Question 1

The nurse is preparing a flyer on rheumatoid arthritis (RA) for distribution during a community health fair. Which information should the nurse include?. Select all that apply.

Accepted Answer

Rheumatoid arthritis is an autoimmune disease that affects the joints, causing inflammation, pain, and stiffness. It can affect any joint in the body and is not limited to weight-bearing joints (A is incorrect). Onset of the disease can occur at any age, but it most commonly occurs between the ages of 40 and 60, with the onset generally occurring between 20 and 40 years of age (B is correct). Women are two to three times more likely to be affected than men (D is correct). There are genetic factors that contribute to the development of rheumatoid arthritis, and family history is a known risk factor (E is correct). Rheumatoid arthritis is not the most common form of arthritis (C is incorrect); that distinction belongs to osteoarthritis.

Question 2

A patient diagnosed with rheumatoid arthritis (RA) is reluctant to start some recommended therapies. The nurse tells the patient that early intervention is crucial for long-term health. What rationales would the nurse provide for this statement?. Select all that apply.

Accepted Answer

B,C

Question 3

A patient is receiving a series of diagnostic tests to confirm the diagnosis of osteoarthritis (OA). The nurse would interpret which results as supporting the diagnosis of OA?. Select all that apply.

Accepted Answer

B,C,D,E

Question 4

A patient is newly diagnosed with osteoarthritis. List the nursing diagnoses for this patient in the order of their priority..
A) Imbalanced Nutrition: Less than Body Requirements related to inadequate intake of calcium
B) Risk for Injury related to effects of change in bone structure secondary to osteoarthritis
C) Acute Pain of the Lower Spine related to vertebral compression
D) Deficient Knowledge related to osteoarthritis and treatment to prevent further damage

Accepted Answer

The answer of A patient is newly diagnosed with osteoarthritis....

Question 5

A patient diagnosed with gouty arthritis is prescribed the drug colchicine to reduce symptoms. Which medication education should the nurse provide?

Accepted Answer

One common side effect of colchicine is gastrointestinal distress, such as vomiting and/or diarrhea. It is important for the nurse to educate the patient on this so that they are aware of the possible adverse effects and can report them to the prescribing provider if they occur. Options A and B are not relevant to the medication, and option C is not an accurate statement as colchicine is used to both reduce pain and inflammation.

Question 6

A butterfly rash on the face is characteristic of which inflammatory connective tissue disease?

Accepted Answer

A butterfly rash on the face is a characteristic feature of Systemic lupus erythematosus (SLE), an autoimmune connective tissue disease. Rheumatoid arthritis is characterized by joint inflammation and damage, Paget's disease affects bone metabolism, and gout is a type of arthritis caused by the buildup of uric acid crystals in the joints.

Question 7

Impaired physical mobility is a major nursing diagnosis for patients with osteoarthritis (OA). Which intervention would be most effective in addressing this patient's limitation?

Accepted Answer

Assessing the patient's range of motion of affected joints is the most effective intervention for addressing impaired physical mobility in a patient with OA. This allows for the planning and implementation of appropriate interventions, such as exercise and physical therapy, to improve mobility and reduce pain. Encouraging the patient to assume responsibility for personal self-care needs may also be helpful, but alone it is not as effective as assessing range of motion. Encouraging high activity levels or managing pain with narcotics may not be appropriate and could actually exacerbate physical limitations.

Question 8

Diagnostic procedures are being performed on a female patient who may have systemic lupus erythematosus (SLE). Which findings would the nurse evaluate as supporting this diagnosis?. Select all that apply.

Accepted Answer

Elevated LE prep is a laboratory test used to detect the presence of antinuclear antibodies, which are commonly found in patients with SLE. Hematuria is a common symptom of SLE resulting from inflammation and damage to the kidneys. A negative anti-SM antibody test does not rule out SLE, as only approximately 30% of patients with SLE have this antibody. A C3 complement protein of 94 mg/dL is within the normal range and does not necessarily support a diagnosis of SLE. Sodium level of 138 is within normal range and is not indicative of SLE.

Question 9

A patient diagnosed with gout is concerned that the small "lumps" on his ear and big toe will become lodged in his blood, resulting in a blood clot. Which explanation by the nurse is most accurate?

Accepted Answer

The "lumps" associated with gout are called tophi, which are collections of uric acid crystals. They do not cause blood clots. However, if left untreated, gout can lead to joint damage and other complications. The patient should continue taking their antigout medicine as prescribed and discuss any concerns with their physician during their next visit.

Question 10

The nurse is preparing for a community education session on autoimmune disorders. The nurse should review information about which diseases?. Select all that apply.

Accepted Answer

Autoimmune disorders occur when the body's immune system attacks healthy cells and tissues. Scleroderma, rheumatoid arthritis, and systemic lupus erythematosus are all autoimmune disorders. Gouty arthritis and reactive arthritis are not typically classified as autoimmune disorders.

Question 11

The nurse is preparing discharge medication instructions for a patient who has been prescribed allopurinol (Aloprim). Which information should the nurse include?. Select all that apply.

Accepted Answer

The answer of The nurse is preparing discharge medication instructions...

Question 12

A patient is experiencing symptoms typical of gout in the right foot. The nurse would prepare the patient for which diagnostic examinations?. Select all that apply.

Accepted Answer

Joint aspiration can confirm gout by detecting urate crystals. Serum uric acid level helps in diagnosing hyperuricemia associated with gout. X-ray can show joint damage or tophi in chronic gout.

Question 13

The patient has experienced an exacerbation of gout resulting in foot pain. Which nursing intervention would aid in promoting comfort?

Accepted Answer

Elevating the extremity can help reduce the swelling and inflammation in the affected joint, thereby promoting comfort. Passive range-of-motion exercises and wrapping the extremity in an elastic bandage may further exacerbate the pain and inflammation. Encouraging liberal fluid intake may help prevent future gout attacks, but it may not provide immediate comfort for the patient experiencing an acute exacerbation.

Question 14

A patient with a history of rheumatoid arthritis reports mobility impairment as a result of hip and knee joint stiffness. Which intervention should the nurse include in an education session to address this problem?. Select all that apply.

Accepted Answer

The answer of A patient with a history of rheumatoid...

Question 15

A patient diagnosed with scleroderma reports heartburn. Which instructions would the nurse provide for treatment of this symptom?. Select all that apply.

Accepted Answer

The answer of A patient diagnosed with scleroderma reports heartburn....

Question 16

The nurse has completed a health assessment, physical examination, and interview with a patient. Which assessment data would support a diagnosis of reactive arthritis?. Select all that apply.

Accepted Answer

The answer of The nurse has completed a health assessment,...

Question 17

A patient has been admitted for treatment of early-stage Lyme disease. The nurse would assess for which findings usually associated with this stage of the illness?. Select all that apply.

Accepted Answer

The answer of A patient has been admitted for treatment...

Question 18

A patient diagnosed with systemic lupus erythematosus exhibits a facial rash. What instruction should the nurse provide regarding skin care?. Select all that apply.

Accepted Answer

Patients with systemic lupus erythematosus should avoid being exposed to the sun during the hours of greatest sun intensity and should use sunscreen if sun exposure is possible. Hydrocortisone cream may be used to treat the rash, but the nurse should specify the frequency with which it should be applied. Washing the rash with antibacterial soap may not be necessary and may irritate the skin further. Swimming in a chlorinated pool may not provide significant relief of burning and should be assessed on a case-by-case basis.

Question 19

The nurse is providing dietary education for a patient recently diagnosed with a form of arthritis. The patient is encouraged to avoid alcohol, organ meats, and dried peas, beans, and peanuts. These recommendations are appropriate for patients with which specific diagnosis?

Accepted Answer

These dietary recommendations are appropriate for patients with gouty arthritis, as they are high in purines, which can lead to an accumulation of uric acid in the body and trigger gout attacks. Alcohol consumption can also increase the risk of gout attacks. These restrictions are not typically recommended for rheumatoid arthritis, reactive arthritis, or osteoarthritis.

Question 20

The nurse is discussing the symptomology of osteoarthritis (OA) with a patient. The nurse would describe which common initial symptom of the disease?

Accepted Answer

Painful stiffness in the joints of the fingers is a common initial symptom of osteoarthritis. This can also occur in other joints, such as the knee or hip, but stiffness and pain in the fingers are often the first signs of the disease. A fine red rash on the elbow (A) is not a common symptom of OA, and a popping sensation in the wrist joint (C) could be a sign of joint inflammation but not necessarily indicative of OA. Knee pain when the leg is at rest (D) could be a symptom of OA, but it is not an initial symptom and usually occurs after the disease has progressed.

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