Osteoarthritis and Rheumatoid Arthritis Practice Exam Questions, Exams of Nursing

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Osteoarthritis and rheumatoid arthritis

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1. The client diagnosed with OA is a resident in a long term care facility. The resident is refusing to bathe because she is hurting. Which instruction should the nurse give the unlicensed nursing assistant? a. Allow the client to stay in bed until the pain becomes bearable b. Tell the assistant to give the client a bed bath this morning c. Try to encourage the client to get up and go to the shower d. Notify the family that the client is refusing to be bathed - Answer c. Try to encourage the client to get up and go to the shower
2. The client has been diagnosed with OA for the last 7 years and has tried multiple medical treatments and alternative treatments but still has significant joint pain. Which psychosocial client problem would the nurse identify? a. Severe pain b. Body-image disturbance c. Knowledge deficit d. Depression - Answer d. Depression
3. Which member of the health care team should the nurse refer the client diagnosed with OA who is complaining of not being able to get in and out of the bathtub? a. Physiatrist b. Social worker c. Physical therapist d. Counselor - Answer c. Physical therapist

4. The occupational health nurse is teaching a class on the risk factors for developing OA. Which is a modifiable risk for developing OA? a. Being overweight b. Increasing age c. Previous joint damage d. Genetic susceptibility - Answer a. Being overweight
5. The client is diagnosed with osteoarthritis. Which sign/symptom would the nurse expect the client to exhibit? a. Severe bone deformity b. Joint stiffness c. Waddling gait d. Swan neck fingers - Answer b. Joint stiffness
6. Which client goal would be most appropriate for a client diagnosed with OA? a. Perform passive range-of-motion exercises b. Maintain optimal functional ability c. Client will walk three miles a day d. Client will join a health club - Answer b. Maintain optimal functional ability
7. The client is complaining of joint stiffness, especially in the morning. Which diagnostic tests would the nurse expect the HCP to order to R/O OA? a. Full body MRI scan b. Serum studies for synovial fluid amount c. X-ray of the affected joints d. Serum erythrocyte sedimentation rate (ESR) - Answer c. X-ray of the affected joints

8. The client diagnosed with OA is prescribed a NSAID. Which instruction should the nurse teach the client? a. Take the medication on an empty stomach b. Make sure the client tapers the medication when discontinuing c. Apply the medication topically over the affected joints d. Notify the HCP if vomiting blood - Answer d. Notify the HCP if vomiting blood
9. The HCP prescribes glucosamine and chondroitin for a client diagnosed with OA. What is the scientific rationale for prescribing this medication? a. It will help decrease the inflammation in the joints b. It improves tissue function and may decrease breakdown of cartilage c. It is a potent medication that decreases the client's joint pain d. It increases the production of synovial fluid in the joint - Answer b. It improves tissue function and may decrease breakdown of cartilage
10. The nurse is admitting the client with OA to the medical floor. Which statement by the client indicates a complementary form of treatment for OA? a. "I take medication every two hours for my pain" b. "I use a heating pad when I go to bed at night" c. "I wear a copper bracelet to help with my OA" d. "I always wear my ankle splints when I sleep" - Answer c. "I wear a copper bracelet to help with my OA"
11. The client diagnosed with RA is receiving care through a nurse practitioner clinic. Which preventive care should the nurse include in the regularly scheduled clinic visits? a. Perform joint x-rays to determine progression of the disease

b. Send blood to the lab for an erythrocyte sedimentation rate (ESR) c. Recommend the flu and pneumonia vaccines d. Assess the client for increasing joint involvement - Answer c. Recommend the flu and pneumonia vaccines

12. The nurse is assessing a client diagnosed with RA. Which assessment findings warrant immediate intervention? a. The client complains of joint stiffness and the knees feel warm to the touch b. The client has experienced one kg weight loss and is very tired c. The client requires a heating pad applied to the hips and back to sleep d. The client is crying, has a flat facial affect, and refuses to speak to the nurse - Answer d. The client is crying, has a flat facial affect, and refuses to speak to the nurse
13. The client diagnosed with RA has developed swan-neck fingers. Which referral would be the most appropriate for the client? a. Physical therapy b. Occupational therapy c. Psychiatric counselor d. Home health nurse - Answer b. Occupational therapy
14. Which client problem is priority for a client diagnosed with RA? a. Activity intolerance b. Fluid and Electrolyte balance c. Alteration in comfort d. Excessive nutritional intake - Answer c. Alteration in comfort
15. The nurse is caring for clients on a medical floor. Which client should the nurse assess first?

a. The client diagnosed with RA who is complaining of pain at a "3" on a 1-10 scale b. The client diagnosed with Systemic Lupus Erythematosus who has a rash across the bridge of the nose c. The client diagnosed with advanced RA who is receiving antineoplastic drugs IV d. The client diagnosed with scleroderma who has hard, waxylike skin near the eyes - Answer c. The client diagnosed with advanced RA who is receiving antineoplastic drugs IV

16. Which intervention has the highest priority when caring for a client diagnosed with RA? a. Encourage the client to ventilate feelings about the disease process b. Discuss the effects of disease on the client's career and other life roles c. Instruct the client to perform most important activities in the morning d. Teach the client the proper use of hot and cold therapy to provide pain relief - Answer d. Teach the client the proper use of hot and cold therapy to provide pain relief
17. Which psychosocial problem would be priority for a client diagnosed with RA? a. Alteration in comfort b. Ineffective coping c. Anxiety d. Altered body image - Answer d. Altered body image
18. The client with RA has nontender movable nodules in subcutaneous tissue over the elbows and shoulders. Which statement is the best explanation for the nodules? a. The nodules indicate a rapidly progressive destruction of the affected tissue b. The nodules are small amounts of synovial fluid that have become crystallized c. The nodules are lymph nodes that have proliferated to try to fight the disease d. The nodules present a favorable prognosis and mean the client is better - Answer a. The nodules indicate a rapidly progressive destruction of the affected tissue

19. The client diagnosed with RA who has been prescribed Plaquenil, shows marked improvement. Which instruction regarding the use of this medication should the nurse teach? a. Explain that the less medication loses its efficacy after a few months b. Continue to have regular eye exams while taking the medication c. Have yearly MRIs to follow the progress d. Discuss that the drug is taken for 3 weeks and then stopped for a week - Answer b. Continue to have regular eye exams while taking the medication
20. The 20 year old female client diagnosed with advanced unremitting RA is being admitted to receive a regimen of immunosuppressive medications. Which question should the nurse ask during the admission process regarding the medications? a. "Are you sexually active, and if so, are you using birth control?" b. "Have you discussed taking these drugs with your parents?" c. "Which arm do you prefer to have an IV in for 4 days?" d. "Have you signed an informed consent for investigational drugs?" - Answer a. "Are you sexually active, and if so, are you using birth control?"
21. The client with early-stage RA is being discharged from the outpatient clinic. Which discharge instructions should the nurse teach regarding the use of NSAIDs? a. Take an over-the-counter medication for the stomach b. Drink a full glass of water with each pill c. If a dose is missed, double the medication at the next dosing time d. Avoid taking the NSAID on an empty stomach - Answer d. Avoid taking the NSAID on an empty stomach
22. The nurse is preparing to administer morning medications. Which medication should the nurse administer first?

a. The pain medication to a client diagnosed with RA b. The diuretic medication to a client diagnosed with Lupus (SLE) c. The steroid to a client diagnosed with polymyositis d. The appetite stimulant to a client diagnosed with OA - Answer a. The pain medication to a client diagnosed with RA

23. The client recently diagnosed with RA is prescribed aspirin, an NSAID medication. Which comment by the client would warrant immediate intervention by the nurse a. "I always take the aspirin with food" b. "If I have dark stools, I will call my HCP" c. "Aspirin will not cure my arthritis" d. "I am having some ringing in my ears" - Answer d. "I am having some ringing in my ears"