MEDICAL-SURGICAL RN B PROPHECY RELIAS EXAM
Medical-Surgical RN B Prophecy Relias Exam
Updated 2025 (A+ Graded 100% Verified Answers)
Rank in order the sequence of events leading to joint destruction in secondary osteoarthritis
(OA) beginning with the effect of an injury to the cervical spine.
A. Exacerbation of abdominal tissue growth
B. Bony articular surfaces in joint exposed
C. Fragile, soft, dull joint cartilage develops
D. Irregular joint motion, stiffness, and pain - ANSWER✅ C. Fragile, soft, dull joint cartilage
develops
A. Exacerbation of abdominal tissue growth
D. Irregular joint motion, stiffness, and pain
B. Bony articular surfaces in joint exposed
A precipitating factor, such as trauma to the spine, leads to the development of OA by
damaging the cartilage. Joint destruction begins with the development of dull, soft, less
elastic, and more fragile cartilage. Because the body is unable to repair the cartilage fast
enough, the cartilage develops fissures and erosion and, in so doing, becomes thinner,
leading to the formation of osteophytes and cartilage at the joint margins. The formation of
abnormal tissue leads to abnormal joint movement. Pain and stiffness increase as the bony
surfaces of the joint are exposed.
Ch. 65 Pre-Assessment #1
, MEDICAL-SURGICAL RN B PROPHECY RELIAS EXAM
The nurse is assessing a patient who is complaining of joint pain and stiffness. Which
assessment does not differentiate between osteoarthritis (OA) and rheumatoid arthritis
(RA)?
A. Symmetry of joint effect
B. Duration of joint stiffness
C. Space between the bones
D. Erythrocyte sedimentation rate - ANSWER✅ C. Space between the bones
Both OA and RA manifest with narrowed joint spaces so this is not a valid assessment to help
differentiate between the two disorders. The remaining options are patient assessments
that facilitate differentiation of OA and RA because symmetric joints are affected in RA but
not in OA; stiffness resolves in less than 30 minutes with OA but not RA; and a patient with
RA, but not OA, is likely to have elevated erythrocyte sedimentation levels indicating
inflammation.
Ch. 65 Pre-Assessment #2
A 75-year-old female patient complains about morning stiffness and increasing joint pain in
her right hip. What is the best initial drug therapy for her?
A. aspirin
B. naproxen (Aleve)
C. ibuprofen (Motrin)
D. acetaminophen (Tylenol) - ANSWER✅ D. acetaminophen (Tylenol)
, MEDICAL-SURGICAL RN B PROPHECY RELIAS EXAM
For patients with osteoarthritis who have mild to moderate pain, the initial drug of choice is
acetaminophen.
Ch. 65 Pre-Assessment #3
Which of the following laboratory values would probably be found in a patient with
osteoarthritis (OA)?
A. Decreased RBCs
B. Increased WBCs
C. Clear yellow synovial fluid
D. Increased C-reactive protein
E. Increased erythrocyte sedimentation rate - ANSWER✅ C. Clear yellow synovial fluid
Normally there are no laboratory abnormalities or biomarkers for OA. Clear yellow fluid is
normal synovial fluid.
Ch. 65 Pre-Assessment #4
A patient who has ankylosing spondylitis (AS) asks the nurse for help in choosing suitable
activities for maintaining good posture. Which exercise should the nurse advise the patient
to avoid?
, MEDICAL-SURGICAL RN B PROPHECY RELIAS EXAM
A. Do stomach crunching
B. Stand on a single leg
C. Face wall and push off
D. Stretch the lower back - ANSWER✅ A. Do stomach crunching
The nurse advises a patient who has AS to avoid stomach crunches because they involve
spinal flexion, which over the long term can aggravate pulmonary complications by
decreasing the thoracic cage. The help strengthen the same muscles, the nurse encourages
exercises to strengthen the upper and lower back such as leg lifts in the prone position
because in the prone position the back is supported to prevent flexion. The remaining
options can be suitable exercises for this patient, standing on one leg promotes core
strength, pushing off a wall strengthens back muscles, and stretching the lower back helps
maintain joint flexibility.
Ch. 65 Pre-Assessment #5
The incidence of Lyme disease is very high in a Pennsylvania county, so the public health
nurse provides community education to increase the number of patients who seek health
care promptly after a tick bite. Which information should the nurse provide in community
teaching people who are at risk for a tick bite?
A. The best therapy for the acute illness is an IV antibiotic.
B. Check for an enlarging reddened area with a clear center.
C. Antibiotics will prevent Lyme disease if taken for 10 days.
D. Surveillance is necessary during the summer months only. - ANSWER✅ B. Check for an
enlarging reddened area with a clear center.
Medical-Surgical RN B Prophecy Relias Exam
Updated 2025 (A+ Graded 100% Verified Answers)
Rank in order the sequence of events leading to joint destruction in secondary osteoarthritis
(OA) beginning with the effect of an injury to the cervical spine.
A. Exacerbation of abdominal tissue growth
B. Bony articular surfaces in joint exposed
C. Fragile, soft, dull joint cartilage develops
D. Irregular joint motion, stiffness, and pain - ANSWER✅ C. Fragile, soft, dull joint cartilage
develops
A. Exacerbation of abdominal tissue growth
D. Irregular joint motion, stiffness, and pain
B. Bony articular surfaces in joint exposed
A precipitating factor, such as trauma to the spine, leads to the development of OA by
damaging the cartilage. Joint destruction begins with the development of dull, soft, less
elastic, and more fragile cartilage. Because the body is unable to repair the cartilage fast
enough, the cartilage develops fissures and erosion and, in so doing, becomes thinner,
leading to the formation of osteophytes and cartilage at the joint margins. The formation of
abnormal tissue leads to abnormal joint movement. Pain and stiffness increase as the bony
surfaces of the joint are exposed.
Ch. 65 Pre-Assessment #1
, MEDICAL-SURGICAL RN B PROPHECY RELIAS EXAM
The nurse is assessing a patient who is complaining of joint pain and stiffness. Which
assessment does not differentiate between osteoarthritis (OA) and rheumatoid arthritis
(RA)?
A. Symmetry of joint effect
B. Duration of joint stiffness
C. Space between the bones
D. Erythrocyte sedimentation rate - ANSWER✅ C. Space between the bones
Both OA and RA manifest with narrowed joint spaces so this is not a valid assessment to help
differentiate between the two disorders. The remaining options are patient assessments
that facilitate differentiation of OA and RA because symmetric joints are affected in RA but
not in OA; stiffness resolves in less than 30 minutes with OA but not RA; and a patient with
RA, but not OA, is likely to have elevated erythrocyte sedimentation levels indicating
inflammation.
Ch. 65 Pre-Assessment #2
A 75-year-old female patient complains about morning stiffness and increasing joint pain in
her right hip. What is the best initial drug therapy for her?
A. aspirin
B. naproxen (Aleve)
C. ibuprofen (Motrin)
D. acetaminophen (Tylenol) - ANSWER✅ D. acetaminophen (Tylenol)
, MEDICAL-SURGICAL RN B PROPHECY RELIAS EXAM
For patients with osteoarthritis who have mild to moderate pain, the initial drug of choice is
acetaminophen.
Ch. 65 Pre-Assessment #3
Which of the following laboratory values would probably be found in a patient with
osteoarthritis (OA)?
A. Decreased RBCs
B. Increased WBCs
C. Clear yellow synovial fluid
D. Increased C-reactive protein
E. Increased erythrocyte sedimentation rate - ANSWER✅ C. Clear yellow synovial fluid
Normally there are no laboratory abnormalities or biomarkers for OA. Clear yellow fluid is
normal synovial fluid.
Ch. 65 Pre-Assessment #4
A patient who has ankylosing spondylitis (AS) asks the nurse for help in choosing suitable
activities for maintaining good posture. Which exercise should the nurse advise the patient
to avoid?
, MEDICAL-SURGICAL RN B PROPHECY RELIAS EXAM
A. Do stomach crunching
B. Stand on a single leg
C. Face wall and push off
D. Stretch the lower back - ANSWER✅ A. Do stomach crunching
The nurse advises a patient who has AS to avoid stomach crunches because they involve
spinal flexion, which over the long term can aggravate pulmonary complications by
decreasing the thoracic cage. The help strengthen the same muscles, the nurse encourages
exercises to strengthen the upper and lower back such as leg lifts in the prone position
because in the prone position the back is supported to prevent flexion. The remaining
options can be suitable exercises for this patient, standing on one leg promotes core
strength, pushing off a wall strengthens back muscles, and stretching the lower back helps
maintain joint flexibility.
Ch. 65 Pre-Assessment #5
The incidence of Lyme disease is very high in a Pennsylvania county, so the public health
nurse provides community education to increase the number of patients who seek health
care promptly after a tick bite. Which information should the nurse provide in community
teaching people who are at risk for a tick bite?
A. The best therapy for the acute illness is an IV antibiotic.
B. Check for an enlarging reddened area with a clear center.
C. Antibiotics will prevent Lyme disease if taken for 10 days.
D. Surveillance is necessary during the summer months only. - ANSWER✅ B. Check for an
enlarging reddened area with a clear center.
