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.
calcium gluconate
B.
furosemide
C.
aspirin
D.
colchicine
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.
"Tell me more about your concerns about this potential diagnosis."
B.
"SLE is a very serious systemic disorder."
C.
"The diagnosis won't be based on the findings of a single test but by combining all data found."
D.
You should discuss that matter with your health care provider."
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.
Ice packs
B.
Surgery
C.
Opioid therapy
D.
Nonsteroidal anti-inflammatory drugs
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.
Hemarthrosis
B.
Diarthrodial
C.
Arthroplasty
D.
Ankylosis
Question #8
Which points should be included in the medication teaching plan for a client taking adalimumab?
A.
It is important to monitor for injection site reactions.
B.
The client should continue taking the medication if fever occurs
C.
The medication is administered intramuscularly.
D.
The medication is given at room temperature.
Question #9
The client with osteoarthritis is seen in the clinic. Which assessment finding indicates the client is having difficulty implementing self-care?
A.
Shows increased joint flexibility
B.
Reports decreased joint pain
C.
Reports ability to perform ADLs
D.
Has a weight gain of 5 pounds
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.
ability to perform activities of daily living (ADL)
B.
a weight gain of 2 pounds
C.
decreased joint pain
D.
increased fatigue
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.
Increased albumin levels
C.
Increased C4 complement
D.
Elevated erythrocyte sedimentation rate
Question #12
The nurse teach the client that osteoarthritis is
A.
affects young males.
B.
affects the cartilaginous joints of the spine and surrounding tissues.
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.
Tolmetin sodium
B.
Ibuprofen
C.
Celecoxib
D.
Piroxicam
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.
cyclophosphamide
B.
hydroxychloroquine
C.
diclofenac
D.
azathioprine
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.
colchicine
B.
anturane
C.
allopurinol
D.
probenecid
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.
It will never get any better than it is right now."
C.
"I'll definitely need surgery for this."
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.
fresh fish
C.
green vegetables
D.
citrus fruits
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.
erythema and edema over the affected joint
B.
fever and malaise
C.
anorexia and weight loss
D.
joint stiffness that decreases with activity
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.
colchicine
C.
penicillamine
D.
methotrexate
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 anti-inflammatory 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 antineoplastic drugs.”
Question #21
The nurse is assessing a client with a history of ankylosing spondylitis. What will the nurse most commonly assess?
A.
red, butterfly-shaped facial rash
B.
low back pain
C.
patchy hair loss on the scalp
D.
increased urine output
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.
butterfly facial rash
B.
jaw locking
C.
Heberden nodes
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.
Etanercept (Enbrel)
B.
Infliximab (Remicade)
C.
Methylprednisolone (Medrol)
D.
Methotrexate (Rheumatrex)
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.
Decreased hemoglobin and hematocrit
C.
Increased AST and ALT
D.
Elevated white blood count
Question #25
A client is taking ibuprofen for the treatment of osteoarthritis. What education will the nurse give the client about the medication?
A.
Inform the health care provider if there is ringing in the ears.
B.
Take the medication on an empty stomach in order to increase effectiveness.
C.
Since the medication is able to be obtained over the counter, it has few side effects.
D.
Take the medication with food to avoid stomach upset.
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 pain in my hands."
B.
"My finger joints are oddly shaped."
C.
"I have trouble with my balance."
D.
"My legs feel weak."
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.
Facial erythema, pericarditis, pleuritis, fever, and weight loss
B.
Hypothermia, weight gain, lethargy, and edema of the arms
C.
Weight gain, hypervigilance, hypothermia, and edema of the legs
D.
Photosensitivity, polyarthralgia, and painful mucous membrane ulcers
Question #29
A client with osteoarthritis asks for information concerning activity and exercise. When assisting the client, which concept should be included?
A.
Exercising immediately upon awakening allows the client to participate in activities when he has the greatest amount of energy.
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.
The time of day when exercise is performed isn't important.
D.
Exercising in the evening before going to bed is beneficial.
Question #30
Which joint is most commonly affected in gout?
A.
Tarsal area
B.
Metatarsophalangeal
C.
Knee
D.
Ankle
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.
detection of systemic complications
D.
strategies for remaining active
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.
Tingling in the arms
B.
Intestinal cramping
C.
Increase in pain in the affected extremity
D.
Diarrhea
E.
Nausea and vomiting
Question #33
Which condition is the leading cause of disability and pain in the elderly?
A.
Osteoarthritis (OA)
B.
Rheumatoid arthritis (RA)
C.
Systemic lupus erythematous (SLE)
D.
Scleroderma
Question #34
What intervention is a priority for a client diagnosed with osteoarthritis?
A.
Allopurinol
B.
Colchicine
C.
Hydrotherapy
D.
Physical therapy and exercise
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.
c. 0.32 mmol/L
B.
d. 0.40 mmol/L
C.
a. 0.19mmol/L
D.
b. 0.24 mmol/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 in the morning, when pain and stiffness are least pronounced."
C.
"Do all your chores in the evening, when pain and stiffness are least pronounced."
D.
"Do all your chores after performing morning exercises to loosen up."
Question #38
Which is an appropriate nursing intervention in the care of the client with osteoarthritis?
A.
Avoid the use of topical analgesics
B.
Provide an analgesic after exercise
C.
Encourage weight loss and an increase in aerobic activity
D.
Assess for gastrointestinal complications associated with COX-2 inhibitors
Question #39
Which assessment suggests to the nurse that a client with systemic lupus erythematous is having renal involvement?
A.
Chest pain
B.
Hypertension
C.
Decreased cognitive ability
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.
reddened
C.
nonmovable
D.
tender to the touch
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.
eating organ meats and sardines
B.
frequently ingesting salicylates
C.
high carbohydrate intake
D.
frequently drinking coffee
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.
Avoid sunlight and ultraviolet radiation.
C.
If you have problems with a medication, you may stop it until your next physician visit.
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.
Sjögren’s syndrome
C.
Reiter’s syndrome
D.
Ankylosing spondylitis
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.
Acupuncture
D.
Heat therapy and nonsteroidal anti-inflammatory medications (NSAIDs)
Question #46
A client is experiencing an acute exacerbation of rheumatoid arthritis. What should the nursing priority be?
A.
Supplying adaptive devices, such as a zipper-pull, easy-to-open beverage cartons, lightweight cups, and unpackaged silverware
B.
Performing meticulous skin care
C.
Providing comprehensive client teaching; including symptoms of the disorder, treatment options, and expected outcomes
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.
Osteotomy
D.
Synovectomy
Question #48
Scleroderma typically starts with which type of organ involvement?
A.
Kidney
B.
Lung
C.
Skin
D.
Brain
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.
After the client has had a warm paraffin hand bath
B.
First thing in the morning when the client wakes
C.
After cool compresses have been applied to the hands
D.
After the client has a diagnostic test
Question #50
Nursing care for the client with fibromyalgia should be guided by the assumption that patients with fibromyalgia
A.
rarely respond to treatment.
B.
all have the same type of symptoms.
C.
may feel as if their symptoms are not taken seriously.
D.
will eventually lose their ability to walk.
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 straw colored.
B.
The fluid will be milky, cloudy, and dark yellow.
C.
The amount of fluid will be scant in volume.
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.
"SLE has very specific manifestations that make diagnosis relatively easy."
B.
"The symptoms are primarily localized to the skin but may involve the joints."
C.
"This disorder is more common in men in their thirties and forties than in women."
D.
"The belief is that it is an autoimmune disorder with an unknown trigger."
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.
Hand and finger deformities are associated with the development of rheumatoid arthritis.
B.
The client should discuss this concern with the health care provider.
C.
It's impossible to determine at the time of diagnosis how the disease will progress.
D.
A small percentage of osteoarthritis sufferers do eventually develop hand and arm deformities
Question #54
Which term refers to fixation or immobility of a joint?
A.
Hemarthrosis
B.
Ankylosis
C.
Diarthrodial
D.
Arthroplasty
Question #55
Which term indicates an accumulation of crystalline depositions in articular surfaces, bones, soft tissue, and cartilage?
A.
Subchondral bone
B.
Joint effusion
C.
Pannus
D.
Tophi
Question #56
Which connective tissue disorder is characterized by insoluble collagen being formed and accumulating excessively in the tissues?
A.
Systemic lupus erythematosus
B.
Rheumatoid arthritis
C.
Scleroderma
D.
Polymyalgia rheumatic
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 good posture.
B.
Perform aerobic exercises.
C.
Keep shifting weight from one foot to the other.
D.
Maintain complete bed rest.
Question #58
Which of the following refers to fixation of a joint?
A.
Pannus
B.
Ankylosis
C.
Synovitis
D.
Articulations
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.
Dressing changes
B.
Medication dosages and side effects
C.
Assistive devices
D.
Narcotic safety
E.
Safe exercise
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 suggestive of rheumatoid arthritis.
B.
It is diagnostic for systemic lupus erythematosus.
C.
It is diagnostic for Sjögren’s syndrome.
D.
It is specific for 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.
Bone scan
B.
Magnetic resonance imaging (MRI)
C.
Muscle biopsy
D.
Computed tomography (CT)
Question #62
The nurse is gathering a health history for a client with osteoarthritis. What clinical manifestation will the nurse expect to find?
A.
joint pain that diminishes with rest
B.
early morning stiffness
C.
subcutaneous nodules
D.
small joint involvement
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.
jogging
C.
t’ai chi
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.
regular exercise and stress reduction
B.
applications of ice
C.
encouraging the client to eat a healthy diet
D.
avoiding caffeine and alcohol
Question #65
Which drug is not used in the treatment of rheumatoid arthritis?
A.
adalimumab
B.
allopurinol
C.
etanercept
D.
methotrexate
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