Question 1

Which is a cause of primary osteoarthritis?&#10;A) Mechanical stress&#10;B) Joint injury&#10;C) Metabolic disease&#10;D) Obesity

Accepted Answer

Primary osteoarthritis may be caused by aging or mechanical stress. Secondary osteoarthritis is caused by a joint injury, metabolic disease, and obesity.

Question 2

Joint effusions and edema occur as a direct result of&#10;A) Formation of osteophytes&#10;B) Uneven remodeling&#10;C) Degradation of the articular surface&#10;D) Activation of the inflammatory process

Accepted Answer

Calcification of the cartilage matrix triggers inflammation, which then causes joint effusions and edema to occur.

Question 3

Which is a joint change that occurs with aging?&#10;A) Decreased cartilage fragility&#10;B) Tendons become more elastic&#10;C) Thinner, less dense chondrocytes&#10;D) Increased synovial fluid

Accepted Answer

Age-related joint changes include thinner, less dense chondrocytes and matrix cells, decreased synovial fluid, increased cartilage fragility and fissure formation, and less elastic tendons. Older adults also experience changes in balance and proprioception that make them more susceptible to falls.

Question 4

Which process occurs during stage 3 of rheumatoid arthritis (RA)?&#10;A) Tendons and ligaments are damaged from the growing pannus formations, contributing to contractures, laxity of the tendons and ligaments, and the development of contractures.&#10;B) Synovial fluid within the joint becomes inflamed and increases in volume.&#10;C) Hypertrophy of synovial fluid occurs, and very vascular and fibrous scar tissue develops.&#10;D) Joints become nonfunctional and inflammation subsides.

Accepted Answer

In stage 3 of rheumatoid arthritis, the cartilage continues to erode, and bone cysts, spurs, and erosions of the subchondral bone develop. The tendons and ligaments are damaged from the growing pannus formations, contributing to contractures, laxity of the tendons and ligaments, and the development of contractures.

Question 5

Which is a nonmodifiable risk factor for osteoarthritis?&#10;A) Excess weight&#10;B) Genetics&#10;C) Infection&#10;D) Occupation

Accepted Answer

Nonmodifiable risk factors for osteoarthritis include age, genetics, ethnicity, and sex.

Question 6

When completing a focused joint assessment, the nurse practitioner should palpate for&#10;A) Pain, range of motion, or any differences in skin temperature&#10;B) Pain, localized edema, or any differences in skin color&#10;C) Joint tenderness, pain, or any differences in skin temperature&#10;D) Joint tenderness, pain, or any differences in skin color

Accepted Answer

Palpation can be used to assess for joint tenderness, pain, deformities, edema, and differences in skin temperature.

Question 7

Diagnostic testing of synovial fluid in rheumatoid arthritis (RA) shows&#10;A) Normal viscosity and few cells&#10;B) Normal viscosity and elevated WBCs&#10;C) Decreased viscosity and elevated RBCs&#10;D) Decreased viscosity and elevated WBCs

Accepted Answer

Synovial fluid in rheumatoid arthritis (RA) shows decreased viscosity and elevated WBCs. Synovial fluid in osteoarthritis (OA) shows normal viscosity and few cells.

Question 8

Which pain medications reduce mild to moderate pain by inhibiting the action of COX enzymes?&#10;A) Tramadol and NSAIDs&#10;B) Opioids and tramadol&#10;C) Salicylate drugs and NSAIDS&#10;D) Salicylate drugs and opioids

Accepted Answer

Nonsteroidal anti-inflammatory drugs (NSAIDs) and salicylate drugs reduce mild to moderate pain by inhibiting the action of COX enzymes. These medications are often used for the initial pain management of arthritis.

Question 9

A patient with rheumatoid arthritis who began taking methotrexate 2 weeks ago calls the clinic and complains that the medication is not working. How should the nurse practitioner respond?&#10;A) &#34;We may need to switch your medication.&#34;&#10;B) &#34;We need to add a steroid medication to increase the effectiveness of methotrexate.&#34;&#10;C) &#34;Methotrexate takes 6 to 8 weeks to see a decrease in a patient's symptoms.&#34;&#10;D) &#34;The dosage may need to be titrated down so that it is more effective.&#34;

Accepted Answer

Methotrexate is a disease-modifying antirheumatic drug (DMARD) with immunosuppressive actions that slow the progression of a disease. The medication may need to be titrated up from the initial dosage and takes 6 to 8 weeks to provide a decrease in patient symptoms and slowing in joint damage on x-ray.

Question 10

Which is a side effect of monoclonal antibody treatment?&#10;A) Pulmonary edema&#10;B) GI bleeding&#10;C) Glaucoma&#10;D) Myocardial infarction

Accepted Answer

Monoclonal antibody treatment can potentially cause pulmonary edema, cytokine release syndrome, and increased risk of infection due to immunosuppression.

Question 11

Which is an example of a condyloid joint?&#10;A) Shoulder&#10;B) Carpals&#10;C) Knee&#10;D) Phalanges

Accepted Answer

The answer of Which is an example of a condyloid...

Question 12

Which of the following is not a characteristic of osteoarthritis?&#10;A) Commonly found in weight-bearing joints&#10;B) Degenerative or age-related&#10;C) Swan-neck deformity&#10;D) Heberden's (DIP) nodules

Accepted Answer

The answer of Which of the following is not a...

Question 13

Which opioid may be prescribed as a transdermal patch?&#10;A) Oxycodone&#10;B) Fentanyl&#10;C) Lidocaine&#10;D) Hydrocodone

Accepted Answer

The answer of Which opioid may be prescribed as a...

Question 14

When referring to Case Study 5 (Geriatric): Osteoporosis, which is an appropriate exercise plan for an individual with osteoporosis?&#10;A) Walking for 30 minutes three times per week&#10;B) Running for 30 minutes three times per week&#10;C) Horseback riding for 20 minutes four times per week&#10;D) All of the above are appropriate.

Accepted Answer

The answer of When referring to Case Study 5 (Geriatric):...

Deck 22: Osteoarthritis and Rheumatoid Arthritis