Rheumatoid Arthritis Study Guide Exam
Questions And Actual Answers.
On a visit to the clinic, a client reports the onset of early symptoms of rheumatoid arthritis. The nurse
should conduct a focused assessment for:
1. Limited motion of joints.
2. Deformed joints of the hands.
3. Early morning stiffness.
4. Rheumatoid nodules. - Answer 3.
Initially, most clients with early symptoms of rheumatoid arthritis complain of early morning stiffness or
stiffness after sitting still for a while. Later symptoms of rheumatoid arthritis include limited joint range
of motion; deformed joints, especially of the hand; and rheumatoid nodules.
2. A client with rheumatoid arthritis states, "I can't do my household chores without becoming tired. My
knees hurt whenever I walk." Which nursing diagnosis would be most appropriate?
1. Activity intolerance related to fatigue and pain.
2. Self-care deficit related to increasing joint pain.
3. Ineffective coping related to chronic pain.
4. Disturbed body image related to fatigue and joint pain. - Answer 1.
Based on the client's complaints, the most appropriate nursing diagnosis would be Activity intolerance
related to fatigue and pain. Nursing interventions would focus on helping the client conserve energy and
decrease episodes of fatigue. Although the client may develop a self-care deficit related to the activity
intolerance and increasing joint pain, the client is voicing concerns about household chores and difficulty
around the house and yard, not self-care issues. Over time, the client may develop ineffective coping or
body image disturbance as the disorder becomes chronic with increasing pain and fatigue.
Of the clients listed below, who is at risk for developing rheumatoid arthritis (RA)? Select all that apply.
1. Adults between the ages of 20 and 50 years.
2. Adults who have had an infectious disease with the Epstein-Barr virus.
, 3. Adults that are of the male gender.
4. Adults who possess the genetic link, specifically HLA-DR4.
5. Adults who also have osteoarthritis. - Answer 1, 2, 4.
Rheumatoid arthritis (RA) affects women three times more often than men, between the ages of 20 and
55 years. Research has determined that RA occurs in clients who have had infectious disease, such as the
Epstein-Barr virus. The genetic link, specifically HLA-DR4, has been found in 65% of clients with RA.
People with osteoarthritis are not necessarily at risk for developing rheumatoid arthritis.
A client is in the acute phase of rheumatoid arthritis. Which of the following should the nurse identify as
lowest priority in the plan of care?
1. Relieving pain.
2. Preserving joint function.
3. Maintaining usual ways of accomplishing tasks.
4. Preventing joint deformity. - Answer 3.
Maintaining usual ways of accomplishing tasks would be the lowest priority during the acute phase.
Rather, the focus is on developing less stressful ways of accomplishing routine tasks. Pain relief is a high
priority during the acute phase because pain is typically severe and interferes with the client's ability to
function. Preserving joint function and preventing joint deformity are high priorities during the acute
phase to promote an optimal level of functioning and reduce the risk of contractures.
The nurse teaches a client about heat and cold treatments to manage arthritis pain. Which of the
following client statements indicates that the client still has a knowledge deficit?
1. "I can use heat and cold as often as I want."
2. "With heat, I should apply it for no longer than 20 minutes at a time."
3. "Heat-producing liniments can be used with other heat devices."
4. "Ten to 15 minutes per application is the maximum time for cold applications." - Answer 3.
Heat-producing liniment can produce a burn if used with other heat devices that could intensify the heat
reaction. Heat and cold can be used as often as the client desires. However, each application of heat
should not exceed 20 minutes, and each application of cold should not exceed 10 to 15 minutes.
Application for longer periods results in the opposite of the intended effect: vasoconstriction instead of
vasodilation with heat, and vasodilation instead of vasoconstriction with cold.
Questions And Actual Answers.
On a visit to the clinic, a client reports the onset of early symptoms of rheumatoid arthritis. The nurse
should conduct a focused assessment for:
1. Limited motion of joints.
2. Deformed joints of the hands.
3. Early morning stiffness.
4. Rheumatoid nodules. - Answer 3.
Initially, most clients with early symptoms of rheumatoid arthritis complain of early morning stiffness or
stiffness after sitting still for a while. Later symptoms of rheumatoid arthritis include limited joint range
of motion; deformed joints, especially of the hand; and rheumatoid nodules.
2. A client with rheumatoid arthritis states, "I can't do my household chores without becoming tired. My
knees hurt whenever I walk." Which nursing diagnosis would be most appropriate?
1. Activity intolerance related to fatigue and pain.
2. Self-care deficit related to increasing joint pain.
3. Ineffective coping related to chronic pain.
4. Disturbed body image related to fatigue and joint pain. - Answer 1.
Based on the client's complaints, the most appropriate nursing diagnosis would be Activity intolerance
related to fatigue and pain. Nursing interventions would focus on helping the client conserve energy and
decrease episodes of fatigue. Although the client may develop a self-care deficit related to the activity
intolerance and increasing joint pain, the client is voicing concerns about household chores and difficulty
around the house and yard, not self-care issues. Over time, the client may develop ineffective coping or
body image disturbance as the disorder becomes chronic with increasing pain and fatigue.
Of the clients listed below, who is at risk for developing rheumatoid arthritis (RA)? Select all that apply.
1. Adults between the ages of 20 and 50 years.
2. Adults who have had an infectious disease with the Epstein-Barr virus.
, 3. Adults that are of the male gender.
4. Adults who possess the genetic link, specifically HLA-DR4.
5. Adults who also have osteoarthritis. - Answer 1, 2, 4.
Rheumatoid arthritis (RA) affects women three times more often than men, between the ages of 20 and
55 years. Research has determined that RA occurs in clients who have had infectious disease, such as the
Epstein-Barr virus. The genetic link, specifically HLA-DR4, has been found in 65% of clients with RA.
People with osteoarthritis are not necessarily at risk for developing rheumatoid arthritis.
A client is in the acute phase of rheumatoid arthritis. Which of the following should the nurse identify as
lowest priority in the plan of care?
1. Relieving pain.
2. Preserving joint function.
3. Maintaining usual ways of accomplishing tasks.
4. Preventing joint deformity. - Answer 3.
Maintaining usual ways of accomplishing tasks would be the lowest priority during the acute phase.
Rather, the focus is on developing less stressful ways of accomplishing routine tasks. Pain relief is a high
priority during the acute phase because pain is typically severe and interferes with the client's ability to
function. Preserving joint function and preventing joint deformity are high priorities during the acute
phase to promote an optimal level of functioning and reduce the risk of contractures.
The nurse teaches a client about heat and cold treatments to manage arthritis pain. Which of the
following client statements indicates that the client still has a knowledge deficit?
1. "I can use heat and cold as often as I want."
2. "With heat, I should apply it for no longer than 20 minutes at a time."
3. "Heat-producing liniments can be used with other heat devices."
4. "Ten to 15 minutes per application is the maximum time for cold applications." - Answer 3.
Heat-producing liniment can produce a burn if used with other heat devices that could intensify the heat
reaction. Heat and cold can be used as often as the client desires. However, each application of heat
should not exceed 20 minutes, and each application of cold should not exceed 10 to 15 minutes.
Application for longer periods results in the opposite of the intended effect: vasoconstriction instead of
vasodilation with heat, and vasodilation instead of vasoconstriction with cold.
