Osteoarthritis Practice Questions 2025

Osteoarthritis Practice Questions 2025 Alternative forms are those that haven't been proven effective The client is complaining of joint stiffness, especially in the morning. Which diagnostic test should the nurse expect for R/O osteoarthritis? 1. Full body MRI 2. Serum studies for synovial fluid amount 3. X-ray of the affected joints 4. Serum erythrocyte sedimentation rate (ESR) - ️ Correct Answer 3. X-ray of the affected jointsX-rays reveal loss of joint cartilage, which appears as a narrowing of the joint space in clients with OA The nurse is providing education at a community health fair about osteoarthritis. Which are the general clinical manifestations associated with osteoarthritis that the nurse should include when providing this education? (Select all that apply.) - ️ Correct Answer A)Crepitus with movement of joint B)Abrupt onset C)Mild fever D)Joint pain with activityE)Pain and stiffness at night Answers: A, D, E Joint pain with activity, grating or crepitus noted with movement, and pain and stiffness with prolonged inactivity are general manifestations of osteoarthritis. Mild fever is associated with rheumatoid arthritis, not osteoarthritis. General manifestations of osteoarthritis include a gradual onset, not an abrupt onset. The nurse is planning care for a client with osteoarthritis. Which potential problem is priority for the nurse to address?(Select all that apply.) - ️ Correct Answer A)Chronic pain B)Fluid volume deficit C)Impaired skin integrity D)Impaired cardiac output E)Impaired physical mobility Answers: A, E Chronic pain and impaired physical mobility are priority potential problems for the nurse to address when planning care for a client diagnosed with osteoarthritis. Skin integrity, fluid volume deficit, and cardiac output are not potential problems for the nurse to address when planning care for a client diagnosed with osteoarthritisThe nurse is providing education about home care for a client with osteoarthritis of the knees. Which information should the nurse include during this educational session? (Select all that apply.) - ️ Correct Answer A)Encouraging heavy lifting to maintain muscle strength B)Installing handrails in bathroom C)Taking pain medications as ordered D)Continuing activity with repetitive movement E)Using assistive devices to minimize stress placed on affected joint Answers; B, C, ETaking pain medications as ordered will assist with pain management and allow the client to participate in daily activities. Installing handrails in the bathroom is information that the nurse should include when educating a client, for this will keep the client safe at home. The nurse should educate the client on the importance of using assistive devices to minimize joint stress. The nurse should instruct the client to avoid repetitive movement and to avoid heavy lifting, for these actions will increase pain and joint degeneration and will not improve physical mobility. The nurse is providing education to a client who is scheduled for an osteotomy. Which information should the nurse include about this procedure? - ️ Correct Answer A)The procedure will stop osteoarthritis from progressing. B)Realignment of the joint will occur. C)The joint will be reconstructed. D)Excess debris will be flushed out.Answer: B An osteotomy is performed to realign the joint or to shift the joint load toward areas of less cartilage damage.An osteotomy will not stop the process of osteoarthritis.Joint arthroplasty, not an osteotomy, is a procedure that reconstructs the joint.Arthroscopy, not an osteotomy, is a procedure used to debride the joint by smoothing rough cartilage and flushing out excess debris. Which diagnostic test will best determine the cause of joint damage with osteoarthritis? - ️ Correct Answer A)Synovial fluid analysis B)Joint x-ray C)Electromyogram (EMG) D)MRI of jointAnswer: A Analyzing the synovial fluid of the involved joint helps to determine the cause of joint damage, which may include inflammatory arthritis and gout. This distinction will determine the factors of treatment. An EMG analyzes the strength of muscle contraction. It does not provide any information about joint mobility. An MRI of the affected joint determines the extent of joint damage but does not differentiate causes of the damage. An x-ray of the joint determines the presence of osteoarthritis and the potential presence of joint complications. Which surgical treatment can be used to realign a joint that is affected by osteoarthritis? - ️ Correct Answer A)Joint biopsy B)Joint arthroplasty C)Arthroscopy D)OsteotomyAnswer: D An osteotomy is an incision into or through the bone that can realign or shift the joint load into a better aligned point or toward a less damaged part of the joint. A joint arthroplasty reconstructs or replaces the affected joint when it is severely damaged and pain seriously alters lifestyle. An arthroscopy is used to debride the rough and irregular damaged cartilage. Although fluid may be aspirated from a joint for analysis, joint cartilage is not biopsied to realign a joint affected by osteoarthritis Which health promotion activities support a healthy lifestyle for clients with osteoarthritis? Select all - ️ Correct Answer A)Increase dietary intake of calcium B)Maintain a normal weight C)Use assistive devices as neededD)Limit participation in ROM exercises E)Use soft chairs and recliners for rest Answers: B, C Maintaining a normal weight places less strain on the joints than carrying additional weight. Assistive devices such as grab bars, a shower chair, or long-handled grippers help the client to maintain an independent lifestyle in safety. ROM exercises assist the client to maintain maximal use of joint mobility and are an important component in the exercise plan. Although calcium intake is essential to prevent osteoporosis, especially in older adults, increasing calcium in the daily intake does not have a positive effect on osteoarthritis. Chairs and mattresses should provide support and help to maintainnormal body alignment. Soft chairs and recliners do not provide such support. Which interventions support effective management of chronic pain that is experienced by a client with osteoarthritis? (Select all that apply.) - ️ Correct Answer A)Applying cool compresses to painful joints to reduce inflammation B)Using firm support in chairs and mattresses to properly align the body C)Limiting isometric exercises to reduce strain on the joints D)Encouraging resting painful joints E)Teaching proper posture and good body mechanics for activities of mobilityAnswers: B, D, E Chronic pain is frequently associated with osteoarthritis. When joints are painful, they should be rested. The rest should be balanced with periods of activity, which will reduce joint stiffness. Using proper posture and good body mechanics places the body in proper alignment and offers the joints a neutral platform to perform ROM activities. Firm chairs and mattresses assist the body in proper alignment. Heat should be applied to painful joints, which will increase joint mobility. Cool compresses may increase joint pain and will limit joint mobility. Isometric exercises strengthen muscle groups, which is important to provide additional strength in movement. Strong muscles will reduce strain on joints.Mrs. Gladek is a 70-year-old White woman who has experienced progressive symptoms of osteoarthritis over the past 5 years. In addition to taking prescribed analgesics and anti-inflammatory medications, she is discussing interventions that she implemented into her daily lifestyle to manage her disease condition. Which activity would you suggest to Mrs. Gladek to provide additional exercise opportunities for her - ️ Correct Answer A)Doubles tennis for older adults B)Meditation C)Interval training to jog a 5K D)Water aerobic activities Answer: DMrs. Kingsley is a 64-year-old African American woman who has returned to the healthcare provider's office for follow-up of the osteoarthritic condition of her knees. Although both knees are affected, today her left knee is more swollen than the right knee. During your assessment, Mrs. Kingsley asks you, "If I am losing the cartilage in my knees, why do my knees look larger?" What would be an appropriate response? - ️ Correct Answer A)Although the cartilage is destroyed, you may be building up more bone in the knee. B)Since your condition has progressed, your knees have developed contractures and this increases the size of the knees. C)As your joint cartilage reduces, with exercise, muscle mass increases, which makes the knees look larger. D)With osteoarthritis, sometimes inflammation increases the size of your knees or fluid build-up occurs.Answer: D Inflammation causes swelling of the knee joint, which makes the joint appear larger. Joint effusion or fluid build-up may also occur. An increase in bone or muscle tissue does not occur in osteoarthritis. Flexion contractures may develop with osteoarthritis of the knee joint, but this will not result in an increase in the size of the joint. The nurse is providing education to a community group about developing osteoarthritis. What joints, commonly affected, will the nurse include in the educational session? - ️ Correct Answer A)Neck, shoulders, and ankles B)Ankles, feet, and spine C)Hands, knees, and hips D)Knees, feet, and spine Answer: CHands, knees and hips are the most commonly affected joints of OA. Feet, spine, neck, shoulders, and ankles are not the most common locations. The nurse is providing home care teaching to a client diagnosed with osteoarthritis. Which statement is appropriate for the nurse to include in the teaching session for this client? - ️ Correct Answer A)"When you begin your strengthening exercises, it is appropriate to start with a large weight and work your way down." B)"Balance and agility exercises can help maintain daily living skills and have been recommended by your healthcare provider." C)"Stretching all muscle groups for 30 minutes each day has been recommended by the healthcare provider."D)"Water exercises should not be tried because water buoyancy increases force on the joints Answer: B Balance and agility exercises are recommended for clients with osteoarthritis because they help to maintain daily living skills. When beginning strengthening exercises, clients should start with a low weight and work their way up. Water exercise is beneficial because the buoyancy of the water decreases the force on the joints. The client should stretch all muscle groups for 10 minutes each day. Overstretching is contraindicated A client diagnosed with osteoarthritis of the hands presents with bony lumps on the end joints of her digits. How will the nurse document this finding in the medical record? - ️ Correct Answer A)Lymph node swellingB)Bouchard nodes C)Osteoblasts D)Heberden nodes Answer: D Heberden nodes are bony lumps occurring at the end joint of the digits in a client with OA. Bouchard nodes occur in the middle joint of the digits. Osteoblasts are cells that form new bone. Lymph node swelling does not occur in the hands. A client complains of knee pain during an appointment at a medical clinic. After reviewing the client's medical record, the nurse notes the client has been taking over-the-counter NSAIDs, with no pain relief. The nurse can anticipate the healthcare provider writing a prescription for what medication at discharge? - ️ Correct Answer A)Morphine sulfateB)Celecoxib (Celebrex) C)Acetaminophen (Tylenol) D)Naproxen (Aleve) Answer: B Celecoxib (Celebrex) is a prescription NSAID, COX-2 inhibitor that relieves pain associated with osteoarthritis. Naproxen (Aleve) does relieve pain and stiffness associated with osteoarthritis; however, it is an OTC NSAID, which has not provided relief for the client. Acetaminophen is a first-line therapy for pain; however, it is OTC and not providing client relief. Morphine sulfate is used for clients experiencing moderate to severe pain, but should not be used before trying celecoxib. A client experiencing severe pain that cannot be managed through pain medications or nonpharmacologic therapy may need surgicalintervention. Which surgical treatments will the nurse include in the teaching session with other members of the healthcare team? (Select all that apply.) - ️ Correct Answer A)Serum hyaluronic acid B)Osteotomy C)Arthroplasty D)Joint fusion Answers: B, C, D Arthroplasty, osteotomy, and joint fusion are all surgical interventions indicated for a client with osteoarthritis. Serum hyaluronic acid is adiagnostic blood test for knee osteoarthritis and is not a surgical treatment. Cortisone therapy is not a surgical treatment; it is injected into the inflamed joint. The nurse is planning care for a client with osteoarthritis of the hips. Which intervention will assist in addressing the potential problem of physical mobility? - ️ Correct Answer A)Recommend a local support group for the client and spouse. B)Teach active and passive range of motion exercises. C)Educate the client about proper skin care. D)Encourage the client to avoid all physical activity. Answer: B Teaching active and passive range of motion exercises will assist in addressing the potential problem of physical mobility with a client with osteoarthritis. Encouraging the client to avoid all physical activitydoes not address the potential problem of physical mobility for a client with osteoarthritis. The client should be encouraged to exercise to develop supportive muscles and tendons. Recommending a local support group for the client and spouse and educating the client about proper skin care do not address the potential problem of physical mobility for a client with osteoarthritis. The nurse is caring for the following clients. After receiving the shift report, which client should the nurse assess first? 1. The client with a total knee replacement who is complaining of a cold foot 2. The client diagnosed with OA who is complaining of stiff joints3. The client who needs to receive a scheduled IV antibiotic 4. The client diagnosed with back pain who is scheduled for a lumbar myelogram - ️ Correct Answer 1. The client with a total knee replacement who is complaining of a cold foot Indicates a neurovascular comp The occupational health nurse is teaching a class on the risk factors for developing osteoarthritis (OA). Which is a modifiable risk factor for developing OA? 1. Being overweight 2. Increasing age3. Previous joint damage 4. Genetic susceptibility - ️ Correct Answer 1. Being overweight The client is diagnosed with OA. Which sign/symptom should the nurse expect the client to exhibit? 1. Severe bone deformity 2. Joint stiffness 3. Waddling gait4. Swan-neck fingers - ️ Correct Answer 2. Joint stiffness Pain, stiffness, and functional impairment are the primary clinical manifestations of OA. Stiffness usually decreases with movement Swan=neck fingers and bone deformity occur in RA The client diagnosed with OA is a resident in a long-term care facility. The resident is refusing to bathe because she is hurting. Which instruction should the nurse give the UAP? 1. Allow the client to stay in bed until the pain becomes bearable 2. Tell the UAP to give the client a bed bath this morning3. Try to encourage the client to get up and go to the shower 4. Notify the family the client is refusing to be bathed - ️ Correct Answer 3. Try to encourage the client to get up and go to the shower Pain will decrease with movement and warm water. The worst thing the client can do is not move. The client has been diagnosed with OA for the last 7 years and has tried multiple medical treatments and alternative treatments but still has significant joint pain. Which psychosocial client problem should the nurse identify? 1. Severe pain2. Body image disturbance 3. Knowledge deficit 4. Depression - ️ Correct Answer 4. Depression This client may experience hopelessness and depression The client diagnosed with OA is prescribed an NSAID. Which instruction should the nurse teach the client? 1. Take the medication on an empty stomach2. Make sure to taper the medication when discontinuing 3. Apply the medication topically over the affected joints 4. Notify the health care provider if vomiting blood - ️ Correct Answer 4. Notify the health care provider if vomiting blood NSAIDs are well known for causing GI upset and PUD Which client goal is most important for a client diagnosed with OA? 1. Perform passive ROM 2. Maintain optimal functional ability3. Client will walk 3 miles every day 4. Client will join a health club - ️ Correct Answer 2. Maintain optimal functional ability The two main goals of treatment for OA are pain management and optimizing the functional ability of the joints To which member of the health care team should the nurse refer the client diagnosed with OA who is complaining of not being able to get in and out of the bathtub? 1. Psychiatrist2. Social worker 3. PT 4. Counselor - ️ Correct Answer 3. PT The nurse is discussing the importance of an exercise program for pain control to a client with OA. Which intervention should the nurse include in the teaching? 1. Wear supportive tennis shoes with white socks 2. Carry a complex carbohydrate while exercising 3. Alternate brisk walking and jogging4. Walk at least 30 minutes three times a week - ️ Correct Answer 1. Wear supportive tennis shoes with white socks Safety is important; colored socks can cause athlete's foot. Walking for pain control should be daily, not 3 times a week. The doctor prescribes glucosamine and chondroitin for a client with OA. What's the rationale for these medications? 1. Decrease inflammation 2. Improves tissue function and slows the breakdown of cartilage3. It is a potent medication that decreases the client's joint pain 4. Increases production of synovial fluid in the joint - ️ Correct Answer 2. Improves tissue function and slows the breakdown of cartilage The nurse is admitting the client with OA to the medical floor. Which statement by the client indicates an alternative form of treatment for OA? 1. I take medication every 2 hours for my pain 2. I use a heating pad when I go to bed at night 3. I wear a copper bracelet to help with my OA4. I always wear my ankle splints when I sleep - ️ Correct Answer 3. I wear a copper bracelet to help with my OA A nurse is providing a preventive teaching discussion with a client at risk for osteoarthritis. Which guideline should be included in this discussion related to exercise? - ️ Correct Answer A)Exercise is not recommended B)If there is pain with exercise, keep going, this is building muscle C)Participate in regular exercise, including walking or swimming D)Perform heavy weightlifting exercises three times per week Answer: C Participating in regular exercise like walking, jogging, swimming and cycling can keep joints strong and functional. Heavy weightlifting isnot recommended for a client with OA and may actually lead to further joint breakdown. Recommending exercise is proven to prevent OA; it should not be discouraged. If pain is experienced with exercise, the client should stop and rest; continuing may build muscle, but will break down the joint cartilage. 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 what reason? - ️ Correct Answer 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 Answer: AJoint fluid analysis is used to detect inflammation, bacteria, and uric acid crystals in order to rule out inflammatory arthritis and gout. This test will not provide information on the extent of the joint damaged. This test cannot identify the amount of joint space that has narrowed. This test cannot evaluate bone density