65 Flashcards
(39 cards)
Which finding will the nurse expect when assessing a 60-year-old patient who has osteoarthritis (OA) of the left knee?
a. Heberden’s nodules
b. Pain upon joint movement
c. Redness and swelling of the knee joint
d. Stiffness that increases with movement
b. Pain upon joint movement
Which assessment finding about a patient who has been using naproxen (Naprosyn) for 3 weeks to treat osteoarthritis is most important for the nurse to report to the health care provider?
a. The patient has dark colored stools.
b. The patient’s pain has not improved.
c. The patient is using capsaicin cream (Zostrix).
d. The patient has gained 3 pounds over 3 weeks.
a. The patient has dark colored stools.
After the nurse has finished teaching a patient with osteoarthritis (OA) of the left hip and knee about how to manage the OA, which patient statement indicates a need for more education?
a. “I can take glucosamine to help decrease my knee pain.”
b. “I will take 1 g of acetaminophen (Tylenol) every 4 hours.”
c. “I will take a shower in the morning to help relieve stiffness.”
d. “I can use a cane to decrease the pressure and pain in my hip.”
b. “I will take 1 g of acetaminophen (Tylenol) every 4 hours.”
When caring for a patient who has osteoarthritis, the nurse will anticipate the need to teach the patient about which of these medications?
a. Adalimumab (Humira)
b. Prednisone (Deltasone)
c. Capsaicin cream (Zostrix)
d. Sulfasalazine (Azulfidine)
c. Capsaicin cream (Zostrix)
A patient who has rheumatoid arthritis is seen in the outpatient clinic and the nurse notes that rheumatoid nodules are present on the patient’s elbows. Which action will the nurse take?
a. Draw blood for rheumatoid factor analysis.
b. Teach the patient about injection of the nodule.
c. Assess the nodules for skin breakdown or infection.
d. Discuss the need for surgical removal of the nodule.
c. Assess the nodules for skin breakdown or infection.
When caring for a patient with a new diagnosis of rheumatoid arthritis, which action will the nurse include in the plan of care?
a. Instruct the patient to purchase a soft mattress.
b. Teach patient to use lukewarm water when bathing.
c. Suggest that the patient take a nap in the afternoon.
d. Suggest exercise with light weights several times daily.
c. Suggest that the patient take a nap in the afternoon.
A home health patient with rheumatoid arthritis (RA) complains to the nurse about having chronically dry eyes. Which action by the nurse is most appropriate?
a. Reassure the patient that dry eyes are a common problem with RA.
b. Teach the patient more about adverse affects of the RA medications.
c. Suggest that the patient start using over-the-counter (OTC) artificial tears.
d. Ask the health care provider about lowering the methotrexate (Rheumatrex) dose.
c. Suggest that the patient start using over-the-counter (OTC) artificial tears.
Which information will the nurse include when teaching range-of-motion exercises to a patient with an exacerbation of rheumatoid arthritis?
a. Affected joints should not be exercised when pain is present.
b. Application of cold packs before exercise may decrease joint pain.
c. Exercises should be performed passively by someone other than the patient.
d. Walking may substitute for range-of-motion (ROM) exercises on some days.
b. Application of cold packs before exercise may decrease joint pain.
Prednisone (Deltasone) is prescribed for a patient with an acute exacerbation of rheumatoid arthritis. Which laboratory result will the nurse monitor to determine whether the medication has been effective?
a. Blood glucose test
b. Liver function tests
c. C-reactive protein level
d. Serum electrolyte levels
c. C-reactive protein level
When teaching a patient who has rheumatoid arthritis (RA) about how to manage activities of daily living, the nurse instructs the patient to
a. stand rather than sit when performing household chores.
b. avoid activities that require continuous use of the same muscles.
c. strengthen small hand muscles by wringing sponges or washcloths.
d. protect the knee joints by sleeping with a small pillow under the knees.
b. avoid activities that require continuous use of the same muscles.
When helping a patient with rheumatoid arthritis (RA) plan a daily routine, the nurse informs the patient that it is most helpful to start the day with
a. a warm bath followed by a short rest.
b. a short routine of isometric exercises.
c. active range-of-motion (ROM) exercises.
d. stretching exercises to relieve joint stiffness.
a. a warm bath followed by a short rest.
Anakinra (Kineret) is prescribed for a patient who has rheumatoid arthritis (RA). When teaching the patient about this drug, the nurse will include information about
a. self-administration of subcutaneous injections.
b. taking the medication with at least 8 oz of fluid.
c. avoiding concurrently taking aspirin or nonsteroidal antiinflammatory drugs (NSAIDs).
d. symptoms of gastrointestinal (GI) irritation or bleeding.
a. self-administration of subcutaneous injections.
A 35-year-old patient with three school-age children who has recently been diagnosed with rheumatoid arthritis (RA) tells the nurse that the inability to be involved in many family activities is causing stress at home. Which response by the nurse is most appropriate?
a. “You may need to see a family therapist for some help.”
b. “Tell me more about the situations that are causing stress.”
c. “Perhaps it would be helpful for you and your family to get involved in a support group.”
d. “Your family may need some help to understand the impact of your rheumatoid arthritis.”
b. “Tell me more about the situations that are causing stress.”
Which information will the nurse include when teaching a patient with newly diagnosed ankylosing spondylitis (AS) about the management of the condition?
a. Exercise by taking long walks.
b. Do daily deep breathing exercises.
c. Sleep on the side with hips flexed.
d. Take frequent naps during the day.
b. Do daily deep breathing exercises.
A 22-year-old patient hospitalized with a fever and red, hot, and painful knees is suspected of having septic arthritis. Information obtained during the nursing history that indicates a risk factor for septic arthritis is that the patient
a. has a parent who has reactive arthritis.
b. is sexually active and has multiple partners.
c. recently returned from a trip to South America.
d. had several sports-related knee injuries as a teenager.
b. is sexually active and has multiple partners.
While working at a summer camp, the nurse notices a circular lesion with a red border and clear center on the arm of a patient who is in the camp clinic complaining of chills and muscle aches. Which action should the nurse take next?
a. Palpate the abdomen.
b. Auscultate the heart sounds.
c. Ask the patient about recent outdoor activities.
d. Question the patient about immunization history.
c. Ask the patient about recent outdoor activities.
A 26-year-old patient with urethritis and knee pain is diagnosed with reactive arthritis. The nurse will plan to teach the patient about the need for several months of therapy with
a. anakinra (Kineret).
b. etanercept (Enbrel).
c. doxycycline (Vibramycin).
d. methotrexate (Rheumatrex).
c. doxycycline (Vibramycin).
A patient with an acute attack of gout is treated with colchicine. The nurse determines that the drug is effective upon finding
a. relief of joint pain.
b. increased urine output.
c. elevated serum uric acid.
d. decreased white blood cells (WBC).
a. relief of joint pain.
A patient with gout tells the nurse that he takes losartan (Cozaar) for control of the condition. The nurse will plan to monitor
a. blood glucose.
b. blood pressure.
c. erythrocyte count.
d. lymphocyte count.
b. blood pressure
A long-term care patient who takes multiple medications develops acute gouty arthritis. The nurse will consult with the health care provider before giving the prescribed dose of
a. sertraline (Zoloft).
b. famotidine (Pepcid).
c. oxycodone (Roxycodone).
d. hydrochlorothiazide (HydroDiuril).
d. hydrochlorothiazide (HydroDiuril).
Which statement by a 24-year-old woman with systemic lupus erythematosus (SLE) indicates that the patient has understood the nurse’s teaching about management of the condition?
a. “I will use a sunscreen whenever I am outside.”
b. “I will try to keep exercising even if I am tired.”
c. “I should take birth control pills to keep from getting pregnant.”
d. “I should not take aspirin or nonsteroidal anti-inflammatory drugs.”
a. “I will use a sunscreen whenever I am outside.”
A patient with systemic lupus erythematosus (SLE) who has a facial rash and alopecia tells the nurse, “I hate the way I look! I never go anywhere except here to the health clinic.” An appropriate nursing diagnosis for the patient is
a. activity intolerance related to fatigue and inactivity.
b. impaired social interaction related to lack of social skills.
c. impaired skin integrity related to itching and skin sloughing.
d. social isolation related to embarrassment about the effects of SLE.
d. social isolation related to embarrassment about the effects of SLE
To determine whether a patient with joint swelling and pain has systemic lupus erythematosus, which test will be most useful for the nurse to review?
a. Rheumatoid factor (RF)
b. Antinuclear antibody (ANA)
c. Anti-Smith antibody (Anti-Sm)
d. Lupus erythematosus (LE) cell prep
c. Anti-Smith antibody (Anti-Sm)
When caring for a patient with gout and a red and painful left great toe, which nursing action will be included in the plan of care?
a. Gently palpate the toe to assess swelling.
b. Use pillows to keep the left foot elevated.
c. Use a footboard to hold bedding away from the toe.
d. Teach patient to avoid use of acetaminophen (Tylenol).
c. Use a footboard to hold bedding away from the toe.
