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?

Accepted Answer

Allopurinol is a medication that decreases uric acid synthesis by inhibiting the enzyme xanthine oxidase, which is responsible for converting xanthine to uric acid.

Question 2

Which treatment does the nurse expect to be beneficial for a client diagnosed with Lyme disease?

Accepted Answer

A 10- to 21-day course of doxycycline is the standard treatment for Lyme disease, especially in the early stages, to effectively eradicate the Borrelia burgdorferi bacteria responsible for the infection.

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?

Accepted Answer

Gout is characterized by sudden, severe attacks of pain, redness, and tenderness in joints, often the joint at the base of the big toe, which is the metatarsophalangeal joint. This aligns with the radiographic findings described.

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?

Accepted Answer

C) is incorrect because synovial fluid is contained within the synovial joint capsule, and while it does receive nutrients and has waste products removed by the bloodstream, there is not a "wide exchange" directly between the bloodstream and the synovial fluid. The exchange of nutrients and waste occurs through the synovial membrane, which controls the movement of substances, rather than a direct, wide exchange with the blood.

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?

Accepted Answer

Psoriatic arthritis often presents with nail changes such as pitting, ridging, and onycholysis (separation of the nail from the nail bed), which are common psoriatic nail manifestations.

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?

Accepted Answer

Ankylosing spondylitis is associated with both iritis (inflammation of the iris) and pulmonary fibrosis, as it is a type of arthritis that primarily affects the spine and can lead to inflammation in other parts of the body.

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?

Accepted Answer

Pott's disease, also known as tuberculous spondylitis, primarily affects the spine, leading to spinal deformity and instability as the vertebrae may become damaged and collapse.

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?

Accepted Answer

Psoriatic arthritis can cause bone changes, including the phenomenon known as "pencil-in-cup" deformity, where the end of the bone is tapered to a sharp point, resembling a pencil that has been sharpened on both ends. This is a characteristic finding in psoriatic arthritis but not typically seen in Lyme disease, ankylosing spondylitis, or Pott's disease.

Question 9

The nurse is reviewing laboratory results for a client. Which pathogen does the nurse recognize as causing ankylosing spondylitis?

Accepted Answer

Ankylosing spondylitis is associated with the bacterium Klebsiella pneumoniae. Research suggests that individuals with this condition may have an immune response to the bacterium, which could play a role in the disease's pathogenesis.

Question 10

A nurse is providing care for a client diagnosed with ankylosing spondylitis. For which test does the nurse prepare the client?

Accepted Answer

X-rays are commonly used to diagnose ankylosing spondylitis by detecting changes in the sacroiliac joints and spine.

Question 11

Which statement made by a client with musculoskeletal inflammation supports the nurse's suspicion of polymyalgia rheumatica?

Accepted Answer

Polymyalgia rheumatica often presents with symptoms that mimic the flu, such as muscle pain and stiffness, but these symptoms last much longer than typical flu symptoms. This differentiates it from the other options, which are more indicative of other conditions.

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

Accepted Answer

An abscess below the bone surface indicates stage 2 of a bone infection.

Question 13

Which statement made by a staff nurse indicates the need for additional information about treatment of various musculoskeletal disorders?

Accepted Answer

Immunosuppressive agents are not typically considered first-line treatments for psoriatic arthritis. Initial treatment often includes nonsteroidal anti-inflammatory drugs (NSAIDs) and disease-modifying antirheumatic drugs (DMARDs), with immunosuppressants being considered for more severe cases or when other treatments have failed.

Question 14

The nurse is teaching a client nonpharmacological therapy to treat gout. Which statement by the client indicates the need for additional teaching?

Accepted Answer

Meats are high in purines, which can increase uric acid levels and trigger gout attacks.

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?

Accepted Answer

The answer of A client presents with joint pain and...

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?

Accepted Answer

Lyme disease is often characterized by a distinctive rash known as erythema migrans, which can appear as an oval-shaped, red lesion, often described as a "bull's-eye" rash. Enlargement of lymph nodes is also a common symptom associated with Lyme disease, which is caused by the Borrelia burgdorferi bacterium transmitted through tick bites.

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?

Accepted Answer

Estrogen has a protective effect against hyperuricemia, which is why premenopausal women have lower rates of gout compared to men.

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?

Accepted Answer

The answer of The laboratory report for a client shows...

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?

Accepted Answer

A knee replacement surgery can introduce bacteria into the body, increasing the risk for infection, especially in individuals with compromised immune systems such as those with diabetes mellitus. The symptoms presented are consistent with an infection, and a recent surgery could be a direct cause of these symptoms.

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?

Accepted Answer

Muscle biopsy is the most definitive diagnostic test for polymyositis and dermatomyositis as it allows for direct examination of muscle tissue to identify inflammation and other characteristic changes.

Quiz 39: Infection and Inflammatory Disorders of the Musculoskeletal System