Question 1

Which laboratory result is important to communicate to the health care provider for a patient who is taking methotrexate to treat rheumatoid arthritis (RA)?

Accepted Answer

A) Rheumatoid factor is positive. 
B) Fasting blood glucose is 90 mg/dL. 
C) The white blood cell (WB
C)  count is 1500/µL. 
D) The erythrocyte sedimentation rate is elevated.

Question 2

A patient with two school-age children has recently been diagnosed with rheumatoid arthritis (RA)and tells the nurse that home life is very stressful. Which initial response by the nurse is most appropriate?

Accepted Answer

A) "You need to see a family therapist for some help with stress." 
B) "Tell me more about the situations that are causing you stress." 
C) "Your family should understand the impact of your rheumatoid arthritis." 
D) "Perhaps it would be helpful for your family to be involved in a support group."

Question 3

A 29-yr-old woman is taking methotrexate to treat rheumatoid arthritis. Which information from the patient's health history is important for the nurse to report to the health care provider related to the methotrexate?

Accepted Answer

A) The patient had a history of infectious mononucleosis as a teenager. 
B) The patient is trying to get pregnant before her disease becomes more severe. 
C) The patient has a family history of age-related macular degeneration of the retina. 
D) The patient has been using large doses of vitamins and health foods to treat the RA.

Question 4

A patient being seen in the clinic has rheumatoid nodules on the elbows. Which action will the nurse take?

Accepted Answer

A) Draw blood for rheumatoid factor analysis. 
B) Teach the patient about injections for the nodules. 
C) Assess the nodules for skin breakdown or infection. 
D) Discuss the need for surgical removal of the nodules.

Question 5

Which action will the nurse include in the plan of care for a patient with a new diagnosis of rheumatoid arthritis (RA)?

Accepted Answer

A) Instruct the patient to purchase a soft mattress. 
B) Encourage the patient to take a nap in the afternoon. 
C) Teach the patient to use lukewarm water when bathing. 
D) Suggest exercise with light weights several times daily.

Question 6

Which assessment finding for a patient using naproxen (Naprosyn)to treat osteoarthritis is likely to require a change in medication?

Accepted Answer

A) The patient has gained 3 lb. 
B) The patient has dark-colored stools. 
C) The patient's pain affects multiple joints. 
D) The patient uses capsaicin cream (Zostrix).

Question 7

After the nurse has finished teaching a patient with osteoarthritis (OA)of the right hip about how to manage the OA,which patient statement indicates a need for more teaching?

Accepted Answer

A) "I can exercise every day to help maintain joint motion." 
B) "I will take 1 g of acetaminophen (Tylenol) every 4 hours." 
C) "I will take a shower in the morning to help relieve stiffness." 
D) "I can use a cane to decrease the pressure and pain in my hip."

Question 8

A 25-yr-old female patient with systemic lupus erythematosus (SLE)who has a facial rash and alopecia tells the nurse,"I never leave my house because I hate the way I look." The nurse will plan interventions with the patient to address the nursing diagnosis of

Accepted Answer

A) social isolation. 
B) activity intolerance. 
C) impaired skin integrity. 
D) impaired social interaction.

Question 9

The home health nurse is making a follow-up visit to a patient with recently diagnosed rheumatoid arthritis (RA). Which assessment made by the nurse indicates more patient teaching is needed?

Accepted Answer

A) The patient takes a 2-hour nap each day. 
B) The patient has been taking 16 aspirins each day. 
C) The patient sits on a stool while preparing meals. 
D) The patient sleeps with two pillows under the head.

Question 10

A patient with an acute attack of gout in the right great toe has a new prescription for probenecid. Which information about the patient's home routine indicates a need for teaching regarding gout management?

Accepted Answer

A) The patient sleeps 8-10 hours each night. 
B) The patient usually eats beef once a week. 
C) The patient takes one aspirin a day to prevent angina. 
D) The patient usually drinks about 3 quarts water each day.

Question 11

The nurse determines that colchicine has been effective for a patient with an acute attack of gout upon finding

Accepted Answer

A) reduced joint pain. 
B) increased urine output. 
C) elevated serum uric acid. 
D) increased white blood cells (WB
C) .

Question 12

Which information will the nurse include when teaching a patient with newly diagnosed systemic exertion intolerance disease (SEID)about self-management?

Accepted Answer

A) Symptoms usually progress as patients become older. 
B) A gradual increase in daily exercise may help decrease fatigue. 
C) Avoid use of over-the-counter antihistamines or decongestants. 
D) A low-residue, low-fiber diet will reduce any abdominal distention.

Question 13

A patient with gout has a new prescription for losartan (Cozaar)to control the condition. The nurse will plan to monitor

Accepted Answer

A) blood glucose. 
B) blood pressure. 
C) erythrocyte count. 
D) lymphocyte count.

Question 14

A patient reporting painful urination and knee pain is diagnosed with reactive arthritis. The nurse will plan to teach the patient about the need for several months of therapy with

Accepted Answer

A) methotrexate 
B) anakinra (Kineret). 
C) etanercept (Enbrel). 
D) doxycycline (Vibramycin).

Question 15

A patient hospitalized with polymyositis has joint pain; erythematous facial rash; eyelid edema; and a weak,hoarse voice. The safety priority for the patient is addressing the

Accepted Answer

A) acute pain. 
B) risk for aspiration. 
C) disturbed visual perception. 
D) risk for impaired skin integrity.

Question 16

The health care provider has prescribed the following interventions for a patient who is taking azathioprine (Imuran)for systemic lupus erythematosus. Which order will the nurse question?

Accepted Answer

A) Draw anti-DNA blood titer. 
B) Administer varicella vaccine. 
C) Naproxen (Aleve) 200 mg BID. 
D) Famotidine (Pepcid) 20 mg daily.

Question 17

When reviewing the health record for a new patient with rheumatoid arthritis,the nurse reads that the patient has swan neck deformities. Which deformity will the nurse expect to observe when assessing the patient?

Accepted Answer

A) A 
B) B 
C) C 
D) D

Question 18

When the nurse brings medications to a patient with rheumatoid arthritis,the patient refuses the prescribed methotrexate. The patient tells the nurse,"My arthritis isn't that bad yet. The side effects of methotrexate are worse than the arthritis." The most appropriate response by the nurse is

Accepted Answer

A) "You have the right to refuse to take the methotrexate." 
B) "Methotrexate is less expensive than some of the newer drugs." 
C) "It is important to start methotrexate early to decrease the extent of joint damage." 
D) "Methotrexate is effective and has fewer side effects than some of the other drugs."

Question 19

The nurse is planning care for a patient with hypertension and gout who has a red,painful right great toe. Which nursing action will be included in the plan of care?

Accepted Answer

A) Gently palpate the toe to assess swelling. 
B) Use pillows to keep the right foot elevated. 
C) Use a footboard to hold bedding away from the toe. 
D) Teach the patient to avoid use of acetaminophen (Tylenol).

Question 20

During assessment of the patient with fibromyalgia,the nurse would expect the patient to report which of the following ?

Accepted Answer

A) Sleep disturbances 
B) Multiple tender points 
C) Cardiac palpitations and dizziness 
D) Multijoint inflammation and swelling 
E) Widespread bilateral, burning musculoskeletal pain

Exam 64: Arthritis and Connective Tissue Diseases

Which laboratory result is important to communicate to the health care provider for a patient who is taking methotrexate to treat rheumatoid arthritis (RA) ?

A patient with two school-age children has recently been diagnosed with rheumatoid arthritis (RA) and tells the nurse that home life is very stressful. Which initial response by the nurse is most appropriate?

A 29-yr-old woman is taking methotrexate to treat rheumatoid arthritis. Which information from the patient's health history is important for the nurse to report to the health care provider related to the methotrexate?

A patient being seen in the clinic has rheumatoid nodules on the elbows. Which action will the nurse take?

Which action will the nurse include in the plan of care for a patient with a new diagnosis of rheumatoid arthritis (RA) ?

Which assessment finding for a patient using naproxen (Naprosyn) to treat osteoarthritis is likely to require a change in medication?

After the nurse has finished teaching a patient with osteoarthritis (OA) of the right hip about how to manage the OA,which patient statement indicates a need for more teaching?

A 25-yr-old female patient with systemic lupus erythematosus (SLE) who has a facial rash and alopecia tells the nurse,"I never leave my house because I hate the way I look." The nurse will plan interventions with the patient to address the nursing diagnosis of

The home health nurse is making a follow-up visit to a patient with recently diagnosed rheumatoid arthritis (RA) . Which assessment made by the nurse indicates more patient teaching is needed?