Deck 39: Infection and Inflammatory Disorders of the Musculoskeletal System

Question 1

The nurse is caring for a client with a diagnosis of gout. Which medication in the client's prescription does the nurse suspect to decrease uric acid synthesis?
1)Probenecid
2)Colchicine
3)Allopurinol
4)Oral corticosteroids

Answer 1

3

Question 2

Which treatment does the nurse expect to be beneficial for a client diagnosed with Lyme disease?
1)A local corticosteroid injection
2)A 10- to 21-day course of doxycycline
3)A high starting dose of NSAIDs
4)An immediate single dose of doxycycline

Answer 2

2

Question 3

The radiographic reports of a client reveal inflammation of the metatarsophalangeal joint of the great toe. Which disorder should the nurse suspect in the client?
1)Gout
2)Lyme disease
3)Septic arthritis
4)Polymyalgia rheumatica

Answer 3

1

Question 4

The nurse is reviewing synovial fluid with a group of staff nurses. Which statement by an attending nurse indicates the need for further review?
1)"Synovial fluid provides stabilizing effects."
2)"The volume of synovial fluid increases in the presence of a joint disease."
3)"There is a wide exchange between the bloodstream and the synovial joint."
4)"All the essential nutrients are delivered and metabolic by-products are cleared by the bloodstream."

Question 5

A client exhibits pitting, ridging, and separation of nails from the nail bed. Which musculoskeletal disorder does the nurse suspect in the client?
1)Septic arthritis
2)Psoriatic arthritis
3)Ankylosing spondylitis
4)Polymyalgia rheumatica

Question 6

The nurse is providing care for a client diagnosed with iritis and pulmonary fibrosis. Which condition does the nurse associate with the client's diagnosis?
1)Polymyositis
2)Psoriatic arthritis
3)Ankylosing spondylitis
4)Polymyalgia rheumatica

Question 7

The nurse is providing care for a client diagnosed with Pott's disease. Which possible complication does the nurse associate with the diagnosis?
1)Spinal rigidity from scarring
2)Development of pulmonary tuberculosis (TB)
3)Spinal deformity with instability
4)Uncorrectable spinal cord compression

Question 8

While reviewing an x-ray of the fingers of a client, the nurse observes that the end of the bone is whittled down to a sharp point. Which musculoskeletal disorder does the nurse suspect in the client?
1)Lyme disease
2)Psoriatic arthritis
3)Ankylosing spondylitis
4)Pott's disease

Question 9

The nurse is reviewing laboratory results for a client. Which pathogen does the nurse recognize as causing ankylosing spondylitis?
1)Escherichia coli
2)Borrelia burgdorferi
3)Klebsiella pneumoniae
4)Staphylococcus aureus

Question 10

A nurse is providing care for a client diagnosed with ankylosing spondylitis. For which test does the nurse prepare the client?
1)X-ray
2)Bone biopsy
3)Electromyography
4)Radionuclide bone scan

Question 11

Which statement made by a client with musculoskeletal inflammation supports the nurse's suspicion of polymyalgia rheumatica?
1)"I feel pain and stiffness in my back when I am up during the day."
2)"I have noticed my nails are separating from my nail beds."
3)"I thought I had the flu, but the symptoms have lasted too long."
4)"I have pain during the night and have not been sleeping or resting well."

Question 12

The laboratory report of a client with a bone infection shows an abscess below the bone surface. Which stage of bone infection does the nurse recognize in the client? 1.1
2)2
3)3
4)4

Question 13

Which statement made by a staff nurse indicates the need for additional information about treatment of various musculoskeletal disorders?
1)"Doxycycline is the first-line treatment for Lyme disease."
2)"Immunosuppressive agents are first-line agents for psoriatic arthritis."
3)"Oral corticosteroids are the first-line treatment for polymyalgia rheumatica."
4)"NSAIDs are the first-line agents for gout."

Question 14

The nurse is teaching a client nonpharmacological therapy to treat gout. Which statement by the client indicates the need for additional teaching?
1)"I need to have some rapid weight loss."
2)"I should increase the intake of meats."
3)"I need to avoid incidences of binge drinking."
4)"I should drink 2 to 3 liters of fluid per day."

Question 15

A client presents with joint pain and limited range of motion (ROM) in the right shoulder. The client has a history of rheumatoid arthritis but states the pain in the shoulder is much worse than usual. Aspiration of synovial fluid indicates the presence of septic arthritis. Which intervention does the nurse include on the client's plan of care?
1)Short-term joint immobilization for pain control
2)Monitoring for the need of additional joint aspiration
3)Implementation and evaluation of active ROM exercises
4)Promotion of physical therapy during the acute stage for maintenance

Question 16

A client has a skin rash presenting as an oval-shaped and red-colored lesion. On assessment, the nurse finds enlargement of lymph nodes in this client. Which condition does the nurse suspect in the client?
1)Sacroiliitis
2)Dactylitis
3)Lyme disease
4)Psoriatic arthritis

Question 17

The nurse is providing care for an older female client diagnosed with gout. Which statement by the nurse to the client conveys correct information?
1)"Thiazides are used to treat gout."
2)"Primary gout is attributed to obesity."
3)"Pott's disease is associated with gout."
4)"Estrogen protects against hyperuricemia."

Question 18

The laboratory report for a client shows elevated levels of interleukin-2 (IL-2) and interleukin-6 (IL-6). Which musculoskeletal disorder does the nurse suspect in the client?
1)Gout
2)Psoriatic arthritis
3)Ankylosing spondylitis
4)Polymyalgia rheumatica

Question 19

The nurse is providing care for an older adult client with a history of diabetes mellitus. The client presents with chills, fever, and malaise. The nurse notes localized tenderness, erythema, edema, and pain with movement of the lower right extremity. Which additional assessment information is most likely to support the presence of an infection?
1)A recent bout of influenza
2)A knee replacement surgery
3)A decrease in physical activity
4)A move to an extended care facility

Question 20

The nurse is providing care for a client diagnosed with polymyositis and dermatomyositis. The nurse prepares the client for which most definitive diagnostic test?
1)Muscle biopsy
2)Western blot test
3)Immunofluorescent assay
4)Dual energy x-ray absorptiometry (DEXA) scan

Question 21

Which are the forms of psoriatic arthritis? Select all that apply.
1)Spondylitis
2)Septic arthritis
3)Dermatomyositis
4)Arthritis mutilans
5)Distal interphalangeal (DIP) predominant

Question 22

The nurse is caring for a client with Lyme disease. Which symptoms in the client lead the nurse to suspect early localized disease? Select all that apply.
1)Arthralgia
2)Cranial neuritis
3)Bull's-eye rash
4)Lymphadenopathy
5)Subacute encephalopathy

Question 23

Which condition is related to ankylosing spondylitis?
1)Formation of abscesses in the bone
2)Inflammation at the joint of the great toe
3)Formation of abscesses in the paravertebral muscles
4)Inflammation where tendons and ligaments join the bone around a joint

Question 24

Which are the causes of secondary gout? Select all that apply.
1)Psoriasis
2)Scleroderma
3)Rheumatoid arthritis
4)Neoplastic disease
5)Glycogen storage disease

Question 25

A client is diagnosed with ankylosing spondylitis. Which complications does the nurse expect to be present in the client? Select all that apply.
1)Neural inflammation
2)Paralysis of facial nerves
3)Inflammation of the eyes
4)Scarring throughout the lungs
5)Inflammation of joints in the extremities