Chapter 54: Assessment and Management of Patients With Rheumatic Disorders

Chapter 54: Assessment and Management of Patients With Rheumatic Disorders

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Multiple Choice

 

 

 

 

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?
2. A) Angiography
3. B) Myelography
4. C) Paracentesis
5. D) Arthocentesis

 

Ans:  D

Chapter:  54

Client Needs:  A-1

Cognitive Level:  Application

Difficulty:  Moderate

Integrated Process:  Nursing Process

Objective:  2

Page and Header:  1643, Diffuse Connective Tissue Diseases

 

Feedback:  Arthrocentesis (needle aspiration of synovial fluid) may be performed not only to obtain a sample of synovial fluid for analysis, but also to relieve pain caused by pressure of increased fluid volume, usually in the knee or shoulder.  Angiography is an x-ray study of circulation with a contrast agent injected into a selected artery.  Myelography is an x-tray 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 all under sterile conditions.

 

 

 

 

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?
3. A) Antimalarial agents
4. B) NSAIDs
5. C) Xanthine oxidase inhibitors
6. D) Uricosuric agents

 

Ans:  B

Chapter:  54

Client Needs:  D-2

Cognitive Level:  Application

Difficulty:  Moderate

Integrated Process:  Nursing Process

Objective:  3

Page and Header:  1643, Diffuse Connective Tissue Diseases

 

Feedback:  Medical management of RA begins with therapeutic doses of salicylates or NSAIDs.  Antimalarial agents are used in the treatment of systemic lupus erythematosus.  Xanthine oxidase inhibitors and uricosuric agents are used in the treatment of gout.

 

 

 

 

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?
4. A) Petechiae
5. B) Butterfly rash across bridge of nose and cheeks
6. C) Absence of wrinkles
7. D) Weight gain

 

Ans:  B

Chapter:  54

Client Needs:  A-1

Cognitive Level:  Application

Difficulty:  Moderate

Integrated Process:  Nursing Process

Objective:  4

Page and Header:  1647, Diffuse Connective Tissue Diseases

 

Feedback:  An acute cutaneous lesion consisting of a butterfly-shaped rash across the bridge of the nose and cheeks occurs in systemic lupus erythematosus (SLE).  Petechiae are pinpoint skin hemorrhages, which are not a clinical manifestation of SLE.  Wrinkles and lines are obliterated in scleroderma.  Weight loss is a classic symptom of SLE.

 

 

 

 

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?
5. A) Thrombocytopenia
6. B) Hypouricemia
7. C) Hyperuricemia
8. D) Hypocalcemia

 

Ans:  C

Chapter:  54

Client Needs:  A-1

Cognitive Level:  Application

Difficulty:  Moderate

Integrated Process:  Teaching/Learning

Objective:  1

Page and Header:  1653, Metabolic and Endocrine Diseases Associated with Rheumatic Disorders

 

Feedback:  Oversecretion of uric acid, a renal defect resulting in decreased excretion of uric acid, or a combination of both occurs in gout.  Hyperuricemia occurs.  Thrombocytopenia is indicative of systemic lupus erythematosus.  Hypercalcemia can cause kidney stones related to gout.

 

 

 

 

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?
6. A) Acute exacerbation, severe pain
7. B) Subacute exacerbation, moderate pain
8. C) Subacute exacerbation, minimal pain
9. D) Remission

 

Ans:  A

Chapter:  54

Client Needs:  D-3

Cognitive Level:  Application

Difficulty:  Moderate

Integrated Process:  Teaching/Learning

Objective:  6

Page and Header:  1637, Rheumatic Diseases

 

Feedback:  Active range of motion and isometric exercises are recommended for periods of inactive disease. Active assisted or active range of motion within pain tolerance is suggested for subacute inflammation. Passive range of motion is suggested during periods of acute exacerbation with severe pain.