Chapter 65: Nursing Management: Arthritis and Connective Tissue Diseases

Chapter 65: Nursing Management: Arthritis and Connective Tissue Diseases

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE
1. Which finding will the nurse expect when assessing a 60-year-old patient who has
osteoarthritis (OA) of the left knee?
a. Heberden’s nodules
b. Pain upon joint movement
c. Redness and swelling of the knee joint
d. Stiffness that increases with movement
ANS: B
Initial symptoms of OA include pain with joint movement. Heberden’s nodules occur on
the fingers. Redness of the joint is more strongly associated with rheumatoid arthritis
(RA), and stiffness in OA is worse right after the patient rests and decreases with joint
movement.
DIF: Cognitive Level: Comprehension REF: 1644
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
2. Which assessment finding about a patient who has been using naproxen (Naprosyn) for 3
weeks to treat osteoarthritis is most important for the nurse to report to the health care
provider?
a. The patient has dark colored stools.
b. The patient’s pain has not improved.
c. The patient is using capsaicin cream (Zostrix).
d. The patient has gained 3 pounds over 3 weeks.
ANS: A
Dark colored stools may indicate that the patient is experiencing gastrointestinal bleeding
caused by the naproxen. The information about the patient’s ongoing pain and weight
gain also will be reported and may indicate a need for a different treatment and/or
counseling about avoiding weight gain, but these are not as large a concern as the
possibility of gastrointestinal bleeding. Use of capsaicin cream with oral medications is
appropriate.
DIF: Cognitive Level: Application REF: 1646 | 1650
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
3. After the nurse has finished teaching a patient with osteoarthritis (OA) of the left hip and
knee about how to manage the OA, which patient statement indicates a need for more
education?
a. “I can take glucosamine to help decrease my knee pain.”
b. “I will take 1 g of acetaminophen (Tylenol) every 4 hours.”
Test Bank 65-2
c. “I will take a shower in the morning to help relieve stiffness.”
d. “I can use a cane to decrease the pressure and pain in my hip.”
ANS: B
No more than 4 g of acetaminophen should be taken daily to avoid liver damage. The
other patient statements are correct and indicate good understanding of OA management.
DIF: Cognitive Level: Application REF: 1645-1646 | 1650-1651
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity
4. When caring for a patient who has osteoarthritis, the nurse will anticipate the need to
teach the patient about which of these medications?
a. Adalimumab (Humira)
b. Prednisone (Deltasone)
c. Capsaicin cream (Zostrix)
d. Sulfasalazine (Azulfidine)
ANS: C
Capsaicin cream blocks the transmission of pain impulses and is helpful for some patients
in treating OA. The other medications would be used for patients with RA.
DIF: Cognitive Level: Application REF: 1646 | 1650 TOP: Nursing Process:
Planning
MSC: NCLEX: Physiological Integrity
5. A patient who has rheumatoid arthritis is seen in the outpatient clinic and the nurse notes
that rheumatoid nodules are present on the patient’s elbows. Which action will the nurse
take?
a. Draw blood for rheumatoid factor analysis.
b. Teach the patient about injection of the nodule.
c. Assess the nodules for skin breakdown or infection.
d. Discuss the need for surgical removal of the nodule.
ANS: C
Rheumatoid nodules can break down or become infected. They are not associated with
changes in rheumatoid factor and injection is not needed. Rheumatoid nodules are usually
not removed surgically because of a high probability of recurrence.
DIF: Cognitive Level: Application REF: 1653-1654
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity