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."

Accepted Answer

Ibuprofen should be taken with food or milk to help prevent gastrointestinal upset. Taking it on an empty stomach can increase the risk of adverse effects on the stomach and intestines, such as bleeding, ulceration, and perforation. The other options demonstrate understanding of the potential adverse effects of the drug.

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

Accepted Answer

Ankylosing spondylitis primarily affects the spine, causing low back pain that is worse with rest and improves with activity. Increased urine output is not typically associated with this condition. A red, butterfly-shaped facial rash and patchy hair loss on the scalp are more commonly seen in conditions such as lupus and alopecia, respectively.

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

Accepted Answer

Small-framed, thin white women are at the greatest risk for osteoporosis, particularly after menopause. The other clients mentioned do not have the same risk factors.

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

Accepted Answer

Raloxifene is a selective estrogen receptor modifier (SERM) and is often prescribed as treatment for osteoporosis. Alendronate is a bisphosphonate drug, calcium gluconate is a calcium supplement, and tamoxifen is an estrogen receptor modulator, but not classified specifically as a SERM.

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.

Accepted Answer

Reviewing the client's medical record would be the most appropriate way for the nurse to evaluate the client's stage of disease. Lupus can affect multiple organ systems, and the medical record would provide information about the client's history of symptoms, diagnostic tests, and treatment. Observing the client's gait, inspecting the client's mouth, or auscultating the client's lung sounds may provide some information about the client's current physical status, but would not be specific to evaluating the stage of the disease.

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

Accepted Answer

Colchicine is often stopped when gastrointestinal side effects such as nausea, vomiting, and intestinal cramping occur, as these are signs of toxicity.

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

Accepted Answer

Staphylococcus aureus is the most common cause of osteomyelitis. Proteus vulgaris and Pseudomonas aeruginosa can also cause osteomyelitis, but they are less common. Escherichia coli is not a typical cause of osteomyelitis.

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

Accepted Answer

The presence of a red macule or papule, known as erythema migrans, is typically the first sign of Lyme disease and indicates early stage infection. Breathlessness, a bony nodule, and swollen painful knees are not typically associated with early stage Lyme disease.

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

Accepted Answer

Hypothyroidism is not a risk factor for osteoporosis; in fact, hyperthyroidism or excessive thyroid hormone can lead to increased bone loss and is a risk factor for osteoporosis. Excess caffeine intake, prolonged corticosteroid use, and prolonged immobility are all recognized risk factors for the development of osteoporosis.

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.

Accepted Answer

The nurse should instruct the client and family to don a hat and pull back any long hair so it doesn't come in contact with shrubs, as ticks often reside in tall grass and shrubs. Wearing dark colored clothing or removing fences would not be effective measures for preventing Lyme disease. Wearing short sleeved shirts and shorts may increase the chance of a tick bite, as there is more exposed skin.

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.

Accepted Answer

Donning proper footwear is the most important suggestion for a client with a mild case of bunions. Wearing shoes with a wide toe box and good arch support can help alleviate symptoms and prevent further progression of the condition. Avoiding strenuous exercise and regularly using analgesics may provide temporary relief but will not address the underlying issue. Avoiding foot creams may be helpful if the client has a concurrent fungal infection, but it is not specific to bunion treatment.

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

Accepted Answer

Clients with gout should limit their intake of purine-rich foods, such as organ meats, shellfish, and certain types of fish, as they can increase the production of uric acid in the body, exacerbating gout symptoms. It is important for clients with gout to maintain adequate fluid intake and consume a balanced diet that includes carbohydrates and protein, but not in excess.

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

Accepted Answer

Etanercept is a TNF-alpha inhibitor commonly used to treat rheumatoid arthritis. Diclofenac, Indomethacin, and Celecoxib are nonsteroidal anti-inflammatory drugs (NSAIDs) that do not target TNF-alpha.

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.

Accepted Answer

Maintaining good posture can help distribute weight evenly throughout the body and relieve pressure on the joints. Shifting weight from one foot to the other may actually increase stress on the joints, and complete bed rest is not recommended for individuals with degenerative joint disease. While aerobic exercise can be beneficial for overall health, it may need to be modified to avoid putting excessive stress on the affected joints.

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

Accepted Answer

Fibromyalgia is a chronic condition characterized by widespread musculoskeletal pain, along with fatigue, sleep disturbances, and other symptoms. Heberden nodes are associated with osteoarthritis, jaw locking with temporomandibular joint disorder, and butterfly facial rash with lupus.

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."

Accepted Answer

Fasting and heavy exercise can lead to dehydration and can further exacerbate gout symptoms. It is important to advise the client to avoid this plan and instead adopt a balanced and sustainable approach to weight loss that includes a healthy diet and moderate exercise. Informing the client about the potential difficulties with her current plan will help her make informed decisions about her health. Option A is incorrect because drinking fluids alone may not be sufficient to prevent dehydration. Option B is incorrect because adding fat to the diet is not a recommended approach to weight loss, and it does not mitigate the negative effects of fasting and heavy exercise. Option C may still pose a risk of dehydration and is not a sustainable approach to weight loss.

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

Accepted Answer

Chronic osteomyelitis is characterized by a persistent draining sinus, which is a hallmark sign of chronic infection in the bone. While the client may have a high fever and tenderness over the affected area, these symptoms can also occur in acute osteomyelitis. A rapid pulse may occur in response to fever, but it is not specific to chronic osteomyelitis.

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

Accepted Answer

Elevated erythrocyte sedimentation rate (ESR) is a common finding in clients with rheumatoid arthritis. It indicates systemic inflammation in the body. The other options are not typically associated with rheumatoid arthritis.

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.

Accepted Answer

Systemic lupus erythematosus is indeed believed to be an autoimmune disorder with an unknown trigger. It is more common in women than men, and diagnosis can be difficult due to its wide range of manifestations. While skin and joint involvement are common symptoms, SLE can affect many other organs and systems in the body.

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

Accepted Answer

Rheumatoid nodules are typically located over bony prominences and are usually firm and non-tender.

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

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?

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

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

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

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

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?

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?

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

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

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

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

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

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?

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

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

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 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?