Question 1

The nurse teaching a support group of women with rheumatoid arthritis (RA)about how to manage activities of daily living suggests that they

Accepted Answer

A)   stand rather than sit when performing household and yard chores.
B)   strengthen small hand muscles by wringing sponges or washcloths.
C)   protect the knee joints by sleeping with a small pillow under the knees.
D)   avoid activities that require repetitive use of the same muscles and joints. D

Question 2

The nurse will anticipate the need to teach a 57-year-old patient who has osteoarthritis (OA)about which medication?

Accepted Answer

A)   Adalimumab (Humira) 
B)   Prednisone (Deltasone) 
C)   Capsaicin cream (Zostrix) 
D)   Sulfasalazine (Azulfidine)  C

Question 3

A 19-year-old patient hospitalized with a fever and red,hot,and painful knees is suspected of having septic arthritis.Information obtained during the nursing history that indicates a risk factor for septic arthritis is that the patient

Accepted Answer

A)   had several knee injuries as a teenager.
B)   recently returned from South America.
C)   is sexually active with multiple partners.
D)   has a parent who has rheumatoid arthritis. C

Question 4

A patient with rheumatoid arthritis 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

After the nurse has taught a 28-year-old with fibromyalgia,which statement by the patient indicates a good understanding of effective self-management?

Accepted Answer

A)   "I am going to join a soccer team to get more exercise."
B)   "I will need to stop drinking so much coffee and soda."
C)   "I will call the doctor every time my symptoms get worse."
D)   "I should avoid using over-the-counter medications for pain."

Question 6

Which result for a 30-year-old patient with systemic lupus erythematosus (SLE)is most important for the nurse to communicate to the health care provider?

Accepted Answer

A)   Decreased C-reactive protein (CRP) 
B)   Elevated blood urea nitrogen (BUN) 
C)   Positive antinuclear antibodies (AN
A)  
D)   Positive lupus erythematosus cell prep

Question 7

A 40-year-old African American patient has scleroderma manifested by CREST (calcinosis,Raynaud's phenomenon,esophageal dysfunction,sclerodactyly,and telangiectasia)syndrome.Which action will the nurse include in the plan of care?

Accepted Answer

A)   Avoid use of capsaicin cream on hands.
B)   Keep environment warm and draft free.
C)   Obtain capillary blood glucose before meals.
D)   Assist to bathroom every 2 hours while awake.

Question 8

Which action will the nurse include in the plan of care for a 40-year-old with newly diagnosed ankylosing spondylitis?

Accepted Answer

A)   Advise the patient to sleep on the back with a flat pillow.
B)   Emphasize that application of heat may worsen symptoms.
C)   Schedule annual laboratory assessment for the HLA-B27 antigen.
D)   Assist patient to choose physical activities that allow the spine to flex.

Question 9

A 25-year-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." An appropriate nursing diagnosis for the patient is

Accepted Answer

A)   activity intolerance related to fatigue and inactivity.
B)   impaired social interaction related to lack of social skills.
C)   impaired skin integrity related to itching and skin sloughing.
D)   social isolation related to embarrassment about the effects of SLE.

Question 10

A 29-year-old 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)   anakinra (Kineret) .
B)   etanercept (Enbrel) .
C)   doxycycline (Vibramycin) .
D)   methotrexate (Rheumatrex) .

Question 11

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

Accepted Answer

A)   relief of 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 chronic fatigue syndrome about self-management?

Accepted Answer

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

Question 13

When the nurse brings medications to a patient with rheumatoid arthritis,the patient refuses the prescribed methotrexate (Rheumatrex).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 14

Anakinra (Kineret)is prescribed for a 49-year-old patient who has rheumatoid arthritis (RA).When teaching the patient about this drug,the nurse will include information about

Accepted Answer

A)   avoiding concurrently taking aspirin.
B)   symptoms of gastrointestinal (GI)  bleeding.
C)   self-administration of subcutaneous injections.
D)   taking the medication with at least 8 oz of fluid.

Question 15

Which finding for a patient who is taking hydroxychloroquine (Plaquenil)to treat rheumatoid arthritis is likely to be an adverse effect of the medication?

Accepted Answer

A)   Blurred vision
B)   Joint tenderness
C)   Abdominal cramping
D)   Elevated blood pressure

Question 16

A 31-year-old woman is taking methotrexate (Rheumatrex)to treat rheumatoid arthritis.Which information from the patient's health history is important for the nurse to report to the health care provider about 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 17

Which information will the nurse include when preparing teaching materials for patients with exacerbations of rheumatoid arthritis?

Accepted Answer

A)   Affected joints should not be exercised when pain is present.
B)   Application of cold packs before exercise may decrease joint pain.
C)   Exercises should be performed passively by someone other than the patient.
D)   Walking may substitute for range-of-motion (ROM)  exercises on some days.

Question 18

Which laboratory result will the nurse monitor to determine whether prednisone (Deltasone)has been effective for a 30-year-old patient with an acute exacerbation of rheumatoid arthritis?

Accepted Answer

A)   Blood glucose test
B)   Liver function tests
C)   C-reactive protein level
D)   Serum electrolyte levels

Question 19

During assessment of the patient with fibromyalgia,the nurse would expect the patient to report which of the following (select all that apply)?

Accepted Answer

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

Question 20

A 37-year-old patient with 2 school-age children who has recently been diagnosed with rheumatoid arthritis (RA)tells the nurse that home life is very stressful.Which response by the nurse is most appropriate?

Accepted Answer

A)   "Tell me more about situations that are causing you stress."
B)   "You need to see a family therapist for some help with 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."

Exam 61: Nursing Management: Arthritis and Connective Tissue Diseases

The nurse teaching a support group of women with rheumatoid arthritis (RA) about how to manage activities of daily living suggests that they

The nurse will anticipate the need to teach a 57-year-old patient who has osteoarthritis (OA) about which medication?

A 19-year-old patient hospitalized with a fever and red,hot,and painful knees 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 patient with rheumatoid arthritis being seen in the clinic has rheumatoid nodules on the elbows.Which action will the nurse take?

After the nurse has taught a 28-year-old with fibromyalgia,which statement by the patient indicates a good understanding of effective self-management?

Which result for a 30-year-old patient with systemic lupus erythematosus (SLE) is most important for the nurse to communicate to the health care provider?

A 40-year-old African American patient has scleroderma manifested by CREST (calcinosis,Raynaud's phenomenon,esophageal dysfunction,sclerodactyly,and telangiectasia) syndrome.Which action will the nurse include in the plan of care?

Which action will the nurse include in the plan of care for a 40-year-old with newly diagnosed ankylosing spondylitis?

A 25-year-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." An appropriate nursing diagnosis for the patient is

A 29-year-old 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

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

Which information will the nurse include when teaching a patient with newly diagnosed chronic fatigue syndrome about self-management?

Anakinra (Kineret) is prescribed for a 49-year-old patient who has rheumatoid arthritis (RA) .When teaching the patient about this drug,the nurse will include information about

Which finding for a patient who is taking hydroxychloroquine (Plaquenil) to treat rheumatoid arthritis is likely to be an adverse effect of the medication?

A 31-year-old woman is taking methotrexate (Rheumatrex) to treat rheumatoid arthritis.Which information from the patient's health history is important for the nurse to report to the health care provider about the methotrexate?

Which information will the nurse include when preparing teaching materials for patients with exacerbations of rheumatoid arthritis?

Which laboratory result will the nurse monitor to determine whether prednisone (Deltasone) has been effective for a 30-year-old patient with an acute exacerbation of rheumatoid arthritis?

During assessment of the patient with fibromyalgia,the nurse would expect the patient to report which of the following (select all that apply) ?

A 37-year-old patient with 2 school-age children who has recently been diagnosed with rheumatoid arthritis (RA) tells the nurse that home life is very stressful.Which response by the nurse is most appropriate?