NUR 1024: NCLEX Questions for
Osteoarthritis
A 32-year-old client who has limited hip joint damage from osteoarthritis asks
the nurse why an osteotomy is being performed rather than other procedures.
Which response by the nurse provides the most accurate information?
A. "This procedure is usually tried first; arthroplasty will be done later if this
does not work."
B. "This procedure can be done since you are young and healthy and your hip
damage is limited."
C. "This procedure prepares you for joint resurfacing and a total hip
replacement later in life."
D. "An osteotomy is much less invasive than all of the other procedures." -
----ANS:Answer: B
Rationale: An osteotomy is performed to realign the joint or to shift the joint
load toward areas of less cartilage damage. It is used instead of joint
replacement surgery if the client is young, healthy, and damage is limited to
only one side of the joint. This would provide the most accurate explanation to
the client. It is not indicated as a surgery to necessarily be done first before an
arthroplasty, nor to prepare the client for joint resurfacing surgery.
A client diagnosed with localized idiopathic osteoarthritis (OA) asks the nurse
what this means. Which response by the nurse provides the most accurate
information?
A. "Idiopathic describes OA overall while localized indicates that it affects one
body joint only."
B. "Idiopathic refers to the fact that the OA has already progressed
significantly in one or two joints."
C. "Idiopathic OA has no identifiable cause; when it is localized, it only affects
one or two joints."
D. "Idiopathic OA, as compared with secondary OA, is caused by some kind of
underlying condition." - ----ANS:Answer: C
Rationale: There are two types of OA, idiopathic and secondary. Idiopathic OA
has no identifiable cause and can be further subdivided as localized or
generalized, with localized indicating that the OA only affects one or two joints,
so stating that it has no identifiable cause and is limited to one or two joints
would be the most accurate response. Idiopathic OA is not due to an
underlying condition. Idiopathic refers to cause, not progression of the
, disease. Idiopathic is not a term used in general for OA, nor does the term
localized indicate that affected joints are either in the upper or lower torso.
A client with osteoarthritis asks the nurse how to decrease wrist swelling.
Which intervention should the nurse suggest?
A. Increasing range of motion exercises for that joint to 3 times a day
B. Applying a warm towel to the wrist joint 3 times per day for 20 minutes at a
time
C. Using compression cold packs to provide a deeper cold to the wrist joint
D. Encouraging use of assistive devices during daily activities to decrease
stress on the joint - ----ANS:Answer: C
Rationale: The use of deep cold can best help to address swelling. Increasing
ROM exercises to 3 times a day is not the best approach to decrease
swelling; ROM helps to maintain flexibility of the joint. Heat decreases pain
and increases flexibility; it does not address swelling. Assistive device use can
decrease stress on the joint to possibly prevent swelling, but it would not be
the best approach to address swelling once it has occurred.
A client with possible osteoarthritis is scheduled for a synovial fluid analysis.
The nurse should explain to the client that this diagnostic test is being
completed for which reason?
A. To rule out inflammatory arthritis and gout
B. To identify irregular joint space narrowing
C. To evaluate for increased density of subchondral bone
D. To determine the extent of joint damage - ----ANS:Answer: A
Rationale: Joint fluid analysis is used to detect inflammation, bacteria, and uric
acid crystals to rule out inflammatory arthritis and gout. This test will not
provide information on the extent of the joint damage. This test cannot identify
the amount of joint space that has narrowed. This test cannot evaluate bone
density.
After performing a physical assessment, the nurse suspects that a client is
experiencing manifestations of osteoarthritis (OA). Which finding supports the
nurse's suspicion? (Select all that apply.)
A. Leg tremors
B. Joint tenderness
C. Reduced joint flexibility
D. Crepitation
E. Joint stiffness - ----ANS:Answer: B, C, D, E
Osteoarthritis
A 32-year-old client who has limited hip joint damage from osteoarthritis asks
the nurse why an osteotomy is being performed rather than other procedures.
Which response by the nurse provides the most accurate information?
A. "This procedure is usually tried first; arthroplasty will be done later if this
does not work."
B. "This procedure can be done since you are young and healthy and your hip
damage is limited."
C. "This procedure prepares you for joint resurfacing and a total hip
replacement later in life."
D. "An osteotomy is much less invasive than all of the other procedures." -
----ANS:Answer: B
Rationale: An osteotomy is performed to realign the joint or to shift the joint
load toward areas of less cartilage damage. It is used instead of joint
replacement surgery if the client is young, healthy, and damage is limited to
only one side of the joint. This would provide the most accurate explanation to
the client. It is not indicated as a surgery to necessarily be done first before an
arthroplasty, nor to prepare the client for joint resurfacing surgery.
A client diagnosed with localized idiopathic osteoarthritis (OA) asks the nurse
what this means. Which response by the nurse provides the most accurate
information?
A. "Idiopathic describes OA overall while localized indicates that it affects one
body joint only."
B. "Idiopathic refers to the fact that the OA has already progressed
significantly in one or two joints."
C. "Idiopathic OA has no identifiable cause; when it is localized, it only affects
one or two joints."
D. "Idiopathic OA, as compared with secondary OA, is caused by some kind of
underlying condition." - ----ANS:Answer: C
Rationale: There are two types of OA, idiopathic and secondary. Idiopathic OA
has no identifiable cause and can be further subdivided as localized or
generalized, with localized indicating that the OA only affects one or two joints,
so stating that it has no identifiable cause and is limited to one or two joints
would be the most accurate response. Idiopathic OA is not due to an
underlying condition. Idiopathic refers to cause, not progression of the
, disease. Idiopathic is not a term used in general for OA, nor does the term
localized indicate that affected joints are either in the upper or lower torso.
A client with osteoarthritis asks the nurse how to decrease wrist swelling.
Which intervention should the nurse suggest?
A. Increasing range of motion exercises for that joint to 3 times a day
B. Applying a warm towel to the wrist joint 3 times per day for 20 minutes at a
time
C. Using compression cold packs to provide a deeper cold to the wrist joint
D. Encouraging use of assistive devices during daily activities to decrease
stress on the joint - ----ANS:Answer: C
Rationale: The use of deep cold can best help to address swelling. Increasing
ROM exercises to 3 times a day is not the best approach to decrease
swelling; ROM helps to maintain flexibility of the joint. Heat decreases pain
and increases flexibility; it does not address swelling. Assistive device use can
decrease stress on the joint to possibly prevent swelling, but it would not be
the best approach to address swelling once it has occurred.
A client with possible osteoarthritis is scheduled for a synovial fluid analysis.
The nurse should explain to the client that this diagnostic test is being
completed for which reason?
A. To rule out inflammatory arthritis and gout
B. To identify irregular joint space narrowing
C. To evaluate for increased density of subchondral bone
D. To determine the extent of joint damage - ----ANS:Answer: A
Rationale: Joint fluid analysis is used to detect inflammation, bacteria, and uric
acid crystals to rule out inflammatory arthritis and gout. This test will not
provide information on the extent of the joint damage. This test cannot identify
the amount of joint space that has narrowed. This test cannot evaluate bone
density.
After performing a physical assessment, the nurse suspects that a client is
experiencing manifestations of osteoarthritis (OA). Which finding supports the
nurse's suspicion? (Select all that apply.)
A. Leg tremors
B. Joint tenderness
C. Reduced joint flexibility
D. Crepitation
E. Joint stiffness - ----ANS:Answer: B, C, D, E
