OA/RA NCLEX Questions and Answers
QUESTION 1: SEPTIC ARTHRITIS - POST-SURGICAL
A patient who had arthroscopic surgery of the left knee 5 days previously is
admitted with a red, swollen, and hot-to-touch knee. Which of these
assessment data obtained by the nurse should be reported to the health care
provider immediately?
a. The white blood cell count is 14,200/μl
b. The patient rates the knee pain at 9 on a 10-point pain scale
c. The patient has recently taken ibuprofen (Motrin)
d. The oral temperature is 104.1° F
CORRECT ANSWER: D
Rationale: The elevated temperature suggests that the patient may have an
infection and be in danger of developing septicemia as a complication of
septic arthritis. Immediate blood cultures and initiation of antibiotic therapy are
indicated. The other information is typical of septic arthritis and should also be
reported to the health care provider, but it does not indicate any immediately
life-threatening problems.
Cognitive Level: Application | NCLEX: Physiological Integrity
QUESTION 2: OSTEOARTHRITIS - MEDICATION EFFECTIVENESS
The health care provider has prescribed naproxen (Naprosyn) twice daily for a
patient with osteoarthritis (OA) of the hands. The patient tells the nurse after 3
weeks of use that the drug does not seem to be effective in controlling the
pain. The nurse should teach the patient that
a. Another type of nonsteroidal antiinflammatory drug (NSAID) may be
indicated because of variations in individual response to the drugs
b. It may take up to 4 to 6 weeks for NSAIDs to reach therapeutic levels in the
blood
c. If NSAIDs are not effective in controlling symptoms, corticosteroids are the
next drug of choice
, d. Adding a twice-daily aspirin to the naproxen may improve the effectiveness
of the drug
CORRECT ANSWER: A
Rationale: Individual responses to NSAIDs can vary, so the health care
provider may prescribe a different NSAID. Full effectiveness of NSAIDs occurs
in 2 to 3 weeks. Corticosteroids are usually reserved for use in RA. Patients
are instructed to avoid aspirin when taking NSAIDs because of the increased
risk for bleeding and gastrointestinal irritation.
Cognitive Level: Application | NCLEX: Physiological Integrity
QUESTION 3: SEPTIC ARTHRITIS - RISK FACTORS
A 22-year-old patient hospitalized with severe pain in the knees and a fever
and shaking chills is suspected of having septic arthritis. Information obtained
during the nursing history that indicates a risk factor for septic arthritis is that
the patient
a. Has a parent who has reactive arthritis
b. Recently returned from a trip to South America
c. Is sexually active and has multiple partners
d. Had several sports-related knee injuries as a teenager
CORRECT ANSWER: C
Rationale: Neisseria gonorrhoeae is the most common cause for septic
arthritis in sexually active young adults. The other information does not point
to any risk for septic arthritis.
Cognitive Level: Application | NCLEX: Physiological Integrity
QUESTION 4: RHEUMATOID ARTHRITIS - PSYCHOSOCIAL ASSESSMENT
A 35-year-old patient with three school-age children who has recently been
diagnosed with rheumatoid arthritis (RA) tells the nurse that the inability to be
involved in many family activities is causing stress at home. Which response
by the nurse is most appropriate?
QUESTION 1: SEPTIC ARTHRITIS - POST-SURGICAL
A patient who had arthroscopic surgery of the left knee 5 days previously is
admitted with a red, swollen, and hot-to-touch knee. Which of these
assessment data obtained by the nurse should be reported to the health care
provider immediately?
a. The white blood cell count is 14,200/μl
b. The patient rates the knee pain at 9 on a 10-point pain scale
c. The patient has recently taken ibuprofen (Motrin)
d. The oral temperature is 104.1° F
CORRECT ANSWER: D
Rationale: The elevated temperature suggests that the patient may have an
infection and be in danger of developing septicemia as a complication of
septic arthritis. Immediate blood cultures and initiation of antibiotic therapy are
indicated. The other information is typical of septic arthritis and should also be
reported to the health care provider, but it does not indicate any immediately
life-threatening problems.
Cognitive Level: Application | NCLEX: Physiological Integrity
QUESTION 2: OSTEOARTHRITIS - MEDICATION EFFECTIVENESS
The health care provider has prescribed naproxen (Naprosyn) twice daily for a
patient with osteoarthritis (OA) of the hands. The patient tells the nurse after 3
weeks of use that the drug does not seem to be effective in controlling the
pain. The nurse should teach the patient that
a. Another type of nonsteroidal antiinflammatory drug (NSAID) may be
indicated because of variations in individual response to the drugs
b. It may take up to 4 to 6 weeks for NSAIDs to reach therapeutic levels in the
blood
c. If NSAIDs are not effective in controlling symptoms, corticosteroids are the
next drug of choice
, d. Adding a twice-daily aspirin to the naproxen may improve the effectiveness
of the drug
CORRECT ANSWER: A
Rationale: Individual responses to NSAIDs can vary, so the health care
provider may prescribe a different NSAID. Full effectiveness of NSAIDs occurs
in 2 to 3 weeks. Corticosteroids are usually reserved for use in RA. Patients
are instructed to avoid aspirin when taking NSAIDs because of the increased
risk for bleeding and gastrointestinal irritation.
Cognitive Level: Application | NCLEX: Physiological Integrity
QUESTION 3: SEPTIC ARTHRITIS - RISK FACTORS
A 22-year-old patient hospitalized with severe pain in the knees and a fever
and shaking chills is suspected of having septic arthritis. Information obtained
during the nursing history that indicates a risk factor for septic arthritis is that
the patient
a. Has a parent who has reactive arthritis
b. Recently returned from a trip to South America
c. Is sexually active and has multiple partners
d. Had several sports-related knee injuries as a teenager
CORRECT ANSWER: C
Rationale: Neisseria gonorrhoeae is the most common cause for septic
arthritis in sexually active young adults. The other information does not point
to any risk for septic arthritis.
Cognitive Level: Application | NCLEX: Physiological Integrity
QUESTION 4: RHEUMATOID ARTHRITIS - PSYCHOSOCIAL ASSESSMENT
A 35-year-old patient with three school-age children who has recently been
diagnosed with rheumatoid arthritis (RA) tells the nurse that the inability to be
involved in many family activities is causing stress at home. Which response
by the nurse is most appropriate?
