Question 1

In planning care for a patient admitted for treatment of a connective tissue disorder, the nurse formulates the nursing diagnosis, "Self-care deficit related to decreased joint mobility secondary to an autoimmune response resulting in Boutonniere deformities" is most relevant for which disorder?

Accepted Answer

Boutonniere deformities are characteristic of rheumatoid arthritis, which is an autoimmune disorder that can lead to decreased joint mobility and subsequently, self-care deficits.

Question 2

The nurse provides care to a patient diagnosed with osteoarthritis who is prescribed daily acetaminophen. Which patient statement requires an intervention?

Accepted Answer

Acetaminophen (Tylenol) is metabolized by the liver, and consuming alcohol while taking acetaminophen can increase the risk of liver damage. The patient's statement about drinking a couple of beers daily requires intervention to prevent potential harm.

Question 3

A nurse is caring for a patient who is newly diagnosed with rheumatoid arthritis (RA). The patient asks the nurse what the difference is between RA and osteoarthritis (OA). Which response by the nurse is most appropriate?

Accepted Answer

Rheumatoid arthritis (RA) often has a more rapid onset compared to osteoarthritis (OA), which typically develops gradually as a result of wear and tear on the joints.

Question 4

A patient with systemic lupus erythematosus (SLE) is being treated with immunosuppressant drugs and corticosteroids. Which patient statement indicates the need for further teaching?

Accepted Answer

The answer of A patient with systemic lupus erythematosus (SLE)...

Question 5

In providing care to a patient who is being evaluated for a possible connective tissue disease, the nurse correlates which finding to the definitive diagnosis of gout?

Accepted Answer

Crystals in synovial fluid, specifically monosodium urate crystals, are definitive for the diagnosis of gout, distinguishing it from other connective tissue diseases.

Question 6

The nurse is providing health education to a diverse group at a neighborhood community center. The nurse includes information about signs and symptoms of systemic lupus erythematosus (SLE) for which of the following reasons?

Accepted Answer

Systemic lupus erythematosus (SLE) is more prevalent in women than men and is known to affect women of childbearing age. Additionally, it has been observed to have a higher incidence and severity in individuals of non-European descent, including those of Asian-American descent. Therefore, providing information about SLE to an audience mainly composed of females of Asian-American descent is relevant due to the increased risk in this demographic.

Question 7

The nurse correlates an increased risk of osteoarthritis in which of the following patients?

Accepted Answer

The answer of The nurse correlates an increased risk of...

Question 8

The nurse is caring for a patient who was diagnosed with rheumatoid arthritis (RA) last year who has a history of type 2 diabetes mellitus. The patient has recently been placed on prednisone for treatment. Which patient statement indicates that the medication teaching was successful?

Accepted Answer

Prednisone should be taken at the same time every day to maintain consistent levels in the body and minimize side effects.

Question 9

The nurse develops the nursing diagnosis "Altered Comfort related to inflammation and pain secondary to urate crystals in the joints and tissues." For which disorder is this nursing diagnosis most relevant?

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, caused by the accumulation of urate crystals. This diagnosis directly relates to the symptoms described.

Question 10

The nurse provides education to a patient with rheumatoid arthritis who is prescribed methotrexate by the healthcare provider. Which patient statement indicates to the nurse the need for further teaching?

Accepted Answer

Methotrexate is a medication that can have serious interactions with alcohol, increasing the risk of liver damage. Patients are generally advised to limit or avoid alcohol consumption while taking methotrexate. The other statements indicate an understanding of the medication's use and precautions.

Question 11

A patient recently diagnosed with rheumatoid arthritis (RA) asks the nurse if the disease is caused by ethnicity. Which response by the nurse is the most appropriate?

Accepted Answer

Rheumatoid arthritis (RA) is more prevalent in females than in males, which is a significant demographic factor in its occurrence. Ethnicity is not directly mentioned in the options, but gender prevalence is a well-documented aspect of RA.

Question 12

A patient with rheumatoid arthritis (RA) is being seen in the outpatient clinic for a progress checkup. The nurse is reviewing the patient's plan of care and determines that the patient has met a goal of treatment when the patient makes which statement?

Accepted Answer

The goal of treatment for rheumatoid arthritis is to manage symptoms and maintain function. Getting help with household tasks indicates the patient is managing their condition by balancing activity and rest, which is a positive outcome in RA management.

Question 13

The nurse provides care for a patient who is admitted to the cardiac care unit for a coronary artery bypass graft (CABG). The patient has a history of osteoarthritis. Which medication does the nurse question if prescribed by the healthcare provider?

Accepted Answer

Ibuprofen (Advil) is a nonsteroidal anti-inflammatory drug (NSAID) that can increase the risk of bleeding, which is a concern for a patient who has undergone a coronary artery bypass graft (CABG) surgery. NSAIDs can also affect renal function and fluid balance, further complicating postoperative care for cardiac patients.

Question 14

The nurse collects assessment data for a patient diagnosed with limited systemic scleroderma. The nurse monitors for which data based on the current diagnosis?

Accepted Answer

Limited systemic scleroderma is often associated with Raynaud's phenomenon, which typically precedes other symptoms.

Question 15

The nurse is providing care for a newly married woman with systemic lupus erythematosus (SLE). Which patient statement indicates an appropriate understanding of the plan of care?

Accepted Answer

Cytotoxic medications, often used in the treatment of systemic lupus erythematosus (SLE), can be harmful to a fetus. Therefore, it is important for patients to use effective birth control methods to avoid pregnancy while on these medications. This understanding indicates appropriate planning and care management.

Question 16

In providing care to a patient admitted for evaluation of a connective tissue disorder, the nurse formulates the nursing diagnosis "Self-Care Deficit related to joint deformities and pain secondary to pathological accumulation of collagen." This is most relevant to which disorder?

Accepted Answer

Scleroderma is characterized by the pathological accumulation of collagen leading to skin tightening and can affect internal organs, including joints, causing deformities and pain. This makes the nursing diagnosis of "Self-Care Deficit related to joint deformities and pain" most relevant to scleroderma.

Question 17

A nurse is caring for a patient with systemic lupus erythematous (SLE) who is taking hydroxychloroquine (Plaquenil). When providing care for this patient, the nurse monitors for which adverse effect associated with the prescribed medication?

Accepted Answer

Hydroxychloroquine (Plaquenil), used in the treatment of systemic lupus erythematosus (SLE), is associated with retinal toxicity, which can lead to vision changes or loss. Regular ophthalmologic examinations are recommended to monitor for this adverse effect.

Question 18

The patient enters the outpatient clinic and states to the triage nurse, "I think I have the flu. I'm so tired, I have no appetite, and everything hurts." The triage nurse assesses the patient and finds a butterfly rash over the bridge of nose and on the cheeks. Then nurse correlates this data with the clinical manifestations of which disorder?

Accepted Answer

The presence of a butterfly rash over the bridge of the nose and cheeks is a hallmark sign of Systemic Lupus Erythematosus (SLE), a chronic autoimmune disease that can affect various parts of the body.

Question 19

A nurse is caring for a patient with systemic lupus erythematosus (SLE). Which intervention does the nurse plan to teach this patient to minimize skin infections associated with SLE?

Accepted Answer

Patients with SLE are photosensitive, and using a high SPF sunscreen helps protect the skin from UV rays, reducing the risk of skin infections and flares.

Question 20

Which statement by the patient with rheumatoid arthritis indicates the need for further teaching?

Accepted Answer

Immunosuppressive medications typically need to be managed carefully during infections, often reduced or temporarily halted, not increased, to allow the immune system to fight the infection effectively. Increasing immunosuppressants during an infection could worsen the infection or make it harder for the body to recover.

Quiz 20: Coordinating Care for Patients With Connective Tissue Disorders