Question 1

The nurse has been providing care to a patient with scleroderma for a number of years. As the patient's disease progresses, the nurse monitors for CREST symptomology. For which finding is the nurse assessing?

Accepted Answer

CREST syndrome is a variant of systemic sclerosis characterized by calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly (thickening and tightening of the skin on the fingers and hands), and telangiectasia (dilated small blood vessels near the surface of the skin). The nurse would assess for these specific symptoms. A recurrence of tophi on the ears or fingers is seen in gout, shiny skin over the involved joints is seen in rheumatoid arthritis, and extremities that are always cool to the touch is seen in peripheral vascular disease.

Question 2

A patient reports using aspirin for years to control severe arthritis pain "because acetaminophen and NSAIDs just don't work well for me." The nurse would advise the patient of which sign of aspirin toxicity?

Accepted Answer

Ringing in the ears is a common sign of aspirin toxicity, also known as salicylism. Other signs may include dizziness, confusion, sweating, nausea, and vomiting. It is important for the patient to be aware of these symptoms and to seek medical attention if they occur.

Question 3

A patient says, "My physician thinks I may have psoriatic arthritis, but there is nothing wrong with my skin." How should the nurse respond?

Accepted Answer

Not all people with psoriatic arthritis also have psoriasis. Psoriatic arthritis can occur in people without skin psoriasis, and it is important to recognize and diagnose it early to prevent joint damage.

Question 4

A patient diagnosed with reactive arthritis says, "I know this condition came from an infection. Can I give it to my family?" How should the nurse respond?

Accepted Answer

The answer of A patient diagnosed with reactive arthritis says,...

Question 5

The nurse would evaluate that a patient with systemic lupus erythematosus understands dietary teaching when the patient selects which food for breakfast?

Accepted Answer

Orange juice is a good choice for someone with systemic lupus erythematosus (SLE) because it is high in vitamin C, which can help support the immune system. SLE is an autoimmune disease, and maintaining a healthy immune system is important. Foods high in saturated fats, sugars, and refined carbohydrates, like those in options B, C, and D, can potentially exacerbate inflammation and symptoms.

Question 6

A patient diagnosed with systemic lupus erythematosus exhibits a facial rash. What instruction should the nurse provide regarding skin care? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

Patients with systemic lupus erythematosus should avoid sun exposure and use sunscreen if exposure is necessary to prevent exacerbation of their symptoms, including the facial rash. Applying hydrocortisone cream and washing the rash excessively with antibacterial soap can further irritate the skin. Swimming in a chlorinated pool may not provide relief and could potentially irritate the skin further.

Question 7

A woman calls the emergency department and says, "I just found a tick crawling on my son. What can I do to keep him from getting Lyme disease?" How should the nurse respond?

Accepted Answer

The nurse should educate the caller that a tick can transmit Lyme disease only if it has bitten the child and has been attached for at least 36 hours. It is important to monitor the child for any signs or symptoms of Lyme disease, such as a rash, fever, or joint pain. A prescription for amoxicillin or an injection of gamma globulin is not necessary unless the child develops symptoms of the disease. Additionally, the size of the tick is not indicative of its ability to transmit Lyme disease.

Question 8

A patient diagnosed with scleroderma has been prescribed methotrexate Rheumatrex). Which medication teaching should the nurse provide? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

The answer of A patient diagnosed with scleroderma has been...

Question 9

A 20-year-old male patient is scheduled for an echocardiogram. The patient says, "I don't understand why this test is necessary when I came in for back and hip pain." The nurse considers which information before responding?

Accepted Answer

Ankylosing spondylitis is a form of arthritis that primarily affects the spine, but it can also have cardiac manifestations. This connection may warrant an echocardiogram to assess the heart's condition in the context of a patient's symptoms, including back and hip pain.

Question 10

A patient diagnosed with rheumatoid arthritis is prescribed hydroxychloroquine Plaquenil). What medication information should the nurse provide?

Accepted Answer

Hydroxychloroquine can cause changes in pigmentation, such as lightening of the hair. This is a known, though less common, side effect of the medication.

Question 11

A patient with Sjögren's syndrome is scheduled to be seen in the clinic this afternoon. The nurse would anticipate treating which symptom?

Accepted Answer

Sjögren's syndrome is an autoimmune disorder that primarily affects the exocrine glands, leading to decreased tear and saliva production. Dry eyes are a common symptom of this condition, which can be treated with artificial tears and other eye lubricants. Muscle pain, pulmonary congestion, and rhinorrhea are not typically associated with Sjögren's syndrome.

Question 12

A patient with rheumatoid arthritis is prescribed infliximab Remicade). Which nursing diagnosis does the nurse include as priority in the patient's plan of care?

Accepted Answer

Infliximab, like other immunosuppressive medications used to treat rheumatoid arthritis, can increase the risk of infections in patients. Therefore, the nurse should prioritize monitoring for signs of infection and educating the patient on infection prevention measures. While the other options may be pertinent to the patient's care, they are not the priority in this situation.

Question 13

The nurse has chosen these nursing diagnoses for a patient who has systemic lupus erythematosus. Which NDX would be assigned the highest priority?

Accepted Answer

The answer of The nurse has chosen these nursing diagnoses...

Question 14

A 59 year-old female is being evaluated for presence of a connective tissue disease. The erythrocyte sedimentation rate ESR) result is reported as 26 mm/hour. How would the nurse evaluate this result?

Accepted Answer

The ESR value of 26 mm/hour is within the normal range for a woman of her age (normal ESR can be roughly estimated as age/2 for women), indicating that while this test does not rule out a connective tissue disease, further testing is necessary for a definitive diagnosis.

Question 15

The nurse is monitoring a patient diagnosed with scleroderma for the development of sclerodactyly. Which area would the nurse assess?

Accepted Answer

Sclerodactyly is a condition characterized by thickening and tightening of the skin of the fingers and toes. Therefore, the nurse would assess the fingers for the development of this condition.

Quiz 51: Caring for the Patient With Arthritis and Connective Tissue Disorders