Deck 20: Coordinating Care for Patients With Connective Tissue Disorders

Question 1

In planning care for a patient admitted for treatment of a connective tissue disorder, the nurse formulates the nursing diagnosis, "Self-care deficit related to decreased joint mobility secondary to an autoimmune response resulting in Boutonniere deformities" is most relevant for which disorder?
1)Fibromyalgia
2)Gout
3)Osteoarthritis
4)Rheumatoid arthritis

Answer 1

4

Question 2

The nurse provides care to a patient diagnosed with osteoarthritis who is prescribed daily acetaminophen. Which patient statement requires an intervention?
1)"I am not experiencing as much pain as I was before."
2)"I joined a gym to learn muscle-strengthening exercises."
3)"I lost 10 lbs. since my last visit by modifying my diet."
4)"I only drink a couple of beers when I get home from work."

Answer 2

4

Question 3

A nurse is caring for a patient who is newly diagnosed with rheumatoid arthritis (RA). The patient asks the nurse what the difference is between RA and osteoarthritis (OA). Which response by the nurse is most appropriate?
1)"The onset of OA is gradual, whereas the onset of RA may be rapid."
2)"With OA, multiple joints are symmetrically affected; RA affects one joint at a time."
3)"The affected joints in RA feel cold to the touch, whereas the joints affected by OA are warm or hot to the touch."
4)"The pain and stiffness with RA is with activity; OA pain and stiffness is predominant on arising."

Answer 3

1

Question 4

A patient with systemic lupus erythematosus (SLE) is being treated with immunosuppressant drugs and corticosteroids. Which patient statement indicates the need for further teaching?
1)"I am relieved that I can still attend concerts with my friends. "
2)"I should avoid getting the flu shot."
3)"I will use contraception to avoid pregnancy."
4)"I will report any symptoms of infection immediately."

Question 5

In providing care to a patient who is being evaluated for a possible connective tissue disease, the nurse correlates which finding to the definitive diagnosis of gout?
1)Boutonniere deformity
2)Crystals in synovial fluid
3)Elevated uric acid levels
4)Joint erosions

Question 6

The nurse is providing health education to a diverse group at a neighborhood community center. The nurse includes information about signs and symptoms of systemic lupus erythematosus (SLE) for which of the following reasons?
1)The neighborhood is composed of many young female children.
2)The neighborhood has a large number of older adult women.
3)The audience is mainly composed of Caucasian women.
4)The audience is mainly females of Asian-American descent.

Question 7

The nurse correlates an increased risk of osteoarthritis in which of the following patients?
1)40-year-old obese female who works as an administrative assistant
2)45-year-old obese male who is a construction worker
3)55-year-old obese female with works as a machine operator
4)60-year-old obese male who works as an accountant

Question 8

The nurse is caring for a patient who was diagnosed with rheumatoid arthritis (RA) last year who has a history of type 2 diabetes mellitus. The patient has recently been placed on prednisone for treatment. Which patient statement indicates that the medication teaching was successful?
1)"I can eat canned vegetables."
2)"I can take this medication on an empty stomach."
3)"I do not need to monitor my blood sugar more frequently while on this medication because I take pills for my diabetes."
4)"I will take the ordered dose at the same time every day."

Question 9

The nurse develops the nursing diagnosis "Altered Comfort related to inflammation and pain secondary to urate crystals in the joints and tissues." For which disorder is this nursing diagnosis most relevant?
1)Gout
2)Osteoarthritis
3)Rheumatoid arthritis
4)Scleroderma

Question 10

The nurse provides education to a patient with rheumatoid arthritis who is prescribed methotrexate by the healthcare provider. Which patient statement indicates to the nurse the need for further teaching?
1)"I can have a glass of wine each night with dinner."
2)"I will take folic acid each day to decrease my risk of mouth ulcers."
3)"I will continue to take my oral contraception to prevent pregnancy."
4)"I didn't have to decrease my medication dose because my kidney tests came back okay."

Question 11

A patient recently diagnosed with rheumatoid arthritis (RA) asks the nurse if the disease is caused by ethnicity. Which response by the nurse is the most appropriate?
1)"RA affects females more often than males"
2)"RA affects about 10% of the population."
3)"The onset of RA is usually in the sixth decade."
4)"RA is most prevalent in men younger than age 20 years."

Question 12

A patient with rheumatoid arthritis (RA) is being seen in the outpatient clinic for a progress checkup. The nurse is reviewing the patient's plan of care and determines that the patient has met a goal of treatment when the patient makes which statement?
1)"I sleep for 10 hours at night."
2)"My joint pain is still severe in the morning."
3)"I get help with household tasks from my children and spouse."
4)"I try not to be too active because of the pain."

Question 13

The nurse provides care for a patient who is admitted to the cardiac care unit for a coronary artery bypass graft (CABG). The patient has a history of osteoarthritis. Which medication does the nurse question if prescribed by the healthcare provider?
1)Ibuprofen (Advil)
2)Fentanyl (Duragesic)
3)Morphine (MS Contin)
4)Acetaminophen (Tylenol)

Question 14

The nurse collects assessment data for a patient diagnosed with limited systemic scleroderma. The nurse monitors for which data based on the current diagnosis?
1)Rapid onset of symptoms
2)Internal organ involvement
3)Trunk and extremity skin involvement
4)Previous diagnosis of Raynaud's phenomenon

Question 15

The nurse is providing care for a newly married woman with systemic lupus erythematosus (SLE). Which patient statement indicates an appropriate understanding of the plan of care?
1)"I will need to use birth control methods while I am taking cytotoxic medications."
2)"I do not need to be concerned with a fever or rash because these are expected with this disorder."
3)"I plan to go to the movies this weekend so that I get out of the house."
4)"I can take aspirin as indicated for pain."

Question 16

In providing care to a patient admitted for evaluation of a connective tissue disorder, the nurse formulates the nursing diagnosis "Self-Care Deficit related to joint deformities and pain secondary to pathological accumulation of collagen." This is most relevant to which disorder?
1)Fibromyalgia
2)Osteoarthritis
3)Rheumatoid arthritis
4)Scleroderma

Question 17

A nurse is caring for a patient with systemic lupus erythematous (SLE) who is taking hydroxychloroquine (Plaquenil). When providing care for this patient, the nurse monitors for which adverse effect associated with the prescribed medication?
1)Renal toxicity
2)Retinal toxicity
3)Cushingoid effects
4)Pulmonary fibrosis

Question 18

The patient enters the outpatient clinic and states to the triage nurse, "I think I have the flu. I'm so tired, I have no appetite, and everything hurts." The triage nurse assesses the patient and finds a butterfly rash over the bridge of nose and on the cheeks. Then nurse correlates this data with the clinical manifestations of which disorder?
1)Gout
2)Lyme disease
3)Fibromyalgia
4)Systemic lupus erythematosus

Question 19

A nurse is caring for a patient with systemic lupus erythematosus (SLE). Which intervention does the nurse plan to teach this patient to minimize skin infections associated with SLE?
1)Use sunscreen with an SPF of 50 or greater
2)Remain indoors on sunny days
3)Avoid swimming in a pool or the ocean
4)Decrease sun exposure between 3:00 p.m. and 5:00 p.m.

Question 20

Which statement by the patient with rheumatoid arthritis indicates the need for further teaching?
1)"I can use analgesics to help decrease the pain."
2)"It is okay to take ibuprofen for the pain."
3)"I may have to take steroids if I have a rheumatoid arthritis (RA) flare."
4)"My immunosuppressive medications need to be increased if I get an infection."

Question 21

The nurse monitors for which of the following clinical manifestations in the patient diagnosed with osteoarthritis? Select all that apply.
1)Bouchard's nodes
2)Butterfly rash
3)Crepitus
4)Heberden's nodes
5)Raynaud's phenomenon

Question 22

Which clinical manifestations does the nurse assess for in the patient diagnosed with gout? Select all that apply.
1)Presence of tophi
2)Raynaud's phenomenon
3)Reports of severe pain in the great toe
4)Redness and swelling of great toe
5)Ulnar deviation

Question 23

The nurse correlates which clinical manifestations to the diagnosis of rheumatoid arthritis? Select all that apply.
1)Bouchard's nodes
2)Boutonniere deformity
3)Swan-neck deformity
4)Tophi
5)Ulnar deviation

Question 24

The nurse monitors for which of the following clinical manifestations in the patient diagnosed with systemic lupus erythematosus? Select all that apply.
1)Alopecia
2)Fever
3)Elevated uric acid
4)Thrombocytosis
5)Leukopenia

Question 25

The nurse is providing care to a patient who is receiving nonsteroidal anti-inflammatory drugs (NSAIDs) for the treatment of rheumatoid arthritis. When providing care to this patient, which actions by the nurse are appropriate? Select all that apply.
1)Assessing for an allergic reaction
2)Monitoring for signs of renal problems
3)Advising against abrupt discontinuation of drugs
4)Assuring the patient that there is no relationship between NSAIDs and heart disease
5)Encouraging the patient to take NSAIDs with water, milk, or a small snack to help avoid stomach distress

Question 26

Which information should the nurse include when teaching a patient information regarding limited systemic scleroderma? Select all that apply.
1)A rapid onset is anticipated.
2)An insidious onset is anticipated.
3)It affects internal organs several years before onset.
4)It can be preceded by a diagnosis of Raynaud's phenomenon.
5)Skin of extremities distal to the elbows and knees are affected.

Question 27

Which statement by the patient diagnosed with gout indicates the need for further teaching by the nurse related to dietary guidelines?
1)"I should drink at least 8 glasses of water daily."
2)"I need to avoid red meats."
3)"I am not allowed to drink wine but can drink beer."
4)"It is okay to eat chicken."

Question 28

The nurse is caring for a patient who has recently been diagnosed with fibromyalgia. The nurse correlates which prescriptions as part of the patient's treatment plan? Select all that apply.
1)Ibuprofen (Advil)
2)Aerobic exercise
3)Pregabalin (Lyrica)
4)Fentanyl (Sublimaze)
5)Cognitive behavioral therapy

Question 29

Which of the following medications prescribed for a patient with acute gout requires an intervention by the nurse?
1)Allopurinol
2)Colchicine
3)Cortisone
4)Indocin

Question 30

The nurse identifies the nursing diagnosis of Chronic Pain for a patient with fibromyalgia. Which manifestation supports this nursing diagnosis?
1)Chest pain
2)Pain from eye strain
3)Tender points in the knees
4)Pain from a severe skin rash