Nursing 406 - Adult Health Care » Spring 2020 » Chapter 38 Quiz
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Question #1
A nurse is caring for a client with a warm and painful toe from gout. What medication will the nurse administer?
A.
colchicine
B.
aspirin
C.
furosemide
D.
calcium gluconate
Question #2
A client suspected of having systemic lupus erythematosus (SLE) is being scheduled for testing. The client asks which of the tests ordered will determine positivity for the disorder. Which statement by the nurse is most accurate?
A.
"SLE is a very serious systemic disorder."
B.
You should discuss that matter with your health care provider."
C.
"The diagnosis won't be based on the findings of a single test but by combining all data found."
D.
"Tell me more about your concerns about this potential diagnosis."
Question #3
Which term indicates an accumulation of crystalline depositions in articular surfaces, bones, soft tissue, and cartilage?
A.
Subchondral bone
B.
Tophi
C.
Pannus
D.
Joint effusion
Question #4
A client with rheumatoid arthritis reports joint pain. What intervention is a priority to assist the client?
A.
Opioid therapy
B.
Nonsteroidal anti-inflammatory drugs
C.
Surgery
D.
Ice packs
Question #5
A client arrives at the clinic with reports of pain in the left great toe. The nurse assesses a swollen, warm, erythematous left great toe. What disorder will the nurse relate the client symptoms to?
A.
Fibromyalgia
B.
Osteoarthritis
C.
Rheumatoid arthritis
D.
Gout
Question #6
A nurse is managing the care of a client with osteoarthritis. What is the appropriate treatment strategy the nurse will teach the about for osteoarthritis?
A.
administration of monthly intra-articular injections of corticosteroids.
B.
vigorous physical therapy for the joints.
C.
administration of nonsteroidal anti-inflammatory drugs (NSAIDs)
D.
administration of opioids for pain control.
Question #7
Which term refers to fixation or immobility of a joint?
A.
Arthroplasty
B.
Diarthrodial
C.
Ankylosis
D.
Hemarthrosis
Question #8
Which points should be included in the medication teaching plan for a client taking adalimumab?
A.
The client should continue taking the medication if fever occurs
B.
The medication is given at room temperature.
C.
The medication is administered intramuscularly.
D.
It is important to monitor for injection site reactions.
Question #9
The client with osteoarthritis is seen in the clinic. Which assessment finding indicates the client is having difficulty implementing self-care?
A.
Reports decreased joint pain
B.
Has a weight gain of 5 pounds
C.
Shows increased joint flexibility
D.
Reports ability to perform ADLs
Question #10
The nurse is discussing life management with the client with rheumatoid arthritis in a health clinic. What assessment finding indicates the client is having difficulty implementing self-care?
A.
increased fatigue
B.
decreased joint pain
C.
a weight gain of 2 pounds
D.
ability to perform activities of daily living (ADL)
Question #11
The nurse is reviewing the diagnostic test findings of a client with rheumatoid arthritis. What would the nurse expect to find?
A.
Increased red blood cell count
B.
Elevated erythrocyte sedimentation rate
C.
Increased albumin levels
D.
Increased C4 complement
Question #12
The nurse teach the client that osteoarthritis is
A.
affects the cartilaginous joints of the spine and surrounding tissues.
B.
affects young males.
C.
requires early treatment because most of the damage appears to occur early in the course of the disease.
D.
the most common and frequently disabling of joint disorders.
Question #13
The nurse is educating a client about the risks of stroke related to the new prescription for a COX-2 inhibitor and what symptoms to report. Which COX-2 inhibitor is the nurse educating the client about?
A.
Piroxicam
B.
Celecoxib
C.
Tolmetin sodium
D.
Ibuprofen
Question #14
A client is prescribed a disease-modifying antirheumatic drug that is successful in the treatment of rheumatoid arthritis but has side effects, including retinal eye changes. What medication will the nurse anticipate educating the client about?
A.
diclofenac
B.
cyclophosphamide
C.
azathioprine
D.
hydroxychloroquine
Question #15
The nurse is caring for a client with a new onset of gout. What medication does the nurse anticipate will be ordered by the health care provider?
A.
allopurinol
B.
anturane
C.
probenecid
D.
colchicine
Question #16
A nurse is teaching a client about rheumatoid arthritis. Which statement by the client indicates understanding of the disease process?
A.
"When it clears up, it will never come back."
B.
"I'll definitely need surgery for this."
C.
It will never get any better than it is right now."
D.
"It will get better and worse again."
Question #17
A diet plan is developed for a client with gouty arthritis. What should the nurse advise the client to limit the intake of?
A.
organ meats
B.
citrus fruits
C.
fresh fish
D.
green vegetables
Question #18
The nurse is completing a health history with a client in a clinic. What assessment finding best correlates with a diagnosis of osteoarthritis?
A.
anorexia and weight loss
B.
erythema and edema over the affected joint
C.
joint stiffness that decreases with activity
D.
fever and malaise
Question #19
The nurse is reviewing the medication administration record of the client. Which medication would lead the nurse to suspect that the client is suffering from an acute attack of gout?
A.
prednisone
B.
methotrexate
C.
penicillamine
D.
colchicine
Question #20
A client with early stage rheumatoid arthritis asks the nurse what to do to help ease the symptoms of the disease. What would be the best response by the nurse?
A.
“The health care provider could prescribe antineoplastic drugs.”
B.
“The health care provider could prescribe antihypertensive drugs.”
C.
“The health care provider could prescribe antipyretic drugs.”
D.
“The health care provider could prescribe anti-inflammatory drugs.”
Question #21
The nurse is assessing a client with a history of ankylosing spondylitis. What will the nurse most commonly assess?
A.
increased urine output
B.
red, butterfly-shaped facial rash
C.
patchy hair loss on the scalp
D.
low back pain
Question #22
The nurse is performing a health history with a new client with fibromyalgia. What will the nurse expect to assess as the most common finding associated with fibromyalgia?
A.
Heberden nodes
B.
butterfly facial rash
C.
jaw locking
D.
widespread chronic pain
Question #23
The nurse is discussing the new medication that a client will be taking for treatment of rheumatoid arthritis. Which disease-modifying antirheumatic drug (DMARD) will the nurse educate the client about?
A.
Methylprednisolone (Medrol)
B.
Infliximab (Remicade)
C.
Methotrexate (Rheumatrex)
D.
Etanercept (Enbrel)
Question #24
A client is complaining of severe pain in the left great toe. What lab studies that the nurse reviews indicate that the client may have gout?
A.
Elevated uric acid levels
B.
Increased AST and ALT
C.
Elevated white blood count
D.
Decreased hemoglobin and hematocrit
Question #25
A client is taking ibuprofen for the treatment of osteoarthritis. What education will the nurse give the client about the medication?
A.
Since the medication is able to be obtained over the counter, it has few side effects.
B.
Take the medication on an empty stomach in order to increase effectiveness.
C.
Take the medication with food to avoid stomach upset.
D.
Inform the health care provider if there is ringing in the ears.
Question #26
A physician orders corticosteroids for a child with systemic lupus erythematosus (SLE). The nurse knows that the purpose of corticosteroid therapy for this child is to:
A.
promote diuresis.
B.
prevent platelet aggregation.
C.
combat inflammation.
D.
prevent infection.
Question #27
A client with rheumatoid arthritis arrives at the clinic for a checkup. Which statement by the client refers to the most overt clinical manifestation of rheumatoid arthritis?
A.
"I have trouble with my balance."
B.
"My finger joints are oddly shaped."
C.
"My legs feel weak."
D.
"I have pain in my hands."
Question #28
A nurse assesses a client in the health care provider's office. Which assessment findings support a suspicion of systemic lupus erythematosus (SLE)?
A.
Hypothermia, weight gain, lethargy, and edema of the arms
B.
Photosensitivity, polyarthralgia, and painful mucous membrane ulcers
C.
Weight gain, hypervigilance, hypothermia, and edema of the legs
D.
Facial erythema, pericarditis, pleuritis, fever, and weight loss
Question #29
A client with osteoarthritis asks for information concerning activity and exercise. When assisting the client, which concept should be included?
A.
The time of day when exercise is performed isn't important.
B.
Delaying exercise for at least 1 hour after awakening allows the client to participate in exercise after some of the morning-related stiffness has subsided.
C.
Exercising immediately upon awakening allows the client to participate in activities when he has the greatest amount of energy.
D.
Exercising in the evening before going to bed is beneficial.
Question #30
Which joint is most commonly affected in gout?
A.
Ankle
B.
Knee
C.
Tarsal area
D.
Metatarsophalangeal
Question #31
The nurse is teaching a client with osteoarthritis about the disease. What is the most important client focus for disease management?
A.
prevention of joint deformity
B.
disease-modifying antirheumatic drug therapy
C.
strategies for remaining active
D.
detection of systemic complications
Question #32
A client is receiving treatment for an acute episode of gout with colchicine. The nurse is administering the medication every 2 hours. What should the nurse be sure the client communicates so that the drug can be temporarily stopped? Select all that apply.,,
A.
Diarrhea
B.
Intestinal cramping
C.
Tingling in the arms
D.
Nausea and vomiting
E.
Increase in pain in the affected extremity
Question #33
Which condition is the leading cause of disability and pain in the elderly?
A.
Systemic lupus erythematous (SLE)
B.
Osteoarthritis (OA)
C.
Scleroderma
D.
Rheumatoid arthritis (RA)
Question #34
What intervention is a priority for a client diagnosed with osteoarthritis?
A.
Colchicine
B.
Physical therapy and exercise
C.
Hydrotherapy
D.
Allopurinol
Question #35
As part of the assessment process for a patient suspected of having gout, the nurse evaluated his serum uric acid levels. Select the value that is considered above the saturation point for crystal formation.
A.
b. 0.24 mmol/L/
B.
d. 0.40 mmol/L
C.
c. 0.32 mmol/L
D.
a. 0.19mmol/L
Question #36
A nurse is preparing a client with systemic lupus erythematosus (SLE) for discharge. Which instruction should the nurse include in the teaching plan?
A.
"Corticosteroids may be stopped when symptoms are relieved."
B.
"Monitor your body temperature."
C.
"Exposure to sunlight will help control skin rashes."
D.
"There are no activity limitations between flare-ups."
Question #37
A client with osteoarthritis expresses concerns that the disease will prevent the ability to complete daily chores. Which suggestion should the nurse offer?
A.
"Pace yourself and rest frequently, especially after activities."
B.
"Do all your chores after performing morning exercises to loosen up."
C.
"Do all your chores in the evening, when pain and stiffness are least pronounced."
D.
"Do all your chores in the morning, when pain and stiffness are least pronounced."
Question #38
Which is an appropriate nursing intervention in the care of the client with osteoarthritis?
A.
Encourage weight loss and an increase in aerobic activity
B.
Provide an analgesic after exercise
C.
Assess for gastrointestinal complications associated with COX-2 inhibitors
D.
Avoid the use of topical analgesics
Question #39
Which assessment suggests to the nurse that a client with systemic lupus erythematous is having renal involvement?
A.
Decreased cognitive ability
B.
Hypertension
C.
Chest pain
D.
Behavioral changes
Question #40
A client asks the nurse how to identify rheumatoid nodules with rheumatoid arthritis. What characteristic will the nurse include?
A.
located over bony prominence
B.
nonmovable
C.
tender to the touch
D.
reddened
Question #41
A client is being treated for hyperuricemia. Part of the treatment strategy is for the client to avoid contributing factors whenever possible. Which activities might bring on an acute attack?
A.
frequently drinking coffee
B.
frequently ingesting salicylates
C.
eating organ meats and sardines
D.
high carbohydrate intake
Question #42
A client is being discharged from the hospital after being diagnosed with and treated for systemic lupus erythematosus (SLE). What would the nurse not include when teaching the client and family information about managing the disease?
A.
Maintain a well-balanced diet and increase fluid intake to raise energy levels and promote tissue healing.
B.
If you have problems with a medication, you may stop it until your next physician visit.
C.
Avoid sunlight and ultraviolet radiation.
D.
Pace activities.
Question #43
The nurse knows that a patient who presents with the symptom of “blanching of fingers on exposure to cold” would be assessed for what rheumatic disease?
A.
Raynaud’s phenomenon
B.
Ankylosing spondylitis
C.
Sjögren’s syndrome
D.
Reiter’s syndrome
Question #44
A nurse is assessing a client with possible osteoarthritis. What is the most significant risk factor for primary osteoarthritis?
A.
age
B.
congenital deformity
C.
trauma
D.
obesity
Question #45
A client diagnosed with arthritis doesn't want to take medications. Physical therapy and occupational therapy have been consulted for nonpharmacologic measures to control pain. What might physical and occupational therapy include in the care plan to help control this client's pain?
A.
An exercise routine that includes range-of-motion (ROM) exercises
B.
Cold therapy
C.
Heat therapy and nonsteroidal anti-inflammatory medications (NSAIDs)
D.
Acupuncture
Question #46
A client is experiencing an acute exacerbation of rheumatoid arthritis. What should the nursing priority be?
A.
Performing meticulous skin care
B.
Providing comprehensive client teaching; including symptoms of the disorder, treatment options, and expected outcomes
C.
Supplying adaptive devices, such as a zipper-pull, easy-to-open beverage cartons, lightweight cups, and unpackaged silverware
D.
Administering ordered analgesics and monitoring their effects
Question #47
Which of the following procedures involves a surgical fusion of the joint?
A.
Arthrodesis
B.
Tenorrhaphy
C.
Synovectomy
D.
Osteotomy
Question #48
Scleroderma typically starts with which type of organ involvement?
A.
Lung
B.
Skin
C.
Brain
D.
Kidney
Question #49
The nurse is caring for a client with rheumatoid arthritis who suffers with chronic pain in the hands. When would be the best time for the nurse to perform range-of-motion exercises?
A.
First thing in the morning when the client wakes
B.
After cool compresses have been applied to the hands
C.
After the client has a diagnostic test
D.
After the client has had a warm paraffin hand bath
Question #50
Nursing care for the client with fibromyalgia should be guided by the assumption that patients with fibromyalgia
A.
will eventually lose their ability to walk.
B.
all have the same type of symptoms.
C.
may feel as if their symptoms are not taken seriously.
D.
rarely respond to treatment.
Question #51
The client with an inflamed knee scheduled to have an arthrocentesis asks the nurse what the synovial fluid will look like. What is the best response by the nurse?
A.
The fluid will be milky, cloudy, and dark yellow.
B.
The amount of fluid will be scant in volume.
C.
The fluid will be straw colored.
D.
The fluid will be clear and pale.
Question #52
The nurse is teaching a newly diagnosed client about systemic lupus erythematosus(SLE). What statement by the client indicates the teaching was successful?
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.
"SLE has very specific manifestations that make diagnosis relatively easy."
D.
"The symptoms are primarily localized to the skin but may involve the joints."
Question #53
A client who has been diagnosed with osteoarthritis asks if he or she will eventually begin to notice deformities in the hands and fingers as the condition progresses. Which concept should the nurse include in the response?
A.
A small percentage of osteoarthritis sufferers do eventually develop hand and arm deformities
B.
It's impossible to determine at the time of diagnosis how the disease will progress.
C.
The client should discuss this concern with the health care provider.
D.
Hand and finger deformities are associated with the development of rheumatoid arthritis.
Question #54
Which term refers to fixation or immobility of a joint?
A.
Hemarthrosis
B.
Ankylosis
C.
Arthroplasty
D.
Diarthrodial
Question #55
Which term indicates an accumulation of crystalline depositions in articular surfaces, bones, soft tissue, and cartilage?
A.
Tophi
B.
Joint effusion
C.
Subchondral bone
D.
Pannus
Question #56
Which connective tissue disorder is characterized by insoluble collagen being formed and accumulating excessively in the tissues?
A.
Polymyalgia rheumatic
B.
Systemic lupus erythematosus
C.
Rheumatoid arthritis
D.
Scleroderma
Question #57
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.
Maintain complete bed rest.
B.
Maintain good posture.
C.
Keep shifting weight from one foot to the other.
D.
Perform aerobic exercises.
Question #58
Which of the following refers to fixation of a joint?
A.
Pannus
B.
Articulations
C.
Synovitis
D.
Ankylosis
Question #59
The nurse is performing discharge teaching for a client with rheumatoid arthritis. What teachings are priorities for the client? Select all that apply.,,
A.
Safe exercise
B.
Assistive devices
C.
Narcotic safety
D.
Dressing changes
E.
Medication dosages and side effects
Question #60
A client has a serum study that is positive for the rheumatoid factor. What will the nurse tell the client about the significance of this test result?
A.
It is diagnostic for systemic lupus erythematosus.
B.
It is diagnostic for Sjögren’s syndrome.
C.
It is specific for rheumatoid arthritis.
D.
It is suggestive of rheumatoid arthritis.
Question #61
A patient is suspected of having myositis. The nurse prepares the patient for what procedure that will confirm the diagnosis?
A.
Magnetic resonance imaging (MRI)
B.
Muscle biopsy
C.
Computed tomography (CT)
D.
Bone scan
Question #62
The nurse is gathering a health history for a client with osteoarthritis. What clinical manifestation will the nurse expect to find?
A.
small joint involvement
B.
early morning stiffness
C.
joint pain that diminishes with rest
D.
subcutaneous nodules
Question #63
The client asks the nurse about types of exercise that do not stress the joints. What exercise will the nurse include in the teaching plan?
A.
weight lifting
B.
t’ai chi
C.
jogging
D.
running on a treadmill
Question #64
A client was seen in the clinic for musculoskeletal pain, fatigue, mood disorders, and sleep disturbances. The physician has diagnosed fibromyalgia. What would not be a part of teaching plan for this condition?
A.
avoiding caffeine and alcohol
B.
applications of ice
C.
regular exercise and stress reduction
D.
encouraging the client to eat a healthy diet
Question #65
Which drug is not used in the treatment of rheumatoid arthritis?
A.
adalimumab
B.
methotrexate
C.
allopurinol
D.
etanercept
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