occurs in 2 to 3 weeks. Corticosteroids are usually reserved for use in RA. Patients are instructed to avoid aspirin when taking NSAIDs because of the increased risk for bleeding and gastrointestinal irritation. 4. When teaching a patient with osteoarthritis (OA) of the left hip and lower lumbar vertebrae about management of the condition, the nurse determines that additional instruction is needed when the patient says, a. "I can use a cane if I find it helpful in relieving the pressure on my back and hip." b. "A warm shower in the morning will help relieve the stiffness I have when I get up." c. "I should try to stay active throughout the day to keep my joints from becoming stiff." d. "I should take no more than 1 g of acetaminophen four times a day to control the pain." Answer: C Rationale: Protection and avoidance of joint stressors are recommended for patients with OA, so this patient should alternate periods of rest with necessary activity. The other patient statements indicate that teaching has been effective. A 58-year-old patient has been diagnosed with osteoarthritis (OA) of the hands and feet. The patient tells the nurse, "I am afraid that I will be hopelessly crippled in just a few years!" The best response by the nurse is that a. progression of OA can be prevented with a regimen of exercise, diet, and drugs. b. OA is an inflammatory process with periods of exacerbation and remission.