Deck 63: Caring for Clients With Orthopedic and Connective Tissue Disorders

Question 1

A female client is taking large doses of ibuprofen as treatment for osteoarthritis. After teaching the client about the possible adverse effect of this drug, the nurse determines that additional teaching is needed when the client states which of the following?

A) "I need to take the drug on an empty stomach for the best effect."
B) "If I notice any blood in my urine or stool, I will call my physician."
C) "I should let my dentist know that I'm taking this drug in large doses."
D) "I might have some nausea or vomiting with this drug."

Answer 1

"I need to take the drug on an empty stomach for the best effect."

Question 2

Which of the following would the nurse most commonly assess in a client with ankylosing spondylitis?

A) Low back pain
B) Increased urine output
C) Red, butterfly-shaped facial rash
D) Patchy hair loss on the scalp

Answer 2

Low back pain

Question 3

Which client would the nurse identify as having the greatest risk for osteoporosis?

A) A 40-year-old overweight African American woman
B) A 16-year-old male with a history of asthma
C) A small-framed, thin 45-year-old white woman
D) A 20-year-old male athlete with repeated injuries

Answer 3

A small-framed, thin 45-year-old white woman

Question 4

A client with osteoporosis is prescribed a selective estrogen receptor modifier (SERM) as treatment. The nurse would identify which drug as belonging to this class?

A) Alendronate
B) Calcium gluconate
C) Tamoxifen
D) Raloxifene

Question 5

A client is diagnosed with systemic lupus erythematosus (SLE). Which of the following would be most appropriate for the nurse to use to evaluate the client's stage of disease?

A) Observe the client's gait.
B) Review the client's medical record.
C) Inspect the client's mouth.
D) Auscultate the client's lung sounds.

Question 6

A client with an acute attack of gout is told to take colchicine every 1 to 2 hours. The client demonstrates understanding of the medication regimen when he states that he will stop taking the drug temporarily when which of the following occurs? Select all that apply?

A) Pain increases
B) Nausea
C) Constipation
D) Vomiting
E) Intestinal cramping

Question 7

A client is diagnosed with osteomyelitis. This is most commonly caused by which of the following?

A) Proteus vulgaris
B) Psuedomonas aeruginosa
C) Escherichia coli
D) Staphylococcus aureus

Question 8

A nurse is monitoring a client diagnosed with Lyme disease. Which finding would suggest that the disease is in the early stages?

A) Breathlessness
B) Red macule or papule
C) Bony nodule
D) Swollen painful knees

Question 9

A group of students are reviewing information about osteoporosis in preparation for a class discussion. The students demonstrate a need for additional review when they state which of the following as a risk factor?

A) Excess caffeine intake
B) Prolonged corticosteroid use
C) Hypothyroidism
D) Prolonged immobility

Question 10

The nurse is discussing measures about how to prevent Lyme disease with a client and his family. Which of the following would the nurse include?

A) Wear dark colored clothing to prevent ticks from being attracted to the body.
B) Wear short sleeved shirts and shorts to allow for easy identification of ticks.
C) Don a hat, pulling any long hair back so it doesn't come in contact with shrubs.
D) Remove fences from around the house and garden to allow deer to be seen.

Question 11

Which suggestion would be most important to give a client who has a mild case of bunions?

A) Avoid strenuous exercise.
B) Avoid foot creams.
C) Don proper footwear.
D) Regularly use analgesics.

Question 12

Which of the following would a nurse encourage a client with gout to limit?

A) Fluid intake
B) Protein-rich foods
C) Purine-rich foods
D) Carbohydrates

Question 13

A client with rheumatoid arthritis is prescribed a tumor necrosis factor (TNF)-alpha inhibitor. Which of the following might be prescribed?

A) Etanercept
B) Diclofenac
C) Indomethacin
D) Celecoxib

Question 14

A client with degenerative joint disease asks the nurse for suggestions to avoid unusual stress on the joints. Which suggestion would be most appropriate?

A) Keep shifting weight from one foot to the other.
B) Perform aerobic exercises.
C) Maintain complete bed rest.
D) Maintain good posture.

Question 15

Which of the following would the nurse expect to assess as the most common finding associated with fibromyalgia?

A) Heberden nodes
B) Jaw locking
C) Widespread chronic pain
D) Butterfly facial rash

Question 16

A client with gout has been advised to lose weight. She informs the nurse that she plans to go on a "guaranteed rapid weight loss" plan that involves fasting and heavy exercise. Which response would be most appropriate?

A) "The fasting is okay, but make sure you drink fluids when exercising."
B) "Make sure to eat some fat occasionally with all that exercise."
C) "Try combining the fasting with moderate exercise."
D) "There might be some difficulties with your plan and fasting."

Question 17

Which of the following would the nurse use to determine that a client is exhibiting signs and symptoms of chronic osteomyelitis?

A) High fever
B) Persistent draining sinus
C) Rapid pulse
D) Tenderness over the affected area

Question 18

The nurse is reviewing the diagnostic test findings of a client with rheumatoid arthritis. Which of the following would the nurse expect to find?

A) Increased red blood cell count
B) Increased C4 complement
C) Elevated erythrocyte sedimentation rate
D) Increased albumin levels

Question 19

After teaching a group of students about systemic lupus erythematosus, the instructor determines that the teaching was successful when the students state which of the following?

A) This disorder is more common in men in their thirties and forties than in women.
B) The belief is that it is an autoimmune disorder with an unknown trigger.
C) It has very specific manifestations that make diagnosis relatively easy.
D) The symptoms are primarily localized to the skin but may involve the joints.

Question 20

A nursing student asks the instructor how to identify rheumatoid nodules in a client with rheumatoid arthritis. Which of the following characteristics would the instructor include?

A) Tender to touch
B) Reddened
C) Nonmovable
D) Located over bony prominence

Question 21

Assessment of a client reveals signs and symptoms of Paget's disease. Which of the following would be most likely?

A) Skull narrowing
B) Lordosis
C) Long bone bowing
D) Waddling gait

Question 22

Synovial fluid analysis of a client with osteoarthritis typically would reveal which of the following?

A) Thin cloudy fluid
B) Elevated protein
C) Elevated polymorphonuclear cells
D) Mild leukocytosis

Question 23

During a routine physical examination of a client, the nurse observes a flexion deformity of the promixal interphalangeal (PIP) joint of two toes on the right foot. The nurse documents this finding as which of the following?

A) Hammer toe
B) Mallet toe
C) Hallux valgus
D) Bunion

Question 24

When describing malignant bone tumors to a group of students, which of the following would the instructor cite as the usual location?

A) Proximal humerus
B) Wrist-hand junction
C) Distal femur around the knee
D) Femur-hip area

Question 25

After teaching a class comparing rheumatoid arthritis and osteoarthritis, the instructor determines that the teaching was successful when the students identify which of the following as characteristic of osteoarthritis?

A) Swan neck deformity
B) Heberden nodes
C) Boutonniere deformity
D) Ulnar deviation