Muscular 1

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  • 1/40 Questions

    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) Petechiae
    • B) Butterfly rash across bridge of nose and cheeks
    • C) Absence of wrinkles
    • D) Weight gain
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Muscular 1 - Quiz
About This Quiz

The 'Muscular 1' quiz assesses knowledge on rheumatic diseases, focusing on procedures, medications, symptoms, and pathophysiology related to conditions like arthritis, lupus, and gout. It is designed to enhance understanding and application in clinical settings, making it crucial for nursing and health science students.

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  • 2. 

    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) Antimalarial agents

    • B) NSAIDs

    • C) Xanthine oxidase inhibitors

    • D) Uricosuric agents

    Correct Answer
    A. B) NSAIDs
    Explanation
    In the early stage of rheumatoid arthritis, the nurse would expect NSAIDs to be ordered for the patient. NSAIDs (nonsteroidal anti-inflammatory drugs) are commonly used to manage the symptoms of rheumatoid arthritis, such as pain and inflammation. They work by reducing inflammation and relieving pain, allowing the patient to have better mobility and quality of life. Other medication classifications listed in the options, such as antimalarial agents, xanthine oxidase inhibitors, and uricosuric agents, are not typically used for the treatment of rheumatoid arthritis.

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  • 3. 

    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) Cool extremities

    • B) Butterfly rash on face

    • C) Joint stiffness

    • D) Absence of wrinkles

    Correct Answer
    A. C) Joint stiffness
    Explanation
    Joint stiffness is a classic sign of rheumatoid arthritis. This is characterized by difficulty in moving the affected joints, especially in the morning or after periods of inactivity. Joint stiffness can lead to decreased range of motion and functional impairment. It is a common symptom of rheumatoid arthritis and is caused by inflammation and swelling in the joints.

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  • 4. 

    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) "You seem angry. Would you like to talk about it?"

    • B) "Calm down. You know that stress will make your symptoms worse."

    • C) "Would you like to talk about the problem with the nursing supervisor?"

    • 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?"
    Explanation
    The most appropriate response in this situation is to acknowledge the patient's anger and offer a listening ear by saying, "You seem angry. Would you like to talk about it?" This response shows empathy and validates the patient's feelings, allowing them to express their emotions and concerns. It creates an opportunity for open communication and helps build a therapeutic relationship between the patient and the nurse.

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  • 5. 

    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) “OA is a considered a noninflammatory joint disease. RA is characterized by inflamed, swollen joints.”

    • B) ” OA and RA are very similar. OA affects the smaller joints, and RA affects the larger, weight-bearing joints.”

    • C) “OA affects joints on both sides of the body. RA is usually unilateral.”

    • 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.”
    Explanation
    The best response by the nurse is A) “OA is considered a noninflammatory joint disease. RA is characterized by inflamed, swollen joints.” This response accurately distinguishes between OA and RA. OA is a degenerative joint disease that is noninflammatory, while RA is an autoimmune disease that causes inflammation and swelling in the joints. This explanation provides a clear and concise differentiation between the two conditions.

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  • 6. 

    23.  What causes the inflammatory response in a patient diagnosed with gout?

    • A) Phosphate crystals

    • B) Calcium crystals

    • C) Urate crystals

    • D) Sodium crystals

    Correct Answer
    A. C) Urate crystals
    Explanation
    The inflammatory response in a patient diagnosed with gout is caused by urate crystals. Gout is a type of arthritis that occurs when there is a buildup of uric acid in the blood, leading to the formation of urate crystals in the joints. These crystals can trigger an immune response, resulting in inflammation, pain, and swelling in the affected joint.

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  • 7. 

    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) “Don't worry about why it hurts, let's just concentrate on taking away the pain.”

    • B) “You are hurting because you aren't following your treatment regimen.”

    • C) “The pain you are feeling is psychological. What is going on in your life to make you hurt so bad?”

    • D) “You are experiencing pain from irritated nerve endings and muscle spasms.”

    Correct Answer
    A. D) “You are experiencing pain from irritated nerve endings and muscle spasms.”
    Explanation
    The nurse's best response would be D) "You are experiencing pain from irritated nerve endings and muscle spasms." This response provides a clear and accurate explanation for the patient's pain. Osteoarthritis is a condition that causes the breakdown of cartilage in the joints, leading to inflammation, irritation of nerve endings, and muscle spasms. By explaining this, the nurse helps the patient understand the source of their pain and can provide appropriate interventions to manage it effectively.

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  • 8. 

    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) “Taking care of you in the best way involves seeing you face-to-face.”

    • B) “Taking care of you in the best way involves making sure you are taking your medication the way it is ordered.”

    • 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) “Taking care of you in the best way involves drawing blood work every month.”

    Correct Answer
    A. C) “Taking care of you in the best way involves monitoring your disease activity and how well the prescribed treatment is controlling the disease.”
    Explanation
    The nurse's best response would be C) "Taking care of you in the best way involves monitoring your disease activity and how well the prescribed treatment is controlling the disease." This response explains the importance of regular check-ups in order to assess the patient's disease activity and the effectiveness of their treatment. It emphasizes the need for ongoing monitoring to ensure that the patient's condition is well-managed.

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  • 9. 

    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) Thrombocytopenia

    • B) Hypouricemia

    • C) Hyperuricemia

    • D) Hypocalcemia

    Correct Answer
    A. C) Hyperuricemia
    Explanation
    Gout is a type of arthritis that occurs when there is a build-up of uric acid in the blood, leading to the formation of urate crystals in the joints. Hyperuricemia refers to elevated levels of uric acid in the blood, which is a major causative factor in the development of gout. Thrombocytopenia refers to low platelet count, hypouricemia refers to low levels of uric acid in the blood, and hypocalcemia refers to low levels of calcium in the blood, none of which are directly related to the pathophysiology of gout.

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  • 10. 

    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) Smoking

    • B) Obesity

    • C) Weight loss

    • D) Less than 20 years of age

    Correct Answer
    A. B) Obesity
    Explanation
    Obesity is a well-recognized risk factor for osteoarthritis. Excessive weight puts extra stress on the joints, particularly the weight-bearing joints such as the knees and hips. This increased stress can lead to the breakdown of cartilage and the development of osteoarthritis. Maintaining a healthy weight can help reduce the risk of developing OA and can also help manage symptoms in those who already have the condition. Smoking, weight loss, and age less than 20 are not recognized as risk factors for osteoarthritis.

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  • 11. 

    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) Angiography

    • B) Myelography

    • C) Paracentesis

    • D) Arthocentesis

    Correct Answer
    A. D) Arthocentesis
    Explanation
    The correct procedure for retrieving synovial fluid from the knee for a definitive diagnosis is arthrocentesis. Arthrocentesis involves inserting a needle into the joint space to aspirate the synovial fluid. Angiography is a procedure used to visualize blood vessels, Myelography is used to visualize the spinal cord, and Paracentesis is used to remove fluid from the abdominal cavity. None of these procedures are appropriate for retrieving synovial fluid from the knee.

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  • 12. 

    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) Maintain body weight at 10% below recommendation of weight for height

    • B) Restrict consumption of foods high in purines

    • C) Stop smoking

    • D) Restrict weight bearing on right foot

    Correct Answer
    A. B) Restrict consumption of foods high in purines
    Explanation
    Gout is a form of arthritis caused by a buildup of uric acid crystals in the joints, which leads to inflammation and pain. Purines are substances found in certain foods that are broken down into uric acid in the body. By restricting consumption of foods high in purines, the patient can help reduce the levels of uric acid in their body, which can help manage the symptoms of gout. Maintaining a healthy body weight, quitting smoking, and restricting weight bearing on the right foot may be beneficial for overall health, but they are not specifically important factors in the management of gout.

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  • 13. 

    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) Infection

    • B) Nystagmus

    • C) Muscle rigidity

    • D) Hyperthermia

    Correct Answer
    A. A) Infection
    Explanation
    The nurse must be alert to the side effect of infection when administering cyclophosphamide (Cytoxan) because it is an immunosuppressant medication. Rheumatoid arthritis is an autoimmune disease where the immune system attacks the body's own tissues, causing inflammation and joint damage. Cyclophosphamide works by suppressing the immune system to reduce inflammation. However, this also makes the patient more susceptible to infections because their immune system is weakened. Therefore, the nurse must closely monitor the patient for any signs of infection and take appropriate measures to prevent and treat infections.

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  • 14. 

    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) Raynaud's phenomenon

    • B) Reye's syndrome

    • C) Rhintis

    • D) Renal failure

    Correct Answer
    A. A) Raynaud's phenomenon
    Explanation
    The "R" in CREST stands for Raynaud's phenomenon. Raynaud's phenomenon is a condition where the blood vessels in the fingers and toes constrict in response to cold temperatures or stress, causing them to turn white or blue and feel numb or painful. It is commonly associated with scleroderma, a chronic autoimmune disease that causes hardening and tightening of the skin and connective tissues.

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  • 15. 

    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) Rheumatoid arthritis (RA)

    • B) Systemic lupus erythematosus

    • C) Osteoporosis

    • D) Polymyositis

    Correct Answer
    A. A) Rheumatoid arthritis (RA)
    Explanation
    Rheumatoid arthritis (RA) is a diffuse connective tissue disease that is caused by an autoimmune reaction. This reaction leads to phagocytosis, which produces enzymes within the joint. These enzymes break down collagen and cause edema. Therefore, RA is the correct answer to the question.

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  • 16. 

    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) Teaching about refraining from sing lotions on the skin

    • B) Teaching about the disease itself

    • C) Teaching about nutrition

    • D) Teaching about renal calculi

    Correct Answer
    A. B) Teaching about the disease itself
    Explanation
    A priority parameter for the teaching plan for a newly diagnosed patient with systemic lupus erythematosus would be teaching about the disease itself. This is because understanding the disease is crucial for the patient to manage their condition effectively. By educating the patient about the disease, its symptoms, progression, and potential complications, they will be better equipped to make informed decisions about their treatment, lifestyle changes, and self-care. This knowledge will empower the patient to actively participate in their own care and improve their overall quality of life.

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  • 17. 

    25.  A patient is suspected of having a rheumatic disorder. What is one laboratory test the nurse would expect the physician to order?

    • A) Erythrocyte count

    • B) Erythrocyte sedimentation rate

    • C) Creatinine clearance

    • D) Basic metabolic panel

    Correct Answer
    A. B) Erythrocyte sedimentation rate
    Explanation
    The nurse would expect the physician to order an erythrocyte sedimentation rate (ESR) test. This test measures the rate at which red blood cells settle in a tube over a certain period of time. It is a non-specific test that can help detect inflammation in the body. In rheumatic disorders, such as rheumatoid arthritis or systemic lupus erythematosus, there is often increased inflammation present. Therefore, an ESR test can be helpful in diagnosing or monitoring these conditions. The other options (erythrocyte count, creatinine clearance, and basic metabolic panel) are not specific tests for rheumatic disorders.

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  • 18. 

    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) Joint pain, crepitus, Heberden's nodes

    • B) Hot, inflamed joints; crepitus; joint pain

    • C) Tophi, enlarged joints, Bouchard's nodes

    • D) Swelling, joint pain, tenderness on palpation

    Correct Answer
    A. A) Joint pain, crepitus, Heberden's nodes
    Explanation
    Osteoarthritis is a degenerative joint disease that commonly affects older individuals. Joint pain is a hallmark symptom of osteoarthritis, as the cartilage in the joints wears down and causes friction and inflammation. Crepitus, which is a crackling or grinding sensation in the joints, is also common. Heberden's nodes, which are bony growths that develop on the finger joints, are a characteristic sign of osteoarthritis. Therefore, option A is the most likely set of signs and symptoms that the nurse will find during the initial assessment of a patient with a history of osteoarthritis.

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  • 19. 

    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) Tinnitus

    • B) Visual changes

    • C) Stomatitis

    • D) Hirsutism

    Correct Answer
    A. A) Tinnitus
    Explanation
    The nurse is developing a teaching plan for a patient with rheumatic disease who is being prescribed salicylate therapy. Salicylates are known to cause tinnitus, which is a ringing or buzzing sound in the ears. Therefore, the patient should be instructed to monitor herself for tinnitus as a potential side effect of the medication.

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  • 20. 

    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) Impaired skin integrity

    • B) Altered Nutrition

    • C) Disturbed sleep pattern

    • D) Fatigue

    Correct Answer
    A. D) Fatigue
    Explanation
    The priority nursing diagnosis for a patient newly diagnosed with fibromyalgia would be fatigue. Fibromyalgia is a chronic condition characterized by widespread pain and fatigue. Fatigue is a common symptom experienced by individuals with fibromyalgia and can significantly impact their quality of life. Addressing and managing fatigue would be a priority in the care plan to help improve the patient's overall well-being and ability to perform daily activities.

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  • 21. 

    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) Get as much exposure to sunlight as possible to help control skin rashes.

    • B) Be as active as possible between flare-ups.

    • C) Monitor body temperature.

    • D) Stop her corticosteroids when symptoms are relieved.

    Correct Answer
    A. C) Monitor body temperature.
    Explanation
    The correct answer is C) Monitor body temperature. This is the correct answer because monitoring body temperature is important for patients with systemic lupus erythematosus (SLE) as it can be an indicator of infection or inflammation. It is important for the patient to be aware of any changes in body temperature and report them to their healthcare provider. Sunlight exposure can actually trigger flare-ups in SLE, so option A is incorrect. Being active between flare-ups is beneficial, but it is not the best indicator of understanding patient teaching. Stopping corticosteroids without medical guidance can be dangerous, so option D is incorrect.

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  • 22. 

    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) Polymyositis

    • B) Polymyalgia rheumatica

    • C) Psoriatic arthritis

    • D) Scleroderma

    Correct Answer
    A. D) Scleroderma
    Explanation
    Scleroderma is a rheumatic disorder that can be diagnosed through a skin biopsy. This procedure involves taking a small sample of skin tissue to examine it under a microscope. In scleroderma, the skin biopsy can reveal characteristic changes such as thickening and hardening of the skin, as well as abnormal collagen deposits. This diagnostic test helps to confirm the presence of scleroderma and differentiate it from other rheumatic disorders.

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  • 23. 

    28.  A 21-year-old male has just been diagnosed with a spondyloarthropathy. What will be a major nursing intervention for this patient?

    • A) Referral for assistive devices

    • B) Teaching about symptom management

    • C) Referral to classes to stop smoking

    • D) Setting up an exercise program

    Correct Answer
    A. B) Teaching about symptom management
    Explanation
    Teaching about symptom management is a major nursing intervention for a 21-year-old male diagnosed with spondyloarthropathy. This intervention is important because it helps the patient understand and learn how to manage their symptoms effectively. By teaching the patient about symptom management, the nurse can provide information on medication management, pain management techniques, and lifestyle modifications that can help improve the patient's quality of life and reduce the impact of the disease on their daily activities.

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  • 24. 

    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) Tinnitus

    • B) Visual changes

    • C) Stomatitis

    • D) Hirsutism

    Correct Answer
    A. B) Visual changes
    Explanation
    The nurse should teach the patient to monitor herself for visual changes because antimalarials can cause retinal toxicity, which can lead to vision problems. Monitoring for visual changes is important to catch any potential issues early and prevent further damage to the eyes. Tinnitus refers to ringing in the ears and is not a common side effect of antimalarials. Stomatitis refers to inflammation of the mouth and hirsutism refers to excessive hair growth, neither of which are related to antimalarial use.

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  • 25. 

    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) Have a neighbor come over and open the bottles for you.

    • B) Have a family member come and open the bottles for you.

    • C) Take your medicine bottles back to the pharmacy and have them put tops on them that are not childproof.

    • D) Get a 7-day pill holder and have someone fill it for you each week.

    Correct Answer
    A. C) Take your medicine bottles back to the pharmacy and have them put tops on them that are not childproof.
    Explanation
    The suggestion to take the medicine bottles back to the pharmacy and have them put tops on them that are not childproof would be the most helpful to the patient. This would address the patient's difficulty in opening the child-proof tops and make it easier for her to access her medication. Having someone else open the bottles for her (options A and B) may not always be feasible or convenient. Getting a 7-day pill holder and having someone fill it for her (option D) may not address the issue of the child-proof tops. Therefore, option C is the most practical and effective solution.

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  • 26. 

    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) Thrombocytopenia

    • B) Elevated hemoglobin level

    • C) Negative antinuclear antibodies level

    • D) Proteinuria

    Correct Answer
    A. A) Thrombocytopenia
    Explanation
    Thrombocytopenia, or low platelet count, is a typical diagnostic finding related to systemic lupus erythematosus. This is because the immune system in patients with lupus may attack and destroy platelets, leading to a decrease in their numbers. Thrombocytopenia can result in an increased risk of bleeding and bruising in these patients. Elevated hemoglobin level, negative antinuclear antibodies level, and proteinuria are not specific diagnostic findings for systemic lupus erythematosus.

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  • 27. 

    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) Hyperuricemia

    • B) Increased erythrocyte sedimentation rate

    • C) Elevated serum creatinine

    • D) Decreased platelets

    Correct Answer
    A. D) Decreased platelets
    Explanation
    A decreased platelet count would indicate bone marrow suppression in this patient. Bone marrow suppression can occur as a side effect of Allopurinol, which is used to treat gout. Platelets are produced in the bone marrow, so a decrease in platelet count suggests that the bone marrow is not functioning properly. This can lead to an increased risk of bleeding and difficulty in clotting. Monitoring platelet levels is important to ensure the safety and well-being of the patient.

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  • 28. 

    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) Exercises to strengthen the muscles

    • B) Possible assistive devices to help with ADLs

    • C) Family educational needs

    • D) Social support network

    Correct Answer
    A. B) Possible assistive devices to help with ADLs
    Explanation
    The home health nurse is asking for a referral to an OT and PT to assess for possible assistive devices to help with activities of daily living (ADLs). This suggests that the patient's proximal muscle weakness is affecting their ability to perform daily tasks independently. The OT and PT can evaluate the patient's functional abilities and recommend assistive devices such as grab bars, walkers, or adaptive equipment to improve their independence and quality of life.

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  • 29. 

    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) Too much activity

    • B) Lack of fluid in the joints

    • C) Calcemia

    • D) Pannus

    Correct Answer
    A. D) Pannus
    Explanation
    The instructor would explain that the cause of degeneration in rheumatic disorders is pannus. Pannus refers to the abnormal tissue growth that occurs in the synovial membrane of the joints affected by rheumatic disorders. This tissue growth leads to inflammation, erosion of cartilage, and ultimately degeneration of the joint.

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  • 30. 

    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) Acute exacerbation, severe pain

    • B) Subacute exacerbation, moderate pain

    • C) Subacute exacerbation, minimal pain

    • D) Remission

    Correct Answer
    A. A) Acute exacerbation, severe pain
    Explanation
    During the acute exacerbation phase of the inflammatory process, the patient experiences severe pain. Performing passive range of motion exercises during this phase is acceptable because it helps maintain joint mobility and prevents stiffness.

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  • 31. 

    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) Heart failure

    • B) Mitral valve failure

    • C) Pericardial friction rub

    • D) Pericardial effusion

    Correct Answer
    A. C) Pericardial friction rub
    Explanation
    When the nurse assesses the patient's cardiovascular system, one thing that is being assessed for is the presence of a pericardial friction rub. A pericardial friction rub is a high-pitched, scratchy sound heard on auscultation of the heart that indicates inflammation of the pericardium. This can be a sign of pericarditis, which can occur in patients with systemic lupus erythematosus (SLE). The presence of a pericardial friction rub can help the nurse identify any cardiac involvement in the patient with SLE.

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  • 32. 

    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) Increase the dosage of the medication.

    • B) Arrange for patient to be hospitalized.

    • C) Refer to psychologist for help improving self-image.

    • D) Decrease the dosage of the medication.

    Correct Answer
    A. D) Decrease the dosage of the medication.
    Explanation
    The patient is experiencing mild side effects from the medication and worsening of their disease, which suggests that the current dosage of the medication may be too high. Decreasing the dosage of the medication would be an appropriate response to address the side effects and potentially improve the patient's condition. Hospitalization or referral to a psychologist would not be necessary based on the information provided.

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  • 33. 

    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) Corticosteroids

    • B) Gold-containing compounds

    • C) Antimalarials

    • D) Salicylate therapy

    Correct Answer
    A. B) Gold-containing compounds
    Explanation
    A patient with rheumatic disease complaining of stomatitis should be further assessed for the side effects of gold-containing compounds. Gold-containing compounds, such as gold salts or gold injections, are sometimes used to treat rheumatic diseases like rheumatoid arthritis. However, stomatitis is a known side effect of these medications. Stomatitis refers to inflammation or sores in the mouth, which can cause pain and discomfort for the patient. Therefore, it is important for the nurse to assess the patient for any signs or symptoms of stomatitis and monitor for other potential side effects of gold-containing compounds.

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  • 34. 

    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) Recommend to the physician that the patient be hospitalized.

    • B) Ask the physician for a referral to an arthritis support group in the community.

    • C) Make a referral for home health so the patient can be assessed in her own environment.

    • D) Make referrals for occupational therapy and physical therapy.

    Correct Answer
    A. C) Make a referral for home health so the patient can be assessed in her own environment.
    Explanation
    An appropriate intervention for the nurse to make for this patient would be to make a referral for home health so the patient can be assessed in her own environment. This is because the patient has lost some of her ability to function since her last office visit, and assessing her in her own environment can provide valuable information about any barriers or challenges she may be facing in her daily life. This can help the healthcare team develop a more comprehensive and individualized care plan for the patient.

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  • 35. 

    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) Hepatic

    • B) Gastrointestinal

    • C) Musculoskeletal

    • D) Neurologic

    Correct Answer
    A. B) Gastrointestinal
    Explanation
    The nurse knows that the physician will order tests to assess for gastrointestinal involvement in the patient with scleroderma. Scleroderma is a chronic autoimmune disease that affects the connective tissue, causing hardening and tightening of the skin and other organs. Gastrointestinal involvement is common in scleroderma and can lead to symptoms such as difficulty swallowing, acid reflux, bloating, diarrhea, and constipation. Therefore, it is important to assess the gastrointestinal system in these patients to monitor for any complications or abnormalities.

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  • 36. 

    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) Diet

    • B) Activity limitations

    • C) Signs and symptoms of exacerbation

    • D) The side effects of the medications

    Correct Answer
    A. D) The side effects of the medications
    Explanation
    The priority subject the nurse needs to teach a patient newly diagnosed with rheumatoid arthritis is the side effects of the medications. This is important because the patient needs to be aware of the potential adverse effects of the medications they will be taking in order to manage their condition. Understanding the side effects will allow the patient to recognize and report any concerning symptoms to their healthcare provider. This knowledge will help the patient make informed decisions about their treatment and ensure their safety and well-being.

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  • 37. 

    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) “Sometimes you just have to push through the pain to do things you like to do.”

    • B) “I will get you a referral for physical therapy.”

    • C) “I am sure you can find other things you like to do just as well.”

    • D) “Your inability to do things you used to do is telling you that your disease is getting worse.”

    Correct Answer
    A. D) “Your inability to do things you used to do is telling you that your disease is getting worse.”
    Explanation
    The nurse's best response would be D) "Your inability to do things you used to do is telling you that your disease is getting worse." This response acknowledges the patient's concerns and validates their experience. It also provides important information about the progression of rheumatoid arthritis, indicating that the disease is worsening. This response shows empathy and understanding towards the patient's situation.

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  • 38. 

    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) There is an association with the genetic marker HLA-DR4

    • B) Immunoglobulin deposits suggest an autoimmune process

    • C) Occurs predominately in Asians

    • D) There is no genetic association known

    • E) Occurs predominately in Caucasians

    Correct Answer(s)
    A. A) There is an association with the genetic marker HLA-DR4
    A. B) Immunoglobulin deposits suggest an autoimmune process
    A. E) Occurs predominately in Caucasians
    Explanation
    Polymyalgia rheumatica is a rheumatic disorder characterized by pain and stiffness in the muscles, particularly in the shoulders and hips. The correct answers are A, B, and E.

    A) There is an association with the genetic marker HLA-DR4: This suggests a genetic predisposition to developing polymyalgia rheumatica.

    B) Immunoglobulin deposits suggest an autoimmune process: The presence of immunoglobulin deposits indicates an immune system dysfunction, suggesting an autoimmune process in the development of polymyalgia rheumatica.

    E) Occurs predominately in Caucasians: Polymyalgia rheumatica is more commonly seen in Caucasians compared to other ethnic groups.

    These factors contribute to the understanding of the pathophysiology of polymyalgia rheumatica.

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  • 39. 

    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) To avoid complications of giant cell arteritis, such as deafness

    • B) To avoid complications of small cell arteritis such as osteoporosis

    • C) To avoid complications of small cell arteritis such as degenerative joint disease

    • D) To avoid complications of giant cell arteritis, such as blindness

    Correct Answer
    A. D) To avoid complications of giant cell arteritis, such as blindness
    Explanation
    The nurse must emphasize the need for continued adherence to the prescribed medication because stopping the medication prematurely can lead to complications of giant cell arteritis, such as blindness. Giant cell arteritis is a condition commonly associated with polymyalgia rheumatica, and it can cause inflammation of the blood vessels in the head, including the arteries that supply blood to the eyes. If left untreated or if medication is stopped too early, it can result in permanent vision loss. Therefore, it is crucial for the patient to continue taking the prescribed medication to prevent these serious complications.

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  • 40. 

    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) Physical limitations and adaptations

    • B) Nutrition and weight maintenance

    • C) The disorder itself

    • D) Possible changes related to the disorder

    • E) Patient safety in the home

    Correct Answer(s)
    A. C) The disorder itself
    A. D) Possible changes related to the disorder
    A. E) Patient safety in the home
    Explanation
    The teaching for this patient will focus on the disorder itself, possible changes related to the disorder, and patient safety in the home. Rheumatoid arthritis is a chronic autoimmune disease that causes inflammation and pain in the joints. It is important for the patient to understand the nature of the disorder, its symptoms, and treatment options. The teaching should also cover possible changes that may occur as a result of the disorder, such as limitations in mobility and daily activities. Patient safety in the home is important to prevent falls and injuries, as well as to promote independence and quality of life.

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Quiz Review Timeline (Updated): Mar 21, 2023 +

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  • Mar 21, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Mar 12, 2012
    Quiz Created by
    Justin82
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