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1. Gold sodium thiomalate is prescribed to a client with rheumatoid arthritis. Which of the
following side effects indicates an overdosage of the medication?
A. Flushing.
B. Dizziness.
C. Joint pain.
D. Metallic taste. - Answer 1. Answer: D. Metallic taste.
D: Gold sodium thiomalate toxicity signs are pruritus, diarrhea, dermatitis, stomatitis, and
metallic taste.
A&B: Flushing and dizziness are the side effects that may occur soon after the injection.
C: Increased joint pain may occur 1-2 days after the injection.
2. Adalimumab (Humira) is given to a client for the treatment of rheumatoid arthritis. Which of
the following side effect is associated with the medication?
A. Numbness.
B. Diarrhea.
C. Urinary retention.
D. Weight gain. - Answer Answer: A. Numbness.
A: Adalimumab (Humira) has been associated with neurological side effects such as numbness,
tingling, dizziness, visual disturbances, and weakness in the legs).
B, C, D: Options B, C, and D are not associated with the use of medication.
3. A client has just been prescribed with Methotrexate (Trexall) for the treatment of rheumatoid
arthritis who did not respond to any other treatment. An important reminder for the client is
to?
A. Clay-colored stool is a normal response of the treatment.
B. Pregnancy is not contraindicated with the use of the medication.
C. Strict hand washing.
D. Get a daily source of sunlight during the day. - Answer 3. Answer: C. Strict hand washing.
C: Clients taking Methotrexate are more likely to get infections or may worsen any current
infections. Therefore, hand washing will help to prevent the spread of infection.
A: Option A is a sign of a liver toxicity and the physician should be notified of it.
B: Pregnancy is not allowed during the treatment.
,D: Photosensitivity may happen during the treatment so the client is advised to wear sunscreen
or any protective gear against the sunlight.
4. Mr. Mc Princeton who is diagnosed with rheumatoid arthritis (RA) complains about joints that
always hurt, saying, "I just feel like staying in bed all day." Which discharge instruction would be
aimed at maintaining as such function as possible?
A. "Refrain from exercise because it only aggravates the disease process."
B. "Apply elastic bandages to all joints to increase the pain threshold."
C. "Maintain a supine position most of the day to prevent the stress of weight bearing."
D. "Promote aquatic (water) exercises to enhance joint mobility." - Answer 4. Answer: D.
"Promote aquatic (water) exercises to enhance joint mobility."
D: Water exercises are excellent because water promotes buoyancy, which eases joint
movement.
A: Persons with RA should maintain an active exercise program to strengthen and preserve
muscle movement.
B: Elastic bandage wraps would not be helpful.
C: Being active instead of just lying supine all day could help strengthen the muscles and joints.
5. The classic signs and symptoms of rheumatoid arthritis include which of the following?
A. Pain on weight-bearing, rash and low-grade fever.
B. Joint swelling, joint stiffness in the morning and bilateral joint movement.
C. Crepitus, development of Heberden's nodes and anemia.
D. Fatigue, leucopenia and joint pain. - Answer 5. Answer: B. Joint swelling, joint stiffness in
the morning and bilateral joint movement.
B: Joint swelling, joint stiffness in the morning and bilateral joint movement are the classic signs
of rheumatoid arthritis. A, C, D: The other symptoms are not found on a patient with
rheumatoid arthritis.
1. Your patient has arthritis that affects the weight-bearing joints such as the hands, knees, hips,
and spine. This type of arthritis is most likely:*
A. Rheumatoid arthritis
B. Osteoarthritis - Answer The answer is B. Osteoarthritis is a form of arthritis that causes
deterioration of the articular hyaline cartilage of the bones. It affects the weight-bearing joints.
This can include the hands, knees, hips, and spine because these joints experience a lot of
stress.
2. Select all the risk factors for developing osteoarthritis:*
A. Malnutrition
B. Obesity
,C. Manual labor jobs
D. Premature birth
E. Older age
F. Diabetes - Answer The answers are B, C, and E. These are risk factors for developing OA. In
addition, repeated joint injuries and genetics can play a role in developing OA.
3. ____________ affects the joints in a symmetrical fashion.*
A. Osteoarthritis
B. Rheumatoid arthritis - Answer The answer is B. RA affects the joints in a symmetrical
fashion. It is UNsymmetrical in OA. RA most commonly affects the fingers and wrist but can also
affect the neck, shoulders, elbows, ankles, knee, and feet.
4. Which patient below is presenting with signs and symptoms of rheumatoid arthritis? Select
all that apply:*
A. A 35 year old patient who has severe morning stiffness for 45 minutes.
B. A 45 year old male with crepitus in the right knee.
C. A 30 year old female with warm, red, soft joints on the hands and wrist.
D. A 40 year old male whose x-ray imaging results showed osteophytes formation and
decreased joint space in the left knee. - Answer The answer is A and C. These are common
findings in RA. However, options B and D are found in OA.
5. You're explaining to a group of outpatients about the signs and symptoms that may present
with osteoarthritis. Select all the signs and symptoms that may present with this condition:*
A. Herberden's Node
B. Morning stiffness for less than 30 minutes
C. Soft, tender, warm joints
D. Fever
E. Anemia
F. Hard and bony joints
G. Crepitus
H. Bouchard's Node - Answer The answers are A, B, F, G, and H. These are common findings
found in osteoarthritis. Options C, D, and E are found in rheumatoid arthritis.
6. ________________ is a form of arthritis that is an autoimmune condition that causes
inflammation within the joints, specifically the synovium.*
A. Rheumatoid arthritis
, B. Osteoarthritis - Answer The answer is A. Rheumatoid arthritis is an autoimmune condition
that causes inflammation of the synovium. Osteoarthritis is a type of arthritis that causes
deterioration of the articular hyaline cartilage of the bone.
7. Which statement is FALSE concerning rheumatoid arthritis?*
A. Rheumatoid arthritis most commonly affects the fingers and wrist.
B. Rheumatoid arthritis is different from osteoarthritis in that it doesn't affect other systems of
the body.
C. Rheumatoid arthritis can occur at any age (20-60 year old most commonly).
D. Ankylosis can occur in severe cases of rheumatoid arthritis. - Answer The answer is B. This
statement is false. It should say that, "Rheumatoid arthritis is different from osteoarthritis in
that it DOES (not doesn't) affect other systems of the body. RA is systemic, while OA only affects
the joints. This is why a fever and anemia can present in RA.
8. You are assessing the diagnostic testing results for a patient that has rheumatoid arthritis.
What result is NOT an indicator of this disease?*
A. Elevated erythrocyte sedimentation
B. X-ray imaging showing osteophyte formation
C. Positive c-reactive protein
D. Positive rheumatoid factor - Answer The answer is B. This is found in osteoarthritis NOT
rheumatoid arthritis. Osteophytes (bones spurs) are only found in OA.
9. During a head-to-toe assessment of a patient with arthritis, you note bony outgrowths on the
proximal interphalangeal joint. These outgrowths are known as __________ and occur in
______________.*
A. Heberden's Node, osteoarthritis
B. Bouchard's Node, rheumatoid arthritis
C. Heberden's Node, rheumatoid arthritis
D. Bouchard's Node, osteoarthritis - Answer The answer is D. Bouchard's Node are bony
outgrowths on the proximal interphalangeal joint (middle joint of the finger and occur in
osteoarthritis). Heberden's Node occur on the distal interphalangeal joint (finger joint closet to
the fingernail).
10. A patient is newly diagnosed with osteoarthritis. Which medication below is NOT ordered to
treat this condition?*
A. NSAIDs
B. Intra-articular corticosteroids
C. DMARDs
D. Glucosamine - Answer The answer is C. DMARDs (disease-modifying antirheumatic drugs)
are ordered in rheumatoid arthritis NOT osteoarthritis. These drugs suppress the immune