Nur 242 exam 6 Questions and Graded Answers.
On reviewing the x-ray report of a client with rheumatoid arthritis, the nurse learns that three
small joints are involved. Which score will the nurse assign the client for joint involvement? -
2. According to the diagnostic criteria for rheumatoid arthritis, involvement of one to
three small joints (with or without large-joint involvement) is given a score of 2. Involvement of
two to 10 large joints is given a score of 1. Involvement of four to 10 small joints (with or
without large-joint involvement) is given a score of 3. Involvement of more than 10 joints (and at
least one small joint) is given a score of 5.
Which surgery is used as a prophylactic measure and as a palliative treatment for clients with
rheumatoid arthritis (RA)? - Synovectomy
The nurse is coordinating care for a client with severe rheumatoid arthritis. Which health team
perspective for planning care would promote the client's self-reliance and independence? -
Developing a positive attitude toward the eventual outcome
The nurse develops a teaching plan for a client with rheumatoid arthritis. Which information
would the nurse include in the plan about ways to reduce joint stress? - If experiencing
pain after 1 to 2 hours of activity, actively take measures to address the pain.
Which client has findings consistent with rheumatoid arthritis? - ESR 65 mm/hour
(Erythrocyte sedimentation rate (ESR) is a nonspecific index of inflammation. Its normal value is
less than 30 mm/hr. Client D, who has elevated levels of ESR to 65 mm/hr, may present with
rheumatoid arthritis, osteomyelitis, rheumatic fever, or respiratory tract infections)
client admitted to the hospital with an acute episode of rheumatoid arthritis (RA) asks why
physical therapy has not been prescribed. Which response would the nurse make - Your
joints are still inflamed, and physical therapy can be harmful
Which finding would the nurse expect to identify in a client who has osteoarthritis that would not
be present in clients with rheumatoid arthritis? - Heberden nodes (Heberden nodules are
the bony or cartilaginous enlargements of the distal interphalangeal joints that are associated
,with osteoarthritis. Ulnar drift, swan-neck deformity, and boutonnière deformity occur with
rheumatoid arthritis)
A client with rheumatoid arthritis arrives in the clinic stating, "I don't take any medications
because they are too expensive." The client reports that family members are arranging for the
medications to be obtained from another country. Which action would the nurse take first? -
Discuss alternative solutions with the client
A client who has rheumatoid arthritis reports that pain with exercising has increased. Which
suggestion would the nurse provide to the client to decrease pain? I'm - Decrease the
number of repetitions of the exercises (Exercise should be performed to tolerance only; limiting
the amount of exercise should decrease pain. To relax the joints, the client should take a hot
shower versus a tub bath. Furthermore, it will be difficult for a client with stiff joints to get into a
typical bathtub. Ice should never be placed against the skin without a layer of protection; further
damage or frostbite could occur. Ceasing exercise for a day will increase stiffness)
A client who has rheumatoid arthritis participates in an individualized exercise program at the
extended care facility where the client resides. Which statement from the client indicates to the
nurse that the client understands the purpose of the program? - I do one set of exercises
slowly after breakfast, then I space the rest of them throughout the day. ( spacing activity
protects joints)
The nurse is providing discharge teaching to a client who was hospitalized for exacerbation of
rheumatoid arthritis. Which statement by the client indicates correct understanding of the
treatment plan? - I will reduce the number of exercise repetitions when I have pain.
A regimen of rest, exercise, and physical therapy is prescribed for a client with rheumatoid
arthritis. Which purpose of the regimen would the nurse teach to the client? - Preventing
additional joint damage
A nurse is creating a plan of care for a client with rheumatoid arthritis who has severe pain and
swelling of the hand joints. Which details about range-of-motion exercises would the plan
include? - Applying heat or cold before the exercises
, Which outcome is likely if direct pressure is applied to the joints of a client who has an acute
episode of rheumatoid arthritis? - Pain
An older client is admitted to a nursing home. The client is incontinent of urine. The client's
rheumatoid arthritis contributes to severely painful joints. Which client need would the nurse
identify as the primary consideration in the care of this client? - Relief of pain
A client with severe chronic rheumatoid arthritis reports that pain lasts for 2 to 3 hours after
exercising. Which information would the nurse teach the client? - Decrease the time and
number of exercise repetitions
Which intervention would the nurse teach the client who has rheumatoid arthritis to alternate
with periods of rest? - Active exercises
Which laboratory test would the nurse review for a client suspected to have rheumatoid arthritis?
- Antinuclear antibody
After a painful exacerbation of rheumatoid arthritis, a client is scheduled to begin a walking and
exercise program. Which statements describes an expected outcome for this client? -
Exercise and be active unless the discomfort becomes too great.
When would the nurse expect the client who has rheumatoid arthritis to experience the most joint
pain and stiffness? - In the morning on awakening
Which factor explains why a client who experiences an acute episode of rheumatoid arthritis has
swollen finger joints? - Inflammation in the joint's synovial lining
Which type of diet would the nurse expect the primary health care provider to prescribe for a
client diagnosed with rheumatoid arthritis? - Regular diet with vitamins and minerals
A client who has passed the acute phase of rheumatoid arthritis is to be out of bed as tolerated.
Which type of chair would the nurse use to position the client? - Straight-back armchair
On reviewing the x-ray report of a client with rheumatoid arthritis, the nurse learns that three
small joints are involved. Which score will the nurse assign the client for joint involvement? -
2. According to the diagnostic criteria for rheumatoid arthritis, involvement of one to
three small joints (with or without large-joint involvement) is given a score of 2. Involvement of
two to 10 large joints is given a score of 1. Involvement of four to 10 small joints (with or
without large-joint involvement) is given a score of 3. Involvement of more than 10 joints (and at
least one small joint) is given a score of 5.
Which surgery is used as a prophylactic measure and as a palliative treatment for clients with
rheumatoid arthritis (RA)? - Synovectomy
The nurse is coordinating care for a client with severe rheumatoid arthritis. Which health team
perspective for planning care would promote the client's self-reliance and independence? -
Developing a positive attitude toward the eventual outcome
The nurse develops a teaching plan for a client with rheumatoid arthritis. Which information
would the nurse include in the plan about ways to reduce joint stress? - If experiencing
pain after 1 to 2 hours of activity, actively take measures to address the pain.
Which client has findings consistent with rheumatoid arthritis? - ESR 65 mm/hour
(Erythrocyte sedimentation rate (ESR) is a nonspecific index of inflammation. Its normal value is
less than 30 mm/hr. Client D, who has elevated levels of ESR to 65 mm/hr, may present with
rheumatoid arthritis, osteomyelitis, rheumatic fever, or respiratory tract infections)
client admitted to the hospital with an acute episode of rheumatoid arthritis (RA) asks why
physical therapy has not been prescribed. Which response would the nurse make - Your
joints are still inflamed, and physical therapy can be harmful
Which finding would the nurse expect to identify in a client who has osteoarthritis that would not
be present in clients with rheumatoid arthritis? - Heberden nodes (Heberden nodules are
the bony or cartilaginous enlargements of the distal interphalangeal joints that are associated
,with osteoarthritis. Ulnar drift, swan-neck deformity, and boutonnière deformity occur with
rheumatoid arthritis)
A client with rheumatoid arthritis arrives in the clinic stating, "I don't take any medications
because they are too expensive." The client reports that family members are arranging for the
medications to be obtained from another country. Which action would the nurse take first? -
Discuss alternative solutions with the client
A client who has rheumatoid arthritis reports that pain with exercising has increased. Which
suggestion would the nurse provide to the client to decrease pain? I'm - Decrease the
number of repetitions of the exercises (Exercise should be performed to tolerance only; limiting
the amount of exercise should decrease pain. To relax the joints, the client should take a hot
shower versus a tub bath. Furthermore, it will be difficult for a client with stiff joints to get into a
typical bathtub. Ice should never be placed against the skin without a layer of protection; further
damage or frostbite could occur. Ceasing exercise for a day will increase stiffness)
A client who has rheumatoid arthritis participates in an individualized exercise program at the
extended care facility where the client resides. Which statement from the client indicates to the
nurse that the client understands the purpose of the program? - I do one set of exercises
slowly after breakfast, then I space the rest of them throughout the day. ( spacing activity
protects joints)
The nurse is providing discharge teaching to a client who was hospitalized for exacerbation of
rheumatoid arthritis. Which statement by the client indicates correct understanding of the
treatment plan? - I will reduce the number of exercise repetitions when I have pain.
A regimen of rest, exercise, and physical therapy is prescribed for a client with rheumatoid
arthritis. Which purpose of the regimen would the nurse teach to the client? - Preventing
additional joint damage
A nurse is creating a plan of care for a client with rheumatoid arthritis who has severe pain and
swelling of the hand joints. Which details about range-of-motion exercises would the plan
include? - Applying heat or cold before the exercises
, Which outcome is likely if direct pressure is applied to the joints of a client who has an acute
episode of rheumatoid arthritis? - Pain
An older client is admitted to a nursing home. The client is incontinent of urine. The client's
rheumatoid arthritis contributes to severely painful joints. Which client need would the nurse
identify as the primary consideration in the care of this client? - Relief of pain
A client with severe chronic rheumatoid arthritis reports that pain lasts for 2 to 3 hours after
exercising. Which information would the nurse teach the client? - Decrease the time and
number of exercise repetitions
Which intervention would the nurse teach the client who has rheumatoid arthritis to alternate
with periods of rest? - Active exercises
Which laboratory test would the nurse review for a client suspected to have rheumatoid arthritis?
- Antinuclear antibody
After a painful exacerbation of rheumatoid arthritis, a client is scheduled to begin a walking and
exercise program. Which statements describes an expected outcome for this client? -
Exercise and be active unless the discomfort becomes too great.
When would the nurse expect the client who has rheumatoid arthritis to experience the most joint
pain and stiffness? - In the morning on awakening
Which factor explains why a client who experiences an acute episode of rheumatoid arthritis has
swollen finger joints? - Inflammation in the joint's synovial lining
Which type of diet would the nurse expect the primary health care provider to prescribe for a
client diagnosed with rheumatoid arthritis? - Regular diet with vitamins and minerals
A client who has passed the acute phase of rheumatoid arthritis is to be out of bed as tolerated.
Which type of chair would the nurse use to position the client? - Straight-back armchair
