Question 1

After the nurse assesses a 78-year-old who uses naproxen (Aleve)daily for hand and knee osteoarthritis management,which information is most important to report to the health care provider?

Accepted Answer

Older patients are at increased risk for renal toxicity caused by nonsteroidal antiinflammatory drugs (NSAIDs)such as naproxen.The other information will also be reported to the health care provider but is consistent with the patient's diagnosis of osteoarthritis and will not require an immediate change in the patient's treatment plan.

Question 2

A 28-year-old with psoriatic arthritis and back pain is receiving etanercept (Enbrel).Which finding is most important for the nurse to report to the health care provider?

Accepted Answer

Because heart failure is a possible adverse effect of etanercept,the medication may need to be discontinued.The other information will also be reported to the health care provider but does not indicate a need for a change in treatment.Red,scaly patches of skin and mild anemia are commonly seen with psoriatic arthritis.Treatment with biologic therapies requires time to improve symptoms.

Question 3

Which nursing action can the registered nurse (RN)delegate to unlicensed assistive personnel (UAP)who are assisting with the care of a patient with scleroderma?

Accepted Answer

Monitoring and documenting patients' oral intake is included in UAP education and scope of practice.Assessments for changes in physical status and administration of medications require more education and scope of practice,and should be done by licensed nurses.

Question 4

After the nurse has taught a 28-year-old with fibromyalgia,which statement by the patient indicates a good understanding of effective self-management?

Accepted Answer

Dietitians frequently suggest that patients with fibromyalgia limit their intake of caffeine and sugar because these substances are muscle irritants.Mild exercise such as walking is recommended for patients with fibromyalgia,but vigorous exercise is likely to make symptoms worse.Because symptoms may fluctuate from day to day,the patient should be able to adapt the regimen independently,rather than calling the provider whenever symptoms get worse.Over-the-counter medications such as ibuprofen and acetaminophen are frequently used for symptom management.

Question 5

During assessment of the patient with fibromyalgia,the nurse would expect the patient to report which of the following (select all that apply)?

Accepted Answer

These symptoms are commonly described by patients with fibromyalgia.Cardiac involvement and joint inflammation are not typical of fibromyalgia.

Question 6

When reviewing the chart shown in the accompanying figure for a new patient with rheumatoid arthritis,the nurse reads that the patient has swan neck deformities.Which deformity will the nurse expect to observe when assessing the patient?

Accepted Answer

Swan neck deformity involves distal interphalangeal joint hyperflexion and proximal interphalangeal joint hyperextension of the hands.The other deformities are also associated with rheumatoid arthritis: ulnar drift,boutonniere deformity,and hallux vagus.

Question 7

Which information will the nurse include when teaching a patient with newly diagnosed chronic fatigue syndrome about self-management?

Accepted Answer

A graduated exercise program is recommended to avoid fatigue while encouraging ongoing activity.Because many patients with chronic fatigue syndrome have allergies,antihistamines and decongestants are used to treat allergy symptoms.A high-fiber diet is recommended.Chronic fatigue syndrome usually does not progress.

Quiz 61: Nursing Management: Arthritis and Connective Tissue Diseases

After the nurse assesses a 78-year-old who uses naproxen (Aleve) daily for hand and knee osteoarthritis management,which information is most important to report to the health care provider?

A 28-year-old with psoriatic arthritis and back pain is receiving etanercept (Enbrel) .Which finding is most important for the nurse to report to the health care provider?

Which nursing action can the registered nurse (RN) delegate to unlicensed assistive personnel (UAP) who are assisting with the care of a patient with scleroderma?

After the nurse has taught a 28-year-old with fibromyalgia,which statement by the patient indicates a good understanding of effective self-management?

During assessment of the patient with fibromyalgia,the nurse would expect the patient to report which of the following (select all that apply) ?

When reviewing the chart shown in the accompanying figure for a new patient with rheumatoid arthritis,the nurse reads that the patient has swan neck deformities.Which deformity will the nurse expect to observe when assessing the patient?

Which information will the nurse include when teaching a patient with newly diagnosed chronic fatigue syndrome about self-management?