Deck 44: Connective Tissue Disorders

Question 1

Two days after a total hip replacement, a patient is being discharged.Which statement indicates that the patient understands the discharge teaching?

A) "I can sit comfortably with my legs crossed."
B) "I will ask my husband to tie my shoes for me."
C) "I am glad I won't have to use that bulky pillow between my legs at night."
D) "My straight dining room chair will be helpful when I do the hip flexion exercises."

Answer 1

"I will ask my husband to tie my shoes for me."

Question 2

A patient asks why systemic glucocorticoid medications are used as the last choice for the treatment of rheumatoid arthritis.What is the nurse's most informative reply?

A) "The other drugs are just as effective and work in similar ways."
B) "They are used as a last choice or for short periods because they have many side effects."
C) "Those drugs are given three or four times daily, which is more difficult for patients to remember."
D) "A higher incidence of vomiting occurs with prolonged use."

Answer 2

"They are used as a last choice or for short periods because they have many side effects."

Question 3

Inadequate nutrition is the patient problem applicable to a patient with progressive systemic sclerosis.What is the most important point for the nurse to teach this patient?

A) Eat three large meals spaced throughout the day.
B) Schedule rest periods to prevent overtiring.
C) Severe stress can trigger vasospasm.
D) Eat smaller, more frequent meals.

Answer 3

Eat smaller, more frequent meals.

Question 4

A nurse, in conjunction with a patient, establishes a plan to treat the pain associated with arthritis.What is the most effective strategy?

A) Avoid exercise to spare painful joints.
B) Use narcotics for pain relief.
C) Apply warm, moist compresses before doing activity.
D) Avoid assistive devices that encourage dependence.

Question 5

An older patient with osteoarthritis complains of stomach discomfort and shortness of breath after years of taking aspirin for pain relief.What change in pain control medication would be most appropriate for the home health care nurse to suggest?

A) Nonsteroidal anti-inflammatory drugs (NSAIDs)
B) Oral corticosteroids
C) Mild exercise
D) Warm baths

Question 6

A nurse is caring for a patient with osteoarthritis.What is the best recommendation by the nurse to this patient to control chronic pain?

A) Administer analgesics only when needed.
B) Administer analgesics as prescribed on a routine basis.
C) Plan activities with no rest periods to complete the activities quickly.
D) Wear high-heeled shoes to keep the body in alignment.

Question 7

What is the best physiologic reason for a patient with osteoporosis to maintain a regular exercise regimen?

A) Involves the patient in her or his own care
B) Increases cardiac output
C) Promotes better mental health
D) Promotes bone formation and improves strength

Question 8

Which is true regarding connective tissue function?

A) Helps provide a source of storage for calcium
B) Stores hormones in the pores of bone tissue
C) Controls the distribution of minerals
D) Provides protection to body parts

Question 9

A nurse is caring for a patient immediately after total knee replacement surgery.What assessment requires priority?

A) Quality of pulses in the affected limb
B) Degree of nausea and vomiting
C) Understanding of the procedure
D) Amount of pain

Question 10

Which patient is most likely to develop a connective tissue disease?

A) A teenage girl who swims
B) A 30-year-old woman who plays tennis
C) A 35-year-old male golfer
D) A 40-year-old male computer analyst

Question 11

A home health care nurse is visiting a patient after a total hip replacement.What should the nurse include when teaching the patient how to protect the new joint?

A) Put an extension on the toilet seat.
B) Keep the legs crossed when at rest.
C) Frequently change positions from side to side.
D) Slowly pull the knee to the chest twice a day to stretch the hip abductors.

Question 12

What instruction should a nurse include in a teaching plan for a patient with carpal tunnel syndrome?

A) Anticoagulants and glucocorticoids
B) Methotrexate
C) Lubricating ointments
D) Splinting to prevent flexion and hyperextension

Question 13

What do connective tissue diseases affect?

A) Bones, ligaments, cartilage, and tendons
B) Bones, ligaments, and tendons
C) Spurs, ligaments, cartilage, and tendons
D) Tendons, cartilage, and tophi

Question 14

A nurse explains to a patient with rheumatoid arthritis that the drug leflunomide (Arava)is a disease-modifying antirheumatic drug (DMARD).What is the action of this medication?

A) Retards the progress of the disease
B) Builds new bone
C) Decreases inflammation
D) Increases flexibility

Question 15

What action would best benefit the patient diagnosed with bursitis of the shoulder?

A) Lifting a 5-lb weight as a daily exercise
B) Walking the fingers of the affected arm up the wall
C) Splinting the affected arm to keep the shoulder immobile
D) Performing gentle push-ups on the floor

Question 16

A 51-year-old professional tennis instructor is newly diagnosed with osteoarthritis.What is the nurse's best explanation to the patient when asked what this diagnosis means?

A) Presence of antibodies in the synovial fluid
B) Dislocation of the patella over the tibia
C) Degeneration of articular cartilage
D) Body's autoimmune response

Question 17

Which characteristic should a nurse recognize as diagnostic of rheumatoid arthritis?

A) Absence of pain
B) Symmetric bilateral joint swelling
C) Evening stiffness that improves with activity
D) Increased appetite

Question 18

A nurse is organizing a teaching plan for a patient with gout.What should the nurse caution this patient he is at an increased risk for?

A) Kidney stones
B) Tophi
C) Visual disturbances
D) Facial lesions

Question 19

After a knee replacement, an 87-year-old patient rejects the use of the continuous passive motion (CPM)machine, saying, "I did not march when I was a child, and I am not marching now." What benefits of CPM should the nurse point out to encourage patient use?

A) Decrease in pain
B) Increase in circulation in the new joint
C) Increase in leg strength
D) Increase in flexibility for the new joint

Question 20

A nurse is educating a patient with gout about a low-purine diet.Which food choice by the patient would indicate the need for further teaching?

A) Pizza with pepperoni
B) Seafood platter with scallops and mussels
C) Chicken salad with nuts
D) Tuna sandwich with potato chips

Question 21

What signs of progressive systemic sclerosis does the anonym CREST represent? (Select all that apply.)

A) Calcinosis
B) Rash
C) Esophageal dysfunction
D) Sore joints
E) Telangiectasis

Question 22

What are the goals of therapy for patients with rheumatic arthritis? (Select all that apply.)

A) Decrease inflammation.
B) Balance activity and rest.
C) Promote adaptation to limitations.
D) Plan frequent periods of bed rest.
E) Supply patient education and support.

Question 23

What actions would be best for patients with osteoarthritis to seek the assistance of physical therapy? (Select all that apply.)

A) Isotonic exercises
B) Moist heat application
C) Instruction with a transcutaneous electrical nerve stimulation (TENS)unit
D) Measures to increase range of motion
E) Measures to increase strength

Question 24

A nurse clarifies that a postmenopausal woman who is not taking hormone replacement therapy should take ______ mg elemental calcium on a daily basis.(Use numeric characters only.)

Question 25

To decrease osteoporosis, a nurse explains that women can benefit from ______ for 15 years after the onset of menopause.

Question 26

A nurse assesses ischemic spots around the nail beds of a patient with rheumatoid arthritis and recognizes that these are a complication of medical diagnosis, rheumatoid arthritis, related to ______.