Nur. 315- Chapter 38: Assessment and Management of Patients With
Rheumatic Disorders UPDATED ACTUAL Questions and CORRECT
Answers
1. The nurse is complet- joint stiffness that decreases with activity
ing a health history
with a client in a clin- A characteristic feature of osteoarthritis (degenerative joint disease) is joint
ic. What assessment stiffness that decreases with activity and movement. Erythema and edema
finding best corre- over the affected joint, anorexia, weight loss, and fever and malaise are
lates with a diagnosis associated with rheumatoid arthritis, a more severe and destructive form of
of osteoarthritis? arthritis.
2. Which newer phar- Viscosupplementation
macological ther-
apy, used to Viscosupplementation, the intra-articular injection of hyaluronates, is thought
treat osteoarthritis, to prevent the loss of cartilage and repair chondral defects. It may also have
is thought to pre- some anti-inflammatory effects. Glucosamine and chondroitin are thought
vent the loss of carti- to improve tissue function and retard breakdown of cartilage. Capsaicin is a
lage and repair chon- topical analgesic.
dral defects, as well
as have some anti-in-
flammatory effects?
3. The presence of crys- gout
tals in synovial flu-
id obtained from The presence of crystals is indicative of gout, whereas the presence of bac-
arthrocentesis is in- teria is indicative of infective arthritis.
dicative of
4. Which joint is most Metatarsophalangeal
commonly affected
in gout? The metatarsophalangeal joint of the big toe is the most commonly affected
joint (90% of clients); this is referred to as podagra. The wrists, fingers, and
elbows are less commonly affected. The tarsal area, ankle, and knee are not
the most commonly affected in gout.
, Nur. 315- Chapter 38: Assessment and Management of Patients With
Rheumatic Disorders UPDATED ACTUAL Questions and CORRECT
Answers
5. The nurse is re- colchicine
viewing the med-
ication administra- Colchicine is prescribed for the treatment of an acute attack of gout.
tion record of the
client. Which medica-
tion would lead the
nurse to suspect that
the client is suffering
from an acute attack
of gout?
6. A client with gout has "There might be some diflculties with your plan and fasting."
been advised to lose
weight. The client Clients should avoid fasting, low-carbohydrate diets, and rapid weight loss
informs the nurse because these measures increase the likelihood of ketone formation, which
of plans to go on inhibits uric acid excretion. Gradual weight loss helps reduce serum uric acid
a "guaranteed rapid levels in clients with gout.
weight loss" plan
that involves fast-
ing and heavy exer-
cise. Which response
would be most ap-
propriate?
7. Which of the fol- Systemic lupus erythematosus (SLE)
lowing disorders is
characterized by an SLE is an immunoregulatory disturbance that results in increased autoanti-
increased autoanti- body production. Scleroderma occurs initially in the skin but also occurs in
body production? blood vessels, major organs, and body systems, potentially resulting in death.
Rheumatoid arthritis results from an autoimmune response in the synovial
, Nur. 315- Chapter 38: Assessment and Management of Patients With
Rheumatic Disorders UPDATED ACTUAL Questions and CORRECT
Answers
tissue, with damage taking place in body joints. In polymyalgia rheumatic,
immunoglobulin is deposited in the walls of inflamed temporal arteries.
8. The nurse intervenes Chronic fatigue, generalized muscle aching, and stiffness
to assist the client
with fibromyalgia to Fibromyalgia is a common condition that involves chronic fatigue, general-
cope with which ized muscle aching, and stiffness. The cause is unknown, and no pathologic
symptoms? characteristics specific for the condition have been identified. Treatment
consists of attention to the specific symptoms reported by the client. NSAIDs
may be used to treat the diffuse muscle aching and stiffness. Tricyclic an-
tidepressants are used to improve or restore normal sleep patterns, and
individualized programs of exercise are used to decrease muscle weakness
and discomfort and to improve the general deconditioning that occurs in
these individuals.
9. A client with rheuma- Nonsteroidal anti-inflammatory drugs
toid arthritis reports
joint pain. What in- Nonsteroidal anti-inflammatory drugs are the mainstay of treatment for
tervention is a priori- rheumatoid arthritis pain. They help to decrease inflammation in the joints.
ty to assist the client? Heat, rather than ice packs, is used to relieve pain. Parafln baths may also
help. Surgery is reserved for joint replacement when the joint is no longer
functional; it is not an intervention specific to relieving pain.
10. The nurse is caring colchicine
for a client with a new
onset of gout. What The treatment of gout involves managing the acute inflammatory stage,
medication does the preventing flare-ups, and controlling hyperuricemia. Colchicine, along with
nurse anticipate will indomethacin, ibuprofen, or a corticosteroid, is prescribed to relieve an acute
be ordered by the attack of gout. Probenecid and anturane increase the urinary excretion of uric
health care provider? acid, and allopurinol breaks down purines before uric acid is formed.
11.
, Nur. 315- Chapter 38: Assessment and Management of Patients With
Rheumatic Disorders UPDATED ACTUAL Questions and CORRECT
Answers
A client asks the "OA is a noninflammatory joint disease. RA is characterized by inflamed,
nurse what the swollen joints."
difference is be-
tween osteoarthritis OA is a degenerative arthritis, characterized by the loss of cartilage on
(OA) and rheumatoid the articular surfaces of weight-bearing joints with spur development. RA
arthritis (RA). Which is characterized by inflammation of synovial membranes and surrounding
response is correct? structures. OA may occur in one hip or knee and not the other, whereas RA
commonly affects the same joints bilaterally. RA is more common in women;
OA affects both sexes equally.
12. The client asks the t'ai chi
nurse about types
of exercise that do T'ai chi is low impact, so this is the best exercise for low joint impact. Jogging,
not stress the joints. weight lifting, and running on a treadmill are high-impact, jarring types of
What exercise will the exercise.
nurse include in the
teaching plan?
13. The client with os- Has a weight gain of 5 pounds
teoarthritis is seen
in the clinic. Which Obesity is a risk factor for osteoarthritis. Excess weight is a stressor on the
assessment finding weight-bearing joints. Weight reduction is often a part of the therapeutic
indicates the client regimen.
is having diffi-
culty implementing
self-care?
14. The nurse is assess- low back pain
ing a client with a
history of ankylosing The most common symptoms of ankylosing spondylitis are low back pain and
spondylitis. What will stiffness. A red, butterfly-shaped rash on the face and a patchy loss of hair are
Rheumatic Disorders UPDATED ACTUAL Questions and CORRECT
Answers
1. The nurse is complet- joint stiffness that decreases with activity
ing a health history
with a client in a clin- A characteristic feature of osteoarthritis (degenerative joint disease) is joint
ic. What assessment stiffness that decreases with activity and movement. Erythema and edema
finding best corre- over the affected joint, anorexia, weight loss, and fever and malaise are
lates with a diagnosis associated with rheumatoid arthritis, a more severe and destructive form of
of osteoarthritis? arthritis.
2. Which newer phar- Viscosupplementation
macological ther-
apy, used to Viscosupplementation, the intra-articular injection of hyaluronates, is thought
treat osteoarthritis, to prevent the loss of cartilage and repair chondral defects. It may also have
is thought to pre- some anti-inflammatory effects. Glucosamine and chondroitin are thought
vent the loss of carti- to improve tissue function and retard breakdown of cartilage. Capsaicin is a
lage and repair chon- topical analgesic.
dral defects, as well
as have some anti-in-
flammatory effects?
3. The presence of crys- gout
tals in synovial flu-
id obtained from The presence of crystals is indicative of gout, whereas the presence of bac-
arthrocentesis is in- teria is indicative of infective arthritis.
dicative of
4. Which joint is most Metatarsophalangeal
commonly affected
in gout? The metatarsophalangeal joint of the big toe is the most commonly affected
joint (90% of clients); this is referred to as podagra. The wrists, fingers, and
elbows are less commonly affected. The tarsal area, ankle, and knee are not
the most commonly affected in gout.
, Nur. 315- Chapter 38: Assessment and Management of Patients With
Rheumatic Disorders UPDATED ACTUAL Questions and CORRECT
Answers
5. The nurse is re- colchicine
viewing the med-
ication administra- Colchicine is prescribed for the treatment of an acute attack of gout.
tion record of the
client. Which medica-
tion would lead the
nurse to suspect that
the client is suffering
from an acute attack
of gout?
6. A client with gout has "There might be some diflculties with your plan and fasting."
been advised to lose
weight. The client Clients should avoid fasting, low-carbohydrate diets, and rapid weight loss
informs the nurse because these measures increase the likelihood of ketone formation, which
of plans to go on inhibits uric acid excretion. Gradual weight loss helps reduce serum uric acid
a "guaranteed rapid levels in clients with gout.
weight loss" plan
that involves fast-
ing and heavy exer-
cise. Which response
would be most ap-
propriate?
7. Which of the fol- Systemic lupus erythematosus (SLE)
lowing disorders is
characterized by an SLE is an immunoregulatory disturbance that results in increased autoanti-
increased autoanti- body production. Scleroderma occurs initially in the skin but also occurs in
body production? blood vessels, major organs, and body systems, potentially resulting in death.
Rheumatoid arthritis results from an autoimmune response in the synovial
, Nur. 315- Chapter 38: Assessment and Management of Patients With
Rheumatic Disorders UPDATED ACTUAL Questions and CORRECT
Answers
tissue, with damage taking place in body joints. In polymyalgia rheumatic,
immunoglobulin is deposited in the walls of inflamed temporal arteries.
8. The nurse intervenes Chronic fatigue, generalized muscle aching, and stiffness
to assist the client
with fibromyalgia to Fibromyalgia is a common condition that involves chronic fatigue, general-
cope with which ized muscle aching, and stiffness. The cause is unknown, and no pathologic
symptoms? characteristics specific for the condition have been identified. Treatment
consists of attention to the specific symptoms reported by the client. NSAIDs
may be used to treat the diffuse muscle aching and stiffness. Tricyclic an-
tidepressants are used to improve or restore normal sleep patterns, and
individualized programs of exercise are used to decrease muscle weakness
and discomfort and to improve the general deconditioning that occurs in
these individuals.
9. A client with rheuma- Nonsteroidal anti-inflammatory drugs
toid arthritis reports
joint pain. What in- Nonsteroidal anti-inflammatory drugs are the mainstay of treatment for
tervention is a priori- rheumatoid arthritis pain. They help to decrease inflammation in the joints.
ty to assist the client? Heat, rather than ice packs, is used to relieve pain. Parafln baths may also
help. Surgery is reserved for joint replacement when the joint is no longer
functional; it is not an intervention specific to relieving pain.
10. The nurse is caring colchicine
for a client with a new
onset of gout. What The treatment of gout involves managing the acute inflammatory stage,
medication does the preventing flare-ups, and controlling hyperuricemia. Colchicine, along with
nurse anticipate will indomethacin, ibuprofen, or a corticosteroid, is prescribed to relieve an acute
be ordered by the attack of gout. Probenecid and anturane increase the urinary excretion of uric
health care provider? acid, and allopurinol breaks down purines before uric acid is formed.
11.
, Nur. 315- Chapter 38: Assessment and Management of Patients With
Rheumatic Disorders UPDATED ACTUAL Questions and CORRECT
Answers
A client asks the "OA is a noninflammatory joint disease. RA is characterized by inflamed,
nurse what the swollen joints."
difference is be-
tween osteoarthritis OA is a degenerative arthritis, characterized by the loss of cartilage on
(OA) and rheumatoid the articular surfaces of weight-bearing joints with spur development. RA
arthritis (RA). Which is characterized by inflammation of synovial membranes and surrounding
response is correct? structures. OA may occur in one hip or knee and not the other, whereas RA
commonly affects the same joints bilaterally. RA is more common in women;
OA affects both sexes equally.
12. The client asks the t'ai chi
nurse about types
of exercise that do T'ai chi is low impact, so this is the best exercise for low joint impact. Jogging,
not stress the joints. weight lifting, and running on a treadmill are high-impact, jarring types of
What exercise will the exercise.
nurse include in the
teaching plan?
13. The client with os- Has a weight gain of 5 pounds
teoarthritis is seen
in the clinic. Which Obesity is a risk factor for osteoarthritis. Excess weight is a stressor on the
assessment finding weight-bearing joints. Weight reduction is often a part of the therapeutic
indicates the client regimen.
is having diffi-
culty implementing
self-care?
14. The nurse is assess- low back pain
ing a client with a
history of ankylosing The most common symptoms of ankylosing spondylitis are low back pain and
spondylitis. What will stiffness. A red, butterfly-shaped rash on the face and a patchy loss of hair are
