Brunner & Suddarth's Textbook of Medical-Surgical Nursing 13e Edition
Brunner & Suddarth's Textbook of Medical-Surgical Nursing 13e Edition
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Chapter 39 Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13e Edition
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
| 1. | A patient is suspected of having rheumatoid arthritis and her diagnostic regimen includes aspiration of synovial fluid from the 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 | |
| Ans: | D | |
| Feedback: | ||
| Arthrocentesis involves needle aspiration of synovial fluid. Angiography is an x-ray study of circulation with a contrast agent injected into a selected artery. Myelography is an x-ray of the spinal subarachnoid space taken after the injection of a contrast agent into the spinal subarachnoid space through a lumbar puncture. Paracentesis is removal of fluid (ascites) from the peritoneal cavity through a small surgical incision or puncture made through the abdominal wall under sterile conditions. | ||
| 2. | A nurse is providing care for a patient who has just been diagnosed as being in the early stage of rheumatoid arthritis. The nurse should anticipate the administration of which of the following? | |
| A) | Hydromorphone (Dilaudid) | |
| B) | Methotrexate (Rheumatrex) | |
| C) | Allopurinol (Zyloprim) | |
| D) | Prednisone | |
| Ans: | B | |
| Feedback: | ||
| In the past, a step-wise approach starting with NSAIDs was standard of care. However, evidence clearly documenting the benefits of early DMARD (methotrexate [Rheumatrex], antimalarials, leflunomide [Arava], or sulfasalazine [Azulfidine]) treatment has changed national guidelines for management. Now it is recommended that treatment with the non-biologic DMARDs begin within 3 months of disease onset. Allopurinol is used to treat gout. Opioids are not indicated in early RA. Prednisone is used in unremitting RA. | ||
| 3. | A nurse is performing the initial assessment of a patient who has a recent diagnosis of systemic lupus erythematosus (SLE). What skin manifestation would the nurse expect to observe on inspection? | |
| A) | Petechiae | |
| B) | Butterfly rash | |
| C) | Jaundice | |
| D) | Skin sloughing | |
| Ans: | B | |
| Feedback: | ||
| An acute cutaneous lesion consisting of a butterfly-shaped rash across the bridge of the nose and cheeks occurs in SLE. Petechiae are pinpoint skin hemorrhages, which are not a clinical manifestation of SLE. Patients with SLE do not typically experience jaundice or skin sloughing. | ||
| 4. | A clinic nurse is caring for a patient with suspected gout. While explaining the pathophysiology of gout to the patient, the nurse should describe which of the following? | |
| A) | Autoimmune processes in the joints | |
| B) | Chronic metabolic acidosis | |
| C) | Increased uric acid levels | |
| D) | Unstable serum calcium levels | |
| Ans: | C | |
| Feedback: | ||
| Gout is caused by hyperuricemia (increased serum uric acid). Gout is not categorized as an autoimmune disease and it does not result from metabolic acidosis or unstable serum calcium levels. | ||
| 5. | A nurse is planning the care of a patient who has a long history of chronic pain, which has only recently been diagnosed as fibromyalgia. What nursing diagnosis is most likely to apply to this woman’s care needs? | |
| A) | Ineffective Role Performance Related to Pain | |
| B) | Risk for Impaired Skin Integrity Related to Myalgia | |
| C) | Risk for Infection Related to Tissue Alterations | |
| D) | Unilateral Neglect Related to Neuropathic Pain | |
| Ans: | A | |
| Feedback: | ||
| Typically, patients with fibromyalgia have endured their symptoms for a long period of time. The neuropathic pain accompanying FM can often impair a patient’s ability to perform normal roles and functions. Skin integrity is unaffected and the disease has no associated infection risk. Activity limitations may result in neglect, but not of a unilateral nature. | ||
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