Connective Tissue Disorders Chapter 20 FA Davs Flashcards

The registered nurse is providing discharge teaching to a patient who is diagnosed with rheumatoid arthritis and was prescribed methotrexate. Which statement made by the patient indicates the teaching has been successful?

“It is okay to consume alcohol moderately.”

“I will take folic acid tablets.”

“I should avoid weight-bearing exercises.”

“I should take this medication once per day.”

Which immunological criteria would aid in diagnosing systemic lupus erythematosus (SLE)?

C-reactive protein

Erythrocyte sedimentation rate (ESR)

Blood urea nitrogen (BUN)

Positive antinuclear antibody (ANA)

The nurse is assessing a patient diagnosed with osteoarthritis who has been taking nonsteroidal anti-inflammatory drugs (NSAIDs) for 2 months. Which finding may indicate a complication due to NSAID use? Select all that apply.

A. Elevated uric acid level

B. Low albumin level

C. Elevated creatinine level

D.Low hemoglobin level

E. Low blood urea nitrogen level

In osteoarthritis, the deteriorations of which structure would cause the bone to be unprotected, leading to joint dysfunction?

Cartilage

Osteophytes

Bouchard’s nodes

Heberden’s nodes

Which nursing intervention would be appropriate for a patient diagnosed with osteoarthritis experiencing intermittent painful joints and achy muscles? Select all that apply.

Provide cold packs

Encourage regular physical activity

Encourage use of over the counter (OTC) NSAIDS

Provide a heating pad

Explain the importance of physical therapy

Which medication used to treat systemic lupus erythematosus (SLE) would require an eye exam to be a priority for the patient?

Methotrexate

Naproxen

Glucocorticoids

Hydroxychloroquine

Which clinical manifestation is seen in patients with fibromyalgia?

Nonrestorative sleep

Pain that improves with rest

Pain that increases with activity

Unsteady gait

The registered nurse is teaching a patient newly diagnosed with systemic lupus erythematosus (SLE) about the condition. Which statement by the patient would indicate teaching has been successful?

It is important I avoid prolonged exposure to sun.”

“I need to keep getting immunized with live vaccines.”

“Performing prolonged vigorous exercises regularly will help me maintain health.”

“I should continue to use my oral contraceptives.”

What medication is most likely to be prescribed to a patient with systemic lupus erythematosus (SLE) who has the symptom shown in the provided image?

Methotrexate

Topical glucocorticoids

High dose oral glucocorticoids

Azathioprine

Which patient is most at risk of ototoxicity?

Patient 1

Patient 2

Patient 3

Patient 4

Which medication prescribed for a patient diagnosed with systemic lupus erythematosus (SLE) and also being treated for a urinary tract infection (UTI) would the nurse question prior to administration?

Hydroxychloroquine

Glucocorticoids

Trimethoprim sulfamethoxazole

Methotrexate

Which statement is true about limited systemic scleroderma?

The onset is rapid.

It involves the trunk.

Internal organ involvement is unlikely.

It involves the occurrence of Raynaud’s phenomenon after the diagnosis.

Which diagnostic tool is most likely used to assess for joint damage in an older adult with systemic lupus erythematosus (SLE)?

Ultrasound

Computed tomography (CT)

X-ray

Magnetic resonance imaging (MRI)

The nurse is caring for different patients. Which patient has the highest risk of developing osteoarthritis?

A 45-year-old male patient

A 50-year-old female patient

A 58-year-old female patient

A 65-year-old male patient

In a patient diagnosed with systemic lupus erythematosus (SLE), the complete blood count would likely show which result?

Increased hemoglobin

Decreased white blood cells (WBC)

Increased platelet count

Increased red blood cells (RBC)

Arrange the sequence of pathophysiological events of rheumatoid arthritis to appear in the correct order.

Which condition is treated with high dose oral glucocorticoids in a patient with systemic lupus erythematosus (SLE)? Select all that apply?

Oral and nasal ulcers

Pneumonitis

Chronic cutaneous lupus

Systemic vasculitis

Hematologic abnormalities

Which connective tissue disorder would be the leading cause of chronic disability in the United States?

Rheumatoid arthritis

Osteoarthritis

Systemic lupus erythematous (SLE)

Fibromyalgia

For which reason would systemic lupus erythematosus (SLE) be considered complicated and frustrating for most patients and providers?

Triggers have not been identified for SLE.

SLE is difficult to diagnose.

SLE affects many people.

SLE is hard to cure.

Which is a biological response modifier used to treat patients with systemic lupus erythematosus (SLE)?

Clobetasol

Belimumab

Azathioprine

Cyclophosphamide

Which epidemiology statement concerning females and systemic lupus erythematosus (SLE) would be considered true? Select all that apply.

Female children have a higher incidence of SLE than males.

African American females are less likely to develop SLE than other populations.

Mexican American females are less likely to develop SLE.

Females are more affected by SLE during childbearing years than males.

Pregnancy may trigger SLE in female patients.

The nurse is assessing the x-ray film of a patient and notes the formation of Bouchard’s nodes on the joints of the left hand. What does this indicate?

Abnormal flexion of the proximal interphalangeal joints

Hyperextension of the proximal interphalangeal joints

Formation of osteophytes on the distal interphalangeal joints

Formation of osteophytes on the proximal interphalangeal joints

Which statement by the nurse to a patient diagnosed with systemic lupus erythematosus (SLE) would be accurate regarding hydroxychloroquine?

This will not address your joint pain.

This was prescribed to improve your headaches.

This will help control your skin-related symptoms.

This will reduce inflammation in your kidneys.

Which drug would be considered a type of disease-modifying antirheumatic (DMARDS)?

Tramadol (Ultram)

Infliximab (Remicade)

Meloxicam (Mobic)

Methotrexate (Rasuvo)

Which is a modifiable risk factor for developing osteoarthritis?

Obesity

Increased age

History of joint injury

Genetic predisposition

The nurse is caring for a patient diagnosed with osteoarthritis. Which clinical manifestation does the nurse suspect in the patient? Select all that apply.

Severe joint pain

Swan-neck deformity

Stiffness of the joints

Severe bone deformity

Formation of edema at the joints

The laboratory report of a patient diagnosed with systemic lupus erythematosus (SLE) shows elevated BUN and creatinine serum levels along with proteinuria. Which factor would be responsible for the increases?

Immunosuppression

Allergies to antibiotics

Failing kidney function

Bone marrow failure

A patient with scleroderma asks the nurse about nonpharmacological treatment options. How should the nurse advise the patient?

Begin jogging daily – gradually increasing the distance.”

“Use active range of motion to decrease joint stiffness.”

“Any weight-bearing exercise will improve your mobility.”

“Join a gym; it will give you a variety of strengthening options.”

Which epidemiology statement concerning females and systemic lupus erythematosus (SLE) would be considered true? Select all that apply.

Female children have a higher incidence of SLE than males.

African American females are less likely to develop SLE than other populations.

Mexican American females are less likely to develop SLE.

Females are more affected by SLE during childbearing years than males.

Pregnancy may trigger SLE in female patients.

Which activity would the patient diagnosed with systemic lupus erythematosus (SLE) completely avoid?

Taking naps

Exercising

Smoking

Sun exposure

Which dietary restriction would the nurse recommend to a patient diagnosed with gout to reduce the incidence of gout flares?

Red meats

Bread

Pork

Fried foods

Alcoholic beverages

Which condition is treated with high dose oral glucocorticoids in a patient with systemic lupus erythematosus (SLE)? Select all that apply.

Oral and nasal ulcers

Pneumonitis

Chronic cutaneous lupus

Systemic vasculitis

Hematologic abnormalities

A patient arrives at the hospital with joint pain and morning stiffness. Which laboratory value used to test for joint pain may indicate the presence of inflammation?

Elevated of C-reactive protein (CRP)

Decreased white blood cells (WBCs)

Decreased erythrocyte sedimentation rate (ESR)

Positive anticyclic citrullinated peptides level

The nurse is assessing a patient with significant joint pain. Which characteristic of pain and body alteration make the nurse suspect rheumatoid arthritis (RA)? Select all that apply.

Frequent fatigue

Pain that worsens after a long rest

Swelling in both ankle joints

Pain mostly in the left knee joint

Joint stiffness in the morning for half an hour

What is the purpose of using an echocardiogram as a diagnostic tool in a patient with systemic lupus erythematosus (SLE)?

To assess for pericardial involvement and elevated pulmonary artery pressure

To assess neurological defects and cognitive dysfunction

To assess the kidney size if there is any sign of renal impairment

To assess joint pain, swelling, and stiffness

Upon assessment of a patient with rheumatoid arthritis, the nurse recognizes hyperextension of the proximal interphalangeal joint of the thumb finger in a patient. What does the nurse suspect?

Osteopenia

Ulnar deviation

Swan-neck deformity

Boutonnière deformity

Selena is a 28-year-old female who has received a clinical diagnosis of lupus from her primary care physician following confirmation of diagnostic testing. After learning of the diagnosis, she returns to the office for initial health promotion measures.

Which of Selena’s behaviors requires that the nurse provide further instruction to prevent flare-ups of lupus symptoms? Select all that apply.

Not covering up while in the sun

Eating a balanced diet to avoid illness

Avoiding dusty work areas

Drinking eight glasses of water each day

Limiting exercise and activity

Hydroxychloroquine has been prescribed for Selena. Which safety measures should be incorporated into the plan of care? Select all that apply.

A. weekly funduscopic exam to denote retinal changes

B. Baseline eye exam prior to initiating therapy

C. Calculation of renal clearance rate

D. Biannual eye exam while the patient is taking hydroxychloroquine

E. Skeletal survey to denote potential arthritic changes in joints.

Selena tells the nurse that she has recurring migraine headaches. Which additional teaching should the nurse provide?

Selena has been taking NSAID therapy for several months and is concerned about possible complications. What is important for the nurse to educate her about?

Increased metabolism leading to hyperthermia

Dyspnea leading to respiratory distress

Renal impairment due to decreased renal blood flow

Blurred vision

Selena is experiencing increased joint pain. Based on this information, what therapy may be considered to decrease pain and inflammation?

High-dose glucocorticoids

Topical glucocorticoids

Biologic response modifier

Immunosuppressive agent

Selena has been treated for lupus for several years. Which clinical finding is a priority concern on a follow-up visit?

Decreased white blood cells, platelets, and red blood cells

Temperature of 99.8°F and complaints of chills and increased fatigue

Fasting blood sugar result of 85 mg/dL

Nonproductive cough for 2 days

Selena has been scheduled for a knee replacement. What is the most likely reason for this surgery?

Ground-level fall with negative imaging study

Avascular necrosis

Osteoporosis

Inflamed tendons and ligaments

Selena is concerned that her kidneys are not functioning as well as they should. Which labs indicate she is experiencing decreased renal function? Select all that apply.

A. Elevated BUN level

B. Elevated CRP

C.Elevated ESR

D. Elevated creatinine level

E. Elevated urine protein

Which patient is mostly likely to have lupus?

An 18-year-old European American female who wears glasses for correction of farsightedness

An 80-year-old Hispanic female who has just been diagnosed with type 2 diabetes

A 32-year-old African American female who is a gravida 2 para 2

A 40-year-old European American male who has a history of hypertension that is well controlled with medication therapy

According to the American College of Rheumatology, which finding would be considered to establish a clinical diagnosis of lupus?

Meeting all 7 established criteria

Meeting 4 out of the 17 established criteria

Meeting 2 out of the 17 established criteria

Meeting 7 out of the 10 established criteria

A patient who has a clinical diagnosis of lupus has an increased chance of acquiring which complication?

Chronic obstructive pulmonary disease

Renal damage

Pulmonary edema

Migraine headaches

Which medication would the nurse anticipate to be prescribed for a patient who was admitted with synovitis from an exacerbation of lupus?

Antibiotics to treat infection

Acetaminophen for pain relief

Immunosuppressive agents to modify immune response

Total parenteral nutrition for nutritional support

A patient with lupus is receiving hydroxychloroquine as part of her therapeutic regimen. Based on this finding, the nurse would anticipate assessing:

Body mass index

Blood pressure

Baseline eye exam

Mental status