Muscular
- 1.
35. The clinic nurse is caring for a patient diagnosed with rheumatoid arthritis. The patient tells you she has not been taking her medication because she cannot get the medicine bottle open. The patient says it is too hard to get the child-proof tops off the bottle. What suggestion could you make that would be the most helpful to your patient, aiding her in being more compliant with her medication treatment regimen?
- A.
A) Have a neighbor come over and open the bottles for you.
- B.
B) Have a family member come and open the bottles for you.
- C.
C) Take your medicine bottles back to the pharmacy and have them put tops on them that are not childproof.
- D.
D) Get a 7-day pill holder and have someone fill it for you each week.
Correct Answer
C. C) Take your medicine bottles back to the pharmacy and have them put tops on them that are not childproof. -
- 2.
40. You are assessing a patient diagnosed with rheumatoid arthritis. The patient tells you that the first joint involved was the right knee. The patient goes on to say that he used to love to walk but just can't handle much of it anymore. What would be the nurse's best response?
- A.
A) “Sometimes you just have to push through the pain to do things you like to do.”
- B.
B) “I will get you a referral for physical therapy.”
- C.
C) “I am sure you can find other things you like to do just as well.”
- D.
D) “Your inability to do things you used to do is telling you that your disease is getting worse.”
Correct Answer
D. D) “Your inability to do things you used to do is telling you that your disease is getting worse.” -
- 3.
39. A patient with rheumatoid arthritis comes into the clinic for a routine check-up. On assessment the nurse notes the patient has lost some of her ability to function since her last office visit. What might be an appropriate intervention for the nurse to make for this patient?
- A.
A) Recommend to the physician that the patient be hospitalized.
- B.
B) Ask the physician for a referral to an arthritis support group in the community.
- C.
C) Make a referral for home health so the patient can be assessed in her own environment.
- D.
D) Make referrals for occupational therapy and physical therapy.
Correct Answer
C. C) Make a referral for home health so the patient can be assessed in her own environment. -
- 4.
37. The patient has just been told by his physician that he has scleroderma. The physician tells the patient that he is going to order some tests to assess for systemic involvement. The nurse knows that the systems to be assessed include what?
- A.
A) Hepatic
- B.
B) Gastrointestinal
- C.
C) Musculoskeletal
- D.
D) Neurologic
Correct Answer
B. B) Gastrointestinal -
- 5.
38. The nursing instructor is discussing the care of the patient with systemic lupus erythematosus. The instructor points out to the class of nursing students that a priority parameter for the teaching plan for a newly diagnosed patient is what?
- A.
A) Teaching about refraining from sing lotions on the skin
- B.
B) Teaching about the disease itself
- C.
C) Teaching about nutrition
- D.
D) Teaching about renal calculi
Correct Answer
B. B) Teaching about the disease itself -
- 6.
36. A patient with rheumatoid arthritis calls the nurse and reports having mild side effects from his medication. The patient also tells the nurse his disease is worse and he is losing some of his ability to function. The nurse schedules an appointment for the patient to see the physician that afternoon. What order might the nurse expect to receive from the physician for this patient?
- A.
A) Increase the dosage of the medication.
- B.
B) Arrange for patient to be hospitalized.
- C.
C) Refer to psychologist for help improving self-image.
- D.
D) Decrease the dosage of the medication.
Correct Answer
D. D) Decrease the dosage of the medication. -
- 7.
32. A 25-year-old mother of a 6-month-old has just been diagnosed with rheumatoid arthritis. The nurse is planning the teaching for this patient. What will the teaching focus on? (Mark all that apply.)
- A.
A) Physical limitations and adaptations
- B.
B) Nutrition and weight maintenance
- C.
C) The disorder itself
- D.
D) Possible changes related to the disorder
- E.
E) Patient safety in the home
Correct Answer(s)
C. C) The disorder itself
D. D) Possible changes related to the disorder
E. E) Patient safety in the home -
- 8.
33. You are preparing a teaching plan for a patient newly diagnosed with rheumatoid arthritis. What is a priority subject the nurse needs to teach this patient?
- A.
A) Diet
- B.
B) Activity limitations
- C.
C) Signs and symptoms of exacerbation
- D.
D) The side effects of the medications
Correct Answer
D. D) The side effects of the medications -
- 9.
34. A patient with rheumatoid arthritis comes to the clinic complaining of pain in the joint of the right big toe. The patient is diagnosed with gout. When planning teaching for this patient, what would the nurse know is an important factor in the management of this disease?
- A.
A) Maintain body weight at 10% below recommendation of weight for height
- B.
B) Restrict consumption of foods high in purines
- C.
C) Stop smoking
- D.
D) Restrict weight bearing on right foot
Correct Answer
B. B) Restrict consumption of foods high in purines -
- 10.
26. A patient with SLE has come to the clinic for a routine check-up. Each time the patient is routinely examined several systems are assessed. When the nurse assesses the patient's cardiovascular system what is one thing that is being assessed for?
- A.
A) Heart failure
- B.
B) Mitral valve failure
- C.
C) Pericardial friction rub
- D.
D) Pericardial effusion
Correct Answer
C. C) Pericardial friction rub -
- 11.
27. You are studying the rheumatic disorders. You should know that one rheumatic disorder has as its diagnostic test a skin biopsy. Which disorder is it?
- A.
A) Polymyositis
- B.
B) Polymyalgia rheumatica
- C.
C) Psoriatic arthritis
- D.
D) Scleroderma
Correct Answer
D. D) Scleroderma -
- 12.
28. A 21-year-old male has just been diagnosed with a spondyloarthropathy. What will be a major nursing intervention for this patient?
- A.
A) Referral for assistive devices
- B.
B) Teaching about symptom management
- C.
C) Referral to classes to stop smoking
- D.
D) Setting up an exercise program
Correct Answer
B. B) Teaching about symptom management -
- 13.
29. A patient with SLE asks the nurse why she has to come to the office so often for “check-ups.” What would be the nurse's best response?
- A.
A) “Taking care of you in the best way involves seeing you face-to-face.”
- B.
B) “Taking care of you in the best way involves making sure you are taking your medication the way it is ordered.”
- C.
C) “Taking care of you in the best way involves monitoring your disease activity and how well the prescribed treatment is controlling the disease.”
- D.
D) “Taking care of you in the best way involves drawing blood work every month.”
Correct Answer
C. C) “Taking care of you in the best way involves monitoring your disease activity and how well the prescribed treatment is controlling the disease.” -
- 14.
30. The patient is diagnosed with polymyalgia rheumatica and is placed on steroids. A concern for this patient is that he will stop taking the medication as soon as he starts to feel better. Why must the nurse emphasize the need for continued adherence to the prescribed medication?
- A.
A) To avoid complications of giant cell arteritis, such as deafness
- B.
B) To avoid complications of small cell arteritis such as osteoporosis
- C.
C) To avoid complications of small cell arteritis such as degenerative joint disease
- D.
D) To avoid complications of giant cell arteritis, such as blindness
Correct Answer
D. D) To avoid complications of giant cell arteritis, such as blindness -
- 15.
14. A nurse is caring for a 78-year-old patient with a history of osteoarthritis. When doing the initial assessment the nurse knows that he will most probably find what signs and symptoms?
- A.
A) Joint pain, crepitus, Heberden's nodes
- B.
B) Hot, inflamed joints; crepitus; joint pain
- C.
C) Tophi, enlarged joints, Bouchard's nodes
- D.
D) Swelling, joint pain, tenderness on palpation
Correct Answer
A. A) Joint pain, crepitus, Heberden's nodes -
- 16.
15. A patient who has been newly diagnosed with systemic lupus erythematosus has been admitted to your unit. You know that a typical diagnostic finding related to this disease is what?
- A.
A) Thrombocytopenia
- B.
B) Elevated hemoglobin level
- C.
C) Negative antinuclear antibodies level
- D.
D) Proteinuria
Correct Answer
A. A) Thrombocytopenia -
- 17.
16. In talking with the nursing students about scleroderma the nursing instructor refers to the CREST syndrome. These are clinical manifestations that may be related to scleroderma. What does the “R” in CREST stand for?
- A.
A) Raynaud's phenomenon
- B.
B) Reye's syndrome
- C.
C) Rhintis
- D.
D) Renal failure
Correct Answer
A. A) Raynaud's phenomenon -
- 18.
17. Allopurinol (Zyloprim) has been ordered for a patient receiving treatment for gout. The nurse caring for this patient would know that what laboratory finding would indicate bone marrow suppression in this patient?
- A.
A) Hyperuricemia
- B.
B) Increased erythrocyte sedimentation rate
- C.
C) Elevated serum creatinine
- D.
D) Decreased platelets
Correct Answer
D. D) Decreased platelets -
- 19.
18. A patient with rheumatic disease is complaining of stomatitis. The nurse caring for the patient should further assess the patient for the side effects of what medications?
- A.
A) Corticosteroids
- B.
B) Gold-containing compounds
- C.
C) Antimalarials
- D.
D) Salicylate therapy
Correct Answer
B. B) Gold-containing compounds -
- 20.
19. The nurse is planning patient education for a patient being discharged home with a diagnosis of rheumatic disease. The patient has been prescribed antimalarials for treatment, so the nurse knows to teach the patient to monitor herself for what?
- A.
A) Tinnitus
- B.
B) Visual changes
- C.
C) Stomatitis
- D.
D) Hirsutism
Correct Answer
B. B) Visual changes -
- 21.
20. The nurse is developing a teaching plan for a patient with rheumatic disease who is being prescribed salicylate therapy to monitor herself for what?
- A.
A) Tinnitus
- B.
B) Visual changes
- C.
C) Stomatitis
- D.
D) Hirsutism
Correct Answer
A. A) Tinnitus -
- 22.
21. In your pathophysiology class you are studying the rheumatic disorders. What should you learn about polymyalgia rheumatica and its pathophysiology? (Mark all that apply.)
- A.
A) There is an association with the genetic marker HLA-DR4
- B.
B) Immunoglobulin deposits suggest an autoimmune process
- C.
C) Occurs predominately in Asians
- D.
D) There is no genetic association known
- E.
E) Occurs predominately in Caucasians
Correct Answer(s)
A. A) There is an association with the genetic marker HLA-DR4
B. B) Immunoglobulin deposits suggest an autoimmune process
E. E) Occurs predominately in Caucasians -
- 23.
7. A patient has been has been admitted to your unit with a diagnoses of rheumatoid arthritis. The nurse documents joint pain and swelling in her initial assessment. In addition to these findings, what is a classic sign of rheumatoid arthritis?
- A.
A) Cool extremities
- B.
B) Butterfly rash on face
- C.
C) Joint stiffness
- D.
D) Absence of wrinkles
Correct Answer
C. C) Joint stiffness -
- 24.
31. You are discussing a patient with polymyositis with a care team consisting of a physician, a social worker, OT and PT, and a home health nurse. The home health nurse reports that the patient's proximal muscle weakness has gotten more pronounced. The home health nurse asks for a referral to and OT and PT to assess for what?
- A.
A) Exercises to strengthen the muscles
- B.
B) Possible assistive devices to help with ADLs
- C.
C) Family educational needs
- D.
D) Social support network
Correct Answer
B. B) Possible assistive devices to help with ADLs -
- 25.
25. A patient is suspected of having a rheumatic disorder. What is one laboratory test the nurse would expect the physician to order?
- A.
A) Erythrocyte count
- B.
B) Erythrocyte sedimentation rate
- C.
C) Creatinine clearance
- D.
D) Basic metabolic panel
Correct Answer
B. B) Erythrocyte sedimentation rate -
- 26.
23. What causes the inflammatory response in a patient diagnosed with gout?
- A.
A) Phosphate crystals
- B.
B) Calcium crystals
- C.
C) Urate crystals
- D.
D) Sodium crystals
Correct Answer
C. C) Urate crystals -
- 27.
24. The pathophysiology instructor is discussing the disease process of rheumatic disorders. What would the instructor tell you is the cause of degeneration in the rheumatic disorders?
- A.
A) Too much activity
- B.
B) Lack of fluid in the joints
- C.
C) Calcemia
- D.
D) Pannus
Correct Answer
D. D) Pannus -
- 28.
22. A patient with osteoarthritis comes to the clinic because he is not able to control the pain. The patient asks the nurse why it hurts so bad. What would be the nurse's best response?
- A.
A) “Don't worry about why it hurts, let's just concentrate on taking away the pain.”
- B.
B) “You are hurting because you aren't following your treatment regimen.”
- C.
C) “The pain you are feeling is psychological. What is going on in your life to make you hurt so bad?”
- D.
D) “You are experiencing pain from irritated nerve endings and muscle spasms.”
Correct Answer
D. D) “You are experiencing pain from irritated nerve endings and muscle spasms.” -
- 29.
12. A patient with systemic lupus erythematosus (SLE) is getting ready for discharge. The nurse knows the patient has understood the patient teaching when the patient states she needs to what?
- A.
A) Get as much exposure to sunlight as possible to help control skin rashes.
- B.
B) Be as active as possible between flare-ups.
- C.
C) Monitor body temperature.
- D.
D) Stop her corticosteroids when symptoms are relieved.
Correct Answer
C. C) Monitor body temperature. -
- 30.
10. A nurse is caring for a patient newly diagnosed with osteoarthritis (OA). The patient asks the nurse what causes OA. What would the nurse tell the patient is a well-recognized risk factor for osteoarthritis?
- A.
A) Smoking
- B.
B) Obesity
- C.
C) Weight loss
- D.
D) Less than 20 years of age
Correct Answer
B. B) Obesity -
- 31.
11. You are caring for a 69-year-old patient who has just been admitted to your unit. The patient asks the nurse what the difference is between osteoarthritis (OA) and rheumatoid arthritis (RA). What is the best response by the nurse?
- A.
A) “OA is a considered a noninflammatory joint disease. RA is characterized by inflamed, swollen joints.”
- B.
B) ” OA and RA are very similar. OA affects the smaller joints, and RA affects the larger, weight-bearing joints.”
- C.
C) “OA affects joints on both sides of the body. RA is usually unilateral.”
- D.
D) “OA is more common in women. RA is more common in men.”
Correct Answer
A. A) “OA is a considered a noninflammatory joint disease. RA is characterized by inflamed, swollen joints.” -
- 32.
13. A patient with an exacerbation of his chronic systemic lupus erythematosus (SLE) has been hospitalized on your unit. He gets angry when his call bell isn't answered immediately. What would be the most appropriate response?
- A.
A) "You seem angry. Would you like to talk about it?"
- B.
B) "Calm down. You know that stress will make your symptoms worse."
- C.
C) "Would you like to talk about the problem with the nursing supervisor?"
- D.
D) "I can see you're angry. I'll come back when you've calmed down."
Correct Answer
A. A) "You seem angry. Would you like to talk about it?" -
- 33.
9. The clinic nurse is caring for a patient newly diagnosed with fibromyalgia. When developing a care plan for this patient, what would be a priority nursing diagnosis for this patient?
- A.
A) Impaired skin integrity
- B.
B) Altered Nutrition
- C.
C) Disturbed sleep pattern
- D.
D) Fatigue
Correct Answer
D. D) Fatigue -
- 34.
8. A patient has had rheumatoid arthritis for over 10 years. The physician has now ordered cyclophosphamide (Cytoxan) for treatment of the disease. The nurse must be alert to what side effects of this medication when administering an immunosuppressant?
- A.
A) Infection
- B.
B) Nystagmus
- C.
C) Muscle rigidity
- D.
D) Hyperthermia
Correct Answer
A. A) Infection -
- 35.
5. The nurse knows that as the symptoms of a disease change, modifications need to be made in the treatment plan. The nurse would teach the patient with rheumatic disease that it is acceptable to perform passive range of motion during which phase of the inflammatory process?
- A.
A) Acute exacerbation, severe pain
- B.
B) Subacute exacerbation, moderate pain
- C.
C) Subacute exacerbation, minimal pain
- D.
D) Remission
Correct Answer
A. A) Acute exacerbation, severe pain -
- 36.
6. The nursing instructor is talking with the pathophysiology class. What diffuse connective tissue disease would the instructor tell the class is the result of an autoimmune reaction that results in phagocytosis, producing enzymes within the joint that break down collagen and cause edema?
- A.
A) Rheumatoid arthritis (RA)
- B.
B) Systemic lupus erythematosus
- C.
C) Osteoporosis
- D.
D) Polymyositis
Correct Answer
A. A) Rheumatoid arthritis (RA) -
- 37.
3. You are doing the initial assessment of a patient admitted to your unit with systemic lupus erythematosus. What skin manifestation would the nurse expect to find on this patient?
- A.
A) Petechiae
- B.
B) Butterfly rash across bridge of nose and cheeks
- C.
C) Absence of wrinkles
- D.
D) Weight gain
Correct Answer
B. B) Butterfly rash across bridge of nose and cheeks -
- 38.
4. A clinic nurse is caring for a patient with suspected gout. While explaining the pathophysiology of gout to the patient, the nurse would include which of the following as a causative agent in gout?
- A.
A) Thrombocytopenia
- B.
B) Hypouricemia
- C.
C) Hyperuricemia
- D.
D) Hypocalcemia
Correct Answer
C. C) Hyperuricemia -
- 39.
1. A 44-year-old patient has been seen in the clinic for suspected arthritis. She is to undergo a procedure to retrieve synovial fluid from her knee for a definitive diagnosis. The nurse knows that which of the following procedures will be involved?
- A.
A) Angiography
- B.
B) Myelography
- C.
C) Paracentesis
- D.
D) Arthocentesis
Correct Answer
D. D) Arthocentesis -
- 40.
2. A patient in the early stage of rheumatoid arthritis has been admitted to your unit. What medication classification would the nurse expect to be ordered for this patient?
- A.
A) Antimalarial agents
- B.
B) NSAIDs
- C.
C) Xanthine oxidase inhibitors
- D.
D) Uricosuric agents
Correct Answer
B. B) NSAIDs -
- 41.
1. A nurse on the orthopedic floor is assessing her patient's peroneal nerve. The nurse will perform this assessment by pricking what?
- A.
A) The skin centered between the great and second toe
- B.
B) The medial and lateral surface of the sole
- C.
C) The skin centered between the thumb and second finger
- D.
D) The top or distal surface of the index finger
Correct Answer
A. A) The skin centered between the great and second toe -
- 42.
2. The nursing instructor is discussing disability in the United States. What would the instructor tell the students is the leading cause of disability in the United States?
- A.
A) Osteoporosis
- B.
B) Arthritis
- C.
C) Hip fractures
- D.
D) Long bone fractures
Correct Answer
B. B) Arthritis -
- 43.
3. You are caring for a patient whose laboratory studies show that the patient is hypocalcemic. When the nurse analyzes the other laboratory studies, the nurse will expect the results to reveal what?
- A.
A) An elevated parathyroid hormone level
- B.
B) A decreased parathyroid hormone level
- C.
C) An elevated potassium level
- D.
D) A decreased potassium level
Correct Answer
A. A) An elevated parathyroid hormone level -
- 44.
4. While doing an initial assessment on a patient, she tells the nurse that she has bone pain. The nurse asks the patient to describe the characteristics of the pain. Which of the following are typical characteristics of bone pain?
- A.
A) Dull, deep ache that is “boring” in nature
- B.
B) Soreness or aching that may include cramping
- C.
C) Sharp and piercing; relieved by immobilization
- D.
D) Spastic or sharp pain that radiates
Correct Answer
A. A) Dull, deep ache that is “boring” in nature -
- 45.
5. A nurse is doing an assessment on his patient for peripheral neurovascular dysfunction. What assessment findings may indicate to the nurse peripheral neurovascular dysfunction?
- A.
A) Pale, warm skin with a capillary refill of 1 to 2 seconds
- B.
B) Absence of feeling, capillary refill of 4 to 5 seconds and cool skin
- C.
C) Pain, increased motion, and redness of the skin
- D.
D) Jaundiced skin, weakness in motion, and capillary refill of 3 seconds
Correct Answer
B. B) Absence of feeling, capillary refill of 4 to 5 seconds and cool skin -
- 46.
6. An elderly patient has symptoms of osteoporosis and is being assessed during her annual physical examination. The assessment shows the patient will require further testing related to the symptoms of osteoporosis. The nurse informs the patient that the most accurate test for osteoporosis is what?
- A.
A) Hip bone densitometry (BMD)
- B.
B) A bone scan
- C.
C) Computed tomography (CT)
- D.
D) Magnetic resonance imaging (MRI)
Correct Answer
A. A) Hip bone densitometry (BMD) -
- 47.
7. A patient injured in a motor vehicle accident has sustained damage to the diaphysis of the right femur. What is the diaphysis of the femur mainly constructed of?
- A.
A) Epiphyses
- B.
B) Cartilage
- C.
C) Cortical bone
- D.
D) Cancellous bone
Correct Answer
C. C) Cortical bone -
- 48.
8. An elderly patient has come to the clinic for a regular check-up. While reviewing a patient's history, the nurse notes that the patient has an increased thoracic curvature of the spine. What is this referred to as?
- A.
A) Scoliosis
- B.
B) Epiphyses
- C.
C) Lordosis
- D.
D) Kyphosis
Correct Answer
D. D) Kyphosis -
- 49.
9. When assessing the patient's peripheral nerve function the nurse uses an instrument to prick the fat pad at the top of the small finger. This action will assess which of the following nerves?
- A.
A) Radial
- B.
B) Ulnar
- C.
C) Median
- D.
D) Tibial
Correct Answer
B. B) Ulnar -
- 50.
10. A patient comes to the free clinic to see the Nurse Practitioner. The Nurse Practitioner notices a spinal abnormality as she observes the patient standing. The Nurse Practitioner observes an increase in the lumbar curvature of the spine. She will document this finding on the assessment record as what?
- A.
A) Osteoporosis
- B.
B) Kyphosis
- C.
C) Lordosis
- D.
D) Scoliosis
Correct Answer
C. C) Lordosis -
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Nov 17, 2012Quiz Edited by
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