Deck 77: Management of Clients with Rheumatic Disorders

Question 1

The nursing assessment of clients with SLE should focus most intensely on the presence of the common and serious sequela of this disorder, which is

A) difficulty swallowing.
B) interruptions in skin integrity.
C) peripheral neuropathies.
D) renal failure.

Answer 1

renal failure.

Question 2

The nurse cautions a client with RA that uninformed self-treatment that has the potential to make her condition worse is

A) application of cold compresses.
B) performing isometric exercises.
C) the use of aspirin to mask pain.
D) the use of deep heat.

Answer 2

the use of deep heat.

Question 3

The nurse caring for a client with systemic sclerosis should include in the teaching plan the measure to prevent pain and injury, which is

A) do not stand for longer than 30 minutes at a time.
B) exercise only moderately.
C) wash the hands with plain water only.
D) wear gloves when removing food from the freezer.

Answer 3

wear gloves when removing food from the freezer.

Question 4

The nurse performing an assessment on a client with fibromyalgia syndrome asks about the most common clinical manifestation, which is

A) deformities of the fingers and toes.
B) fatigue, unrelieved by sleep.
C) migratory areas of numbness.
D) varying degrees of paresthesias.

Question 5

When the nurse is caring for a client with progressive systemic sclerosis (PSS), the highest-priority nursing diagnosis would be

A) Constipation.
B) Disturbed Thought Processes.
C) Risk for Imbalanced Body Temperature.
D) Risk for Impaired Skin Integrity.

Question 6

The nurse caring for a client who had a shoulder arthroplasty yesterday will include in the postoperative care provisions for

A) assessing the ability to grasp the nurse's hand.
B) avoiding lifting objects heavier than 10 pounds.
C) limiting flexion and extension of the elbow.
D) positioning the arm below the shoulder.

Question 7

The nurse caring for a client with systemic lupus erythematosus (SLE) should warn the client that the factor most likely to cause an exacerbation of this disorder is

A) a diet high in saturated fats.
B) changes in temperature.
C) exposure to the sun.
D) ingestion of aspirin.

Question 8

A client has dermatomyositis. The nurse will include priority interventions in the care plan provisions to meet the problem of

A) difficulty ambulating.
B) difficulty swallowing.
C) disorientation.
D) phlebitis.

Question 9

A client with RA asks the nurse about the purpose of a synovectomy. The most appropriate response from the nurse is "This operation will provide you with

A) improved appearance of the joint."
B) pain relief."
C) reduced amount of inflammation."
D) removal of infected material in the joint."

Question 10

The nursing care plan should be modified for a client with RA who develops Sjögren's syndrome to include

A) encouraging fluids to prevent constipation.
B) lubricating the eyes with artificial tears.
C) providing skin care daily.
D) restricting activity in the late evening.

Question 11

A client with ankylosing spondylitis has severe kyphosis. The nurse planning care for this client would provide priority interventions to

A) create a safe environment.
B) consult with physical therapy for an exercise regimen.
C) encourage a high-calorie diet with vitamin supplements.
D) use meticulous technique when changing surgical dressings.

Question 12

The caution the nurse should give the client who is taking nonsteroidal anti-inflammatory drugs (NSAIDs) as a remedy for arthritis is to

A) avoid taking NSAIDs with milk.
B) liberalize fluids while taking NSAIDs.
C) take NSAIDs with food.
D) watch for manifestations of skin damage.

Question 13

A client with RA is anxious to perform all of her activities of daily living. The nurse can best help the client by encouraging

A) a slow, progressive schedule of daily activities.
B) complete rest during periods of exacerbation.
C) performance of activities in the early morning.
D) the use of assistive devices for dressing.

Question 14

The intervention the client with rheumatoid arthritis (RA) can do that is most effective in preserving motor function during periods when the affected joints are not inflamed is

A) application of moist heat to joints.
B) encouraging moderate increase in activity.
C) promotion of a high-protein diet.
D) restriction of the client's activity.

Question 15

The nurse planning teaching for the client with ankylosing spondylitis includes information on which drug?

A) Acetaminophen (Tylenol)
B) Antihistamines
C) Etanercept
D) Lorazepam (Ativan)

Question 16

The nurse explains that one of the few rheumatic joint diseases about which we know the infectious etiology is

A) ankylosing spondylitis.
B) Lyme disease.
C) rheumatoid arthritis.
D) Sjögren's syndrome.

Question 17

The common complication of ankylosing spondylitis that the nurse should address in the plan of care is

A) cardiac dysrhythmias.
B) respiratory compromise.
C) renal failure.
D) weight gain.

Question 18

To help promote sleep for a client with RA, the nurse would recommend

A) exercising just before bedtime.
B) sleeping in thermal underwear.
C) taking a cool shower before bedtime.
D) using a large pillow and warm, heavy blankets.

Question 19

An important health promotion measure the nurse would advise the client beginning therapy with hydroxychloroquine for RA would be to

A) avoid drinking red wine.
B) avoid excessive sun exposure.
C) have eye examinations every 6 months.
D) measure blood pressure daily.

Question 20

A client is being evaluated for SLE. The nurse would be concerned when the client lists which drug as one of his/her routine medications?

A) Aspirin
B) Digoxin (Lanoxin)
C) Gentamicin (Garamycin)
D) Procainamide (Pronestyl)

Question 21

The nurse clarifies that a client can be diagnosed with RA when, out of the seven criteria, the client exhibits

A) two.
B) three.
C) four.
D) five.

Question 22

A client who has dermatomyositis (DM) and is receiving high-dose steroids needs surgery for an unrelated problem. The surgeon orders the steroids to be stopped at midnight the night before surgery. The most appropriate action by the nurse is to

A) call the physician and ask to have the order clarified.
B) consult with the pharmacist about tapering the dose instead.
C) discontinue the steroid because the client will be NPO.
D) speak to the physician and explain concerns with this order.

Question 23

A client has just been admitted to the nursing unit with the diagnosis of CREST syndrome. The findings the nurse would expect to note during the assessment are (Select all that apply)

A) calcinosis.
B) esophageal dysfunction.
C) rash.
D) Raynaud's phenomenon.
E) spider angiomas.
F) telangiectasia.

Question 24

A client has advanced systemic sclerosis and presents with a mask-like face and limited ROM of the mouth. Which nursing diagnosis is most important to address an important concept related to this client?

A) Altered Body Image
B) Impaired Skin Integrity
C) Risk for Constipation
D) Risk for Imbalanced Nutrition

Question 25

A client newly diagnosed with RA is depressed after the nurse provides education on the disease process. Important interventions the nurse can offer include helping the client

A) choose a high-protein, high-carbohydrate diet to provide energy.
B) find medical supply companies that carry adaptive devices.
C) learn to participate actively in response to their illness.
D) understand the importance of taking medications on time.