Exam 56: Understanding Rheumatoid Arthritis, Sle, Scleroderma, Ankylosing Spondylitis, and Osteoarthritis: Pathophysiology, Diagnosis, and Treatment

A 64-year-old man was diagnosed 19 months ago with bilateral osteoarthritis (OA) in his knees, and has come to his family physician for a checkup. The client and his physician are discussing the effects of his health problem and the measures that the man has taken to accommodate and treat his OA in his daily routines. Which of the following statements by the client would necessitate further teaching?

Although the client's primary care provider has downplayed the symptoms, a geriatrician suspects that an 82-year-old female has polymyalgia rheumatica. Which characteristic symptomatology would most likely have led the specialist to suspect this health problem?

The physician is considering prescribing an anti-tumor necrosis factor (TNF) like infliximab for a rheumatoid arthritis patient. Which of the following statements is accurate about the advantages of using a TNF inhibitor?

A new patient arrives at the clinic. The physician is suspecting that the patient may have systemic lupus erythematosus (SLE) given the clinical manifestations related to joint pain, skin changes, and a history of pleural effusions. The nurse should anticipate which of the following diagnostic test will be a priority to facilitate with the diagnosis?

Which of the following individuals is most likely to develop a form of reactive arthritis?

A physician is attempting a differential diagnosis of a 30-year-old female who is suspected of having systemic lupus erythematosus (SLE). Which of the following aspects of the physician's assessment and the client's history would be considered potentially indicative of SLE? Select all that apply.

When educating the patient with ankylosing spondylitis, the nurse should emphasize which of the following treatment interventions? Select all that apply.

While reviewing the following diagnostic findings on a group of patients with joint complaints, which finding would be a priority for further investigation and possible medical intervention?

Due to her progressing osteoarthritis (OA), an 80-year-old woman is no longer able to perform her activities of daily living without assistance. Which of the following phenomena most likely underlies the woman's situation?

A 36-year-old female who has experienced diverse symptoms for several years has finally had her health problems attributed to scleroderma (systemic sclerosis) and has committed herself to learning as much about the disease as she can. Which of her following statements would her nurse want to correct or clarify?

An 8-year-old child has just been diagnosed with systemic lupus erythematosus (SLE). The parents wonder what the child's prognosis is going to be. Which of the following findings would be considered a good prognostic indicator of the extent/seriousness of the disease?

A 7-year-old boy has been diagnosed with juvenile idiopathic arthritis (JIA), and his parents are anxious to know how his health problem will affect his short-term and longer-term future. What can his health care provider most accurately tell the family?

While speaking to a senior citizen club about osteoarthritis (OA), which of the following facts are accurate to share? Select all that apply.

Which of the following pathophysiological phenomena would be most indicative of ankylosing spondylitis?

A 44-year-old woman who has a long-standing diagnosis of SLE has been able to control her symptoms with lifestyle modifications for several years, but has presented to her care provider due to recent exacerbation. Which of the following pharmacological treatment options is her care provider most likely to rule out first?

When working with a patient with diffuse scleroderma who is exhibiting a "stone face" expression, the nurse should consider which of the following to be a priority nursing diagnosis for this patient?

A 68-year-old woman has had her mobility and quality of life severely affected by rheumatoid arthritis (RA). Place the following pathophysiological events involved in her health problem in the correct order that they most likely occurred. Use all the options.

A 16-year-old boy has been diagnosed with ankylosing spondylitis. Which of the following etiologies is responsible for his health problem?

A male patient in his 50s has just been diagnosed with hyperuricemia. He has had multiple flare-ups of his first metatarsophalangeal joint pain and swelling. The pain is so severe that he cannot sleep with any covers/sheets over his feet at night. The nurse should anticipate that the patient will likely be prescribed: Select all that apply.

Following a progressive onset of fatigue, aching, and joint stiffness over the last 2 years, a 69-year-old male has recently been diagnosed with rheumatoid arthritis (RA). Which of the following teaching points should his primary care physician include during the office visit in which this diagnosis is communicated to the client?