front 1 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.” | back 1 “I will take folic acid tablets.” |
front 2 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) | back 2 Positive antinuclear antibody (ANA) |
front 3 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 | back 3 C. Elevated creatinine level D.Low hemoglobin level |
front 4 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 | back 4 Cartilage |
front 5 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 | back 5 1.Provide cold packs 2.Encourage regular physical activity 4.Provide a heating pad 5.Explain the importance of physical therapy |
front 6 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 | back 6 Hydroxychloroquine |
front 7 Which clinical manifestation is seen in patients with fibromyalgia? Nonrestorative sleep Pain that improves with rest Pain that increases with activity Unsteady gait | back 7 Nonrestorative sleep |
front 8 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.” | back 8 It is important I avoid prolonged exposure to sun.” |
front 9 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 | back 9 Topical glucocorticoids |
front 10 Which patient is most at risk of ototoxicity? Patient 1 Patient 2 Patient 3 Patient 4 | back 10 Patient 4 |
front 11 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 | back 11 Trimethoprim sulfamethoxazole |
front 12 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. | back 12 Internal organ involvement is unlikely. |
front 13 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) | back 13 X-ray |
front 14 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 | back 14 A 58-year-old female patient |
front 15 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) | back 15 Decreased white blood cells (WBC) |
front 16 Arrange the sequence of pathophysiological events of rheumatoid arthritis to appear in the correct order. | back 16 1. Activation of monocyte and T lymphocytes 2. Formation of immune complexes 3. Production of leukotrienes and prostaglandins 4. Production of collagenase 5. Proliferation of synovial membrane |
front 17 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 | back 17 Pneumonitis Systemic vasculitis Hematologic abnormalities |
front 18 Which connective tissue disorder would be the leading cause of chronic disability in the United States? Rheumatoid arthritis Osteoarthritis Systemic lupus erythematous (SLE) Fibromyalgia | back 18 Osteoarthritis |
front 19 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. | back 19 SLE is difficult to diagnose. |
front 20 Which is a biological response modifier used to treat patients with systemic lupus erythematosus (SLE)? Clobetasol Belimumab Azathioprine Cyclophosphamide | back 20 Belimumab |
front 21 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. | back 21 Female children have a higher incidence of SLE than males. Females are more affected by SLE during childbearing years than males. Pregnancy may trigger SLE in female patients. |
front 22 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 | back 22 Formation of osteophytes on the proximal interphalangeal joints |
front 23 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. | back 23 This will help control your skin-related symptoms. |
front 24 Which drug would be considered a type of disease-modifying antirheumatic (DMARDS)? Tramadol (Ultram) Infliximab (Remicade) Meloxicam (Mobic) Methotrexate (Rasuvo) | back 24 Methotrexate (Rasuvo) |
front 25 Which is a modifiable risk factor for developing osteoarthritis? Obesity Increased age History of joint injury Genetic predisposition | back 25 Obesity |
front 26 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 | back 26 Severe joint pain Stiffness of the joints Formation of edema at the joints |
front 27 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 | back 27 Failing kidney function |
front 28 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.” | back 28 “Use active range of motion to decrease joint stiffness.” |
front 29 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. | back 29 Female children have a higher incidence of SLE than males. Females are more affected by SLE during childbearing years than males. Pregnancy may trigger SLE in female patients. |
front 30 Which activity would the patient diagnosed with systemic lupus erythematosus (SLE) completely avoid? Taking naps Exercising Smoking Sun exposure | back 30 Smoking |
front 31 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 | back 31 Red meats Alcoholic beverages |
front 32 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 | back 32 Pneumonitis Systemic vasculitis Hematologic abnormalities |
front 33 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 | back 33 Elevated of C-reactive protein (CRP) |
front 34 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 | back 34 Frequent fatigue Pain that worsens after a long rest Swelling in both ankle joints Joint stiffness in the morning for half an hour |
front 35 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 | back 35 To assess for pericardial involvement and elevated pulmonary artery pressure |
front 36 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 | back 36 Swan-neck deformity |
front 37 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 | back 37 Not covering up while in the sun Limiting exercise and activity |
front 38 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. | back 38 B. Baseline eye exam prior to initiating therapy D. Biannual eye exam while the patient is taking hydroxychloroquine |
front 39 Selena tells the nurse that she has recurring migraine headaches. Which additional teaching should the nurse provide? | back 39 Avoid oral contraceptives. |
front 40 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 | back 40 Renal impairment due to decreased renal blood flow |
front 41 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 | back 41 Immunosuppressive agent |
front 42 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 | back 42 Decreased white blood cells, platelets, and red blood cells |
front 43 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 | back 43 Avascular necrosis |
front 44 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 | back 44 A. Elevated BUN level D. Elevated creatinine level E. Elevated urine protein |
front 45 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 | back 45 A 32-year-old African American female who is a gravida 2 para 2 |
front 46 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 | back 46 Meeting 4 out of the 17 established criteria |
front 47 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 | back 47 Renal damage |
front 48 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 | back 48 Immunosuppressive agents to modify immune response |
front 49 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 | back 49 Baseline eye exam |