NUR 555 QUIZ 4 | QUESTIONS AND ANSWERS | 2026 UPDATE | 100% CORRECT - SNHU.
Question 1
What is the mean age of onset for a patient diagnosed with Giant Cell Arteritis (GCA)?
A) 45 years
B) 55 years
C) 62 years
D) 72 years
E) 79 years
Correct Answer: E) 79 years
Rationale: Giant Cell Arteritis is a disease almost exclusively of the elderly. It is virtually
never seen in patients under the age of 50, and its incidence peaks significantly in the late
70s, with a mean onset age of 79 years.
Question 2
Which of the following statements best describes the pathophysiological relationship between
Polymyalgia Rheumatica (PMR) and Giant Cell Arteritis (GCA)?
A) They are two unrelated diseases that occur in different age groups.
B) PMR is a localized muscle disease, while GCA is a systemic bone disorder.
C) They probably represent a spectrum of one disease process and frequently coexist.
D) GCA always precedes the development of PMR by at least five years.
E) PMR is caused by a virus, while GCA is strictly genetic.
Correct Answer: C) They probably represent a spectrum of one disease process and
frequently coexist.
Rationale: PMR and GCA are closely linked inflammatory conditions. While PMR focuses
on proximal joint pain and stiffness and GCA involves large-vessel vasculitis, they share
similar genetic backgrounds and inflammatory markers, often appearing together in the
same patient.
Question 3
What is the standard initial oral prednisone dosage used to manage a patient with isolated
Polymyalgia Rheumatica (PMR)?
A) 5 mg/day
B) 10-20 mg/day
C) 40-60 mg/day
D) 80-100 mg/day
E) 125 mg pulse therapy
Correct Answer: B) 10-20 mg/day
Rationale: PMR is typically very sensitive to low-dose corticosteroids. A dose of 10-20
mg/day usually results in a dramatic improvement in symptoms within 24 to 72 hours.
Higher doses are generally reserved for GCA.
, 2
Question 4
Which of the following is considered a major, potentially permanent complication of untreated
Giant Cell Arteritis?
A) Osteoarthritis of the hip
B) Irreversible blindness
C) Chronic obstructive pulmonary disease
D) Iron deficiency anemia
E) Alopecia areata
Correct Answer: B) Irreversible blindness
Rationale: The most feared complication of GCA is ophthalmic artery involvement leading
to anterior ischemic optic neuropathy. Without rapid steroid treatment, the resulting loss of
vision is usually permanent.
Question 5
How does the incidence of both PMR and GCA change as the population ages?
A) Incidence peaks at age 40 and then declines.
B) Incidence remains stable from age 50 to 90.
C) Incidence increases with each decade of life after age 50.
D) It is more common in children than in adults.
E) It is only found in patients with a history of smoking.
Correct Answer: C) Incidence increases with each decade of life after age 50.
Rationale: Both PMR and GCA are age-related inflammatory conditions. The frequency of
these diagnoses rises significantly with every decade of life, particularly in those of
Northern European descent.
Question 6
Giant Cell Arteritis is pathologically classified as which type of vasculitis?
A) Necrotizing small-vessel vasculitis
B) Immune-complex mediated capillaritis
C) Granulomatous vasculitis affecting large and medium arteries
D) Eosinophilic granulomatosis with polyangiitis
E) Isolated cutaneous vasculitis
Correct Answer: C) Granulomatous vasculitis affecting large and medium arteries
Rationale: GCA is characterized by chronic granulomatous inflammation that primarily
targets the arch of the aorta and the branches of the carotid arteries, such as the temporal
artery.
Question 7
What percentage of patients diagnosed with Giant Cell Arteritis (GCA) also exhibit symptoms of
Polymyalgia Rheumatica (PMR)?
A) 5-10%
, 3
B) 15-25%
C) 40-60%
D) 80-90%
E) 100%
Correct Answer: C) 40-60%
Rationale: There is a high degree of overlap between the two conditions. Roughly half of
GCA patients will also have the proximal limb girdle stiffness characteristic of PMR.
Question 8
A 75-year-old female presents with severe stiffness in her shoulders and hips that is worse in the
morning and lasts for two hours. She also reports fatigue and a low-grade fever. These findings
are classic for:
A) Primary Raynaud Phenomenon
B) Systemic Lupus Erythematosus
C) Polymyalgia Rheumatica (PMR)
D) Osteoporosis
E) Fibromyalgia
Correct Answer: C) Polymyalgia Rheumatica (PMR)
Rationale: The hallmark of PMR is profound morning stiffness and pain in the proximal
muscle groups (shoulders and pelvic girdle). Systemic symptoms like fever and weight loss
are also common due to the high inflammatory state.
Question 9
Which symptom, if new for an elderly patient, should immediately raise suspicion for Giant Cell
Arteritis?
A) Pain in the small joints of the feet
B) A new headache and jaw claudication
C) Chronic cough and wheezing
D) Heartburn after eating spicy food
E) Numbness in the fingertips when cold
Correct Answer: B) A new headache and jaw claudication
Rationale: New-onset headache, scalp tenderness (e.g., pain when brushing hair), and jaw
claudication (pain when chewing) are specific signs of cranial artery inflammation in GCA.
Question 10
During a physical exam of a patient suspected of having GCA, what might the clinician find
when palpating the temporal artery?
A) The artery is always invisible and cannot be felt.
B) The artery may show nodularity, enlargement, tenderness, or reduced pulses.
C) The artery will be soft and compressible with a rapid pulse.
D) The artery will be blue in color.
, 4
E) The artery will be located behind the ear.
Correct Answer: B) The artery may show nodularity, enlargement, tenderness, or reduced
pulses.
Rationale: Inflammation causes the artery wall to thicken and become tender. In some
cases, the vessel becomes so occluded that the pulse is significantly diminished or absent.
Question 11
Which imaging technique is increasingly used to visualize the "halo sign" in the temporal artery
to support a GCA diagnosis?
A) Plain X-ray
B) Ultrasound
C) Bone scan
D) Barium swallow
E) Electroencephalogram (EEG)
Correct Answer: B) Ultrasound
Rationale: High-resolution ultrasound can detect edema within the vessel wall, appearing as
a dark "halo" around the artery. While biopsy remains the gold standard, ultrasound is a
valuable non-invasive tool.
Question 12
In over 90% of patients with Polymyalgia Rheumatica, which laboratory findings would the
nurse practitioner expect to see?
A) Decreased white blood cell count
B) Elevated Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP)
C) Positive Rheumatoid Factor and Anti-CCP
D) Low Thyroid Stimulating Hormone (TSH)
E) Elevated blood glucose
Correct Answer: B) Elevated Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein
(CRP)
Rationale: PMR is characterized by a very high systemic inflammatory response. ESR often
exceeds 50 mm/hr, and CRP is almost always significantly elevated. Normal levels of these
markers make a diagnosis of PMR much less likely.
Question 13
What is considered the "gold standard" for confirming a diagnosis of Giant Cell Arteritis?
A) MRI of the brain
B) Temporal artery biopsy
C) Response to Ibuprofen
D) Arteriogram of the leg
E) Blood cultures
Correct Answer: B) Temporal artery biopsy
Question 1
What is the mean age of onset for a patient diagnosed with Giant Cell Arteritis (GCA)?
A) 45 years
B) 55 years
C) 62 years
D) 72 years
E) 79 years
Correct Answer: E) 79 years
Rationale: Giant Cell Arteritis is a disease almost exclusively of the elderly. It is virtually
never seen in patients under the age of 50, and its incidence peaks significantly in the late
70s, with a mean onset age of 79 years.
Question 2
Which of the following statements best describes the pathophysiological relationship between
Polymyalgia Rheumatica (PMR) and Giant Cell Arteritis (GCA)?
A) They are two unrelated diseases that occur in different age groups.
B) PMR is a localized muscle disease, while GCA is a systemic bone disorder.
C) They probably represent a spectrum of one disease process and frequently coexist.
D) GCA always precedes the development of PMR by at least five years.
E) PMR is caused by a virus, while GCA is strictly genetic.
Correct Answer: C) They probably represent a spectrum of one disease process and
frequently coexist.
Rationale: PMR and GCA are closely linked inflammatory conditions. While PMR focuses
on proximal joint pain and stiffness and GCA involves large-vessel vasculitis, they share
similar genetic backgrounds and inflammatory markers, often appearing together in the
same patient.
Question 3
What is the standard initial oral prednisone dosage used to manage a patient with isolated
Polymyalgia Rheumatica (PMR)?
A) 5 mg/day
B) 10-20 mg/day
C) 40-60 mg/day
D) 80-100 mg/day
E) 125 mg pulse therapy
Correct Answer: B) 10-20 mg/day
Rationale: PMR is typically very sensitive to low-dose corticosteroids. A dose of 10-20
mg/day usually results in a dramatic improvement in symptoms within 24 to 72 hours.
Higher doses are generally reserved for GCA.
, 2
Question 4
Which of the following is considered a major, potentially permanent complication of untreated
Giant Cell Arteritis?
A) Osteoarthritis of the hip
B) Irreversible blindness
C) Chronic obstructive pulmonary disease
D) Iron deficiency anemia
E) Alopecia areata
Correct Answer: B) Irreversible blindness
Rationale: The most feared complication of GCA is ophthalmic artery involvement leading
to anterior ischemic optic neuropathy. Without rapid steroid treatment, the resulting loss of
vision is usually permanent.
Question 5
How does the incidence of both PMR and GCA change as the population ages?
A) Incidence peaks at age 40 and then declines.
B) Incidence remains stable from age 50 to 90.
C) Incidence increases with each decade of life after age 50.
D) It is more common in children than in adults.
E) It is only found in patients with a history of smoking.
Correct Answer: C) Incidence increases with each decade of life after age 50.
Rationale: Both PMR and GCA are age-related inflammatory conditions. The frequency of
these diagnoses rises significantly with every decade of life, particularly in those of
Northern European descent.
Question 6
Giant Cell Arteritis is pathologically classified as which type of vasculitis?
A) Necrotizing small-vessel vasculitis
B) Immune-complex mediated capillaritis
C) Granulomatous vasculitis affecting large and medium arteries
D) Eosinophilic granulomatosis with polyangiitis
E) Isolated cutaneous vasculitis
Correct Answer: C) Granulomatous vasculitis affecting large and medium arteries
Rationale: GCA is characterized by chronic granulomatous inflammation that primarily
targets the arch of the aorta and the branches of the carotid arteries, such as the temporal
artery.
Question 7
What percentage of patients diagnosed with Giant Cell Arteritis (GCA) also exhibit symptoms of
Polymyalgia Rheumatica (PMR)?
A) 5-10%
, 3
B) 15-25%
C) 40-60%
D) 80-90%
E) 100%
Correct Answer: C) 40-60%
Rationale: There is a high degree of overlap between the two conditions. Roughly half of
GCA patients will also have the proximal limb girdle stiffness characteristic of PMR.
Question 8
A 75-year-old female presents with severe stiffness in her shoulders and hips that is worse in the
morning and lasts for two hours. She also reports fatigue and a low-grade fever. These findings
are classic for:
A) Primary Raynaud Phenomenon
B) Systemic Lupus Erythematosus
C) Polymyalgia Rheumatica (PMR)
D) Osteoporosis
E) Fibromyalgia
Correct Answer: C) Polymyalgia Rheumatica (PMR)
Rationale: The hallmark of PMR is profound morning stiffness and pain in the proximal
muscle groups (shoulders and pelvic girdle). Systemic symptoms like fever and weight loss
are also common due to the high inflammatory state.
Question 9
Which symptom, if new for an elderly patient, should immediately raise suspicion for Giant Cell
Arteritis?
A) Pain in the small joints of the feet
B) A new headache and jaw claudication
C) Chronic cough and wheezing
D) Heartburn after eating spicy food
E) Numbness in the fingertips when cold
Correct Answer: B) A new headache and jaw claudication
Rationale: New-onset headache, scalp tenderness (e.g., pain when brushing hair), and jaw
claudication (pain when chewing) are specific signs of cranial artery inflammation in GCA.
Question 10
During a physical exam of a patient suspected of having GCA, what might the clinician find
when palpating the temporal artery?
A) The artery is always invisible and cannot be felt.
B) The artery may show nodularity, enlargement, tenderness, or reduced pulses.
C) The artery will be soft and compressible with a rapid pulse.
D) The artery will be blue in color.
, 4
E) The artery will be located behind the ear.
Correct Answer: B) The artery may show nodularity, enlargement, tenderness, or reduced
pulses.
Rationale: Inflammation causes the artery wall to thicken and become tender. In some
cases, the vessel becomes so occluded that the pulse is significantly diminished or absent.
Question 11
Which imaging technique is increasingly used to visualize the "halo sign" in the temporal artery
to support a GCA diagnosis?
A) Plain X-ray
B) Ultrasound
C) Bone scan
D) Barium swallow
E) Electroencephalogram (EEG)
Correct Answer: B) Ultrasound
Rationale: High-resolution ultrasound can detect edema within the vessel wall, appearing as
a dark "halo" around the artery. While biopsy remains the gold standard, ultrasound is a
valuable non-invasive tool.
Question 12
In over 90% of patients with Polymyalgia Rheumatica, which laboratory findings would the
nurse practitioner expect to see?
A) Decreased white blood cell count
B) Elevated Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP)
C) Positive Rheumatoid Factor and Anti-CCP
D) Low Thyroid Stimulating Hormone (TSH)
E) Elevated blood glucose
Correct Answer: B) Elevated Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein
(CRP)
Rationale: PMR is characterized by a very high systemic inflammatory response. ESR often
exceeds 50 mm/hr, and CRP is almost always significantly elevated. Normal levels of these
markers make a diagnosis of PMR much less likely.
Question 13
What is considered the "gold standard" for confirming a diagnosis of Giant Cell Arteritis?
A) MRI of the brain
B) Temporal artery biopsy
C) Response to Ibuprofen
D) Arteriogram of the leg
E) Blood cultures
Correct Answer: B) Temporal artery biopsy
