Chapter 18: Care of Patients with Arthritis and Other Connective Tissue Diseases

Chapter 18: Care of Patients with Arthritis and Other Connective Tissue Diseases

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A nurse is working with a community group promoting healthy aging. What recommendation is best to help prevent osteoarthritis (OA)?
   1. Avoid contact sports.
   2. Get plenty of calcium.
   3. Lose weight if needed.
   4. Engage in weight-bearing exercise.

ANS:   C

Obesity can lead to OA, and if the client is overweight, losing weight can help prevent OA or reduce symptoms once it occurs. Arthritis can be caused by contact sports, but this is less common than obesity. Calcium and weight-bearing exercise are both important for osteoporosis.

DIF:     Understanding/Comprehension         REF: 294                     KEY: Client teaching| health promotion| osteoarthritis| weight loss             MSC: Integrated Process: Teaching/Learning          NOT:   Client Needs Category: Health Promotion and Maintenance

2. A nurse in the family clinic is teaching a client newly diagnosed with osteoarthritis (OA) about drugs used to treat the disease. For which medication does the nurse plan primary teaching?
   1. Acetaminophen (Tylenol)
   2. Cyclobenzaprine hydrochloride (Flexeril)
   3. Hyaluronate (Hyalgan)
   4. Ibuprofen (Motrin)

ANS:   A

All of the drugs are appropriate to treat OA. However, the first-line drug is acetaminophen. Cyclobenzaprine is a muscle relaxant given to treat muscle spasms. Hyaluronate is a synthetic joint fluid implant. Ibuprofen is a nonsteroidal anti-inflammatory drug.

DIF:     Remembering/Knowledge                 REF: 293                     KEY: Osteoarthritis| acetaminophen| pharmacologic pain management| patient teaching MSC: Integrated Process: Teaching/Learning                                                      NOT:              Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

3. The clinic nurse assesses a client with diabetes during a checkup. The client also has osteoarthritis (OA). The nurse notes the client’s blood glucose readings have been elevated. What question by the nurse is most appropriate?
   1. “Are you compliant with following the diabetic diet?”
   2. “Have you been taking glucosamine supplements?”
   3. “How much exercise do you really get each week?”
   4. “You’re still taking your diabetic medication, right?”

ANS:           B

All of the topics are appropriate for a client whose blood glucose readings have been higher than usual. However, since this client also has OA, and glucosamine can increase blood glucose levels, the nurse should ask about its use. The other questions all have an element of nontherapeutic communication in them. “Compliant” is a word associated with negative images, and the client may deny being “noncompliant.” Asking how much exercise the client “really” gets is accusatory. Asking if the client takes his or her medications “right?” is patronizing.

DIF:            Applying/Application                         REF: 295                     KEY: Osteoarthritis| nursing assessment| supplements                                        MSC:                         Integrated Process: Nursing Process: Assessment                                               NOT:                          Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

4. The nurse working in the orthopedic clinic knows that a client with which factor has an absolute contraindication for having a total joint replacement?
   1. Needs multiple dental fillings
   2. Over age 85
   3. Severe osteoporosis
   4. Urinary tract infection

ANS:           C

Osteoporosis is a contraindication to joint replacement because the bones have a high risk of shattering as the new prosthesis is implanted. The client who needs fillings should have them done prior to the surgery. Age greater than 85 is not an absolute contraindication. A urinary tract infection can be treated prior to surgery.

DIF:            Remembering/Knowledge                 REF: 295                     KEY: Osteoarthritis| osteoporosis| joint replacement| surgical procedures  MSC:      Integrated Process: Nursing Process: Assessment      NOT:          Client Needs Category: Physiological Integrity: Reduction of Risk Potential