Question 1

A nurse is caring for a client who was admitted to the hospital with an exacerbation of rheumatoid arthritis (RA). The client reports that her pain is a 3 on a scale from 0 (none)to 10 (high)today. Which nonpharmacologic interventions can the nurse provide to enhance the client's comfort? Select all that apply.

Accepted Answer

A)Nonpharmacologic activities for pain relief include relaxation, distraction, and application of heat and cold. Position changes are encouraged along with supportive equipment. Immobilization would likely cause contractures in the joints.
B)Nonpharmacologic activities for pain relief include relaxation, distraction, and application of heat and cold. Position changes are encouraged along with supportive equipment. Immobilization would likely cause contractures in the joints.
C)Nonpharmacologic activities for pain relief include relaxation, distraction, and application of heat and cold. Position changes are encouraged along with supportive equipment. Immobilization would likely cause contractures in the joints.
D)Nonpharmacologic activities for pain relief include relaxation, distraction, and application of heat and cold. Position changes are encouraged along with supportive equipment. Immobilization would likely cause contractures in the joints.
E)Nonpharmacologic activities for pain relief include relaxation, distraction, and application of heat and cold. Position changes are encouraged along with supportive equipment. Immobilization would likely cause contractures in the joints.

Question 2

Why are second-generation antihistamines often preferred to first-generation histamines in the treatment of hypersensitivity reactions?

Accepted Answer

A)An important difference between first- and second-generation antihistamines is that unlike the first-generation drugs, the newer second-generation drugs do not cause drowsiness. Both first- and second-generation antihistamines are available by prescription and over the counter. The preferred route of administration for both first- and second-generation antihistamines is oral, although diphenhydramine (a first-generation drug)and some other medications may be given parenterally. Second-generation antihistamines are not universally faster-acting than their first-generation counterparts.
B)An important difference between first- and second-generation antihistamines is that unlike the first-generation drugs, the newer second-generation drugs do not cause drowsiness. Both first- and second-generation antihistamines are available by prescription and over the counter. The preferred route of administration for both first- and second-generation antihistamines is oral, although diphenhydramine (a first-generation drug)and some other medications may be given parenterally. Second-generation antihistamines are not universally faster-acting than their first-generation counterparts.
C)An important difference between first- and second-generation antihistamines is that unlike the first-generation drugs, the newer second-generation drugs do not cause drowsiness. Both first- and second-generation antihistamines are available by prescription and over the counter. The preferred route of administration for both first- and second-generation antihistamines is oral, although diphenhydramine (a first-generation drug)and some other medications may be given parenterally. Second-generation antihistamines are not universally faster-acting than their first-generation counterparts.
D)An important difference between first- and second-generation antihistamines is that unlike the first-generation drugs, the newer second-generation drugs do not cause drowsiness. Both first- and second-generation antihistamines are available by prescription and over the counter. The preferred route of administration for both first- and second-generation antihistamines is oral, although diphenhydramine (a first-generation drug)and some other medications may be given parenterally. Second-generation antihistamines are not universally faster-acting than their first-generation counterparts.

Question 3

The nurse is caring for a client who was diagnosed with rheumatoid arthritis (RA)last year. The client has just been prescribed methotrexate as part of his RA treatment regimen. The nurse is teaching the client about use of this medication. Which client statement indicates that this teaching was successful?

Accepted Answer

A)Clients who are on methotrexate therapy should be advised to take folic acid, as this can help control side effects such as gastric irritation and stomatitis. Methotrexate is typically taken once per week (not daily), and it can be safely used along with NSAIDs in the treatment of RA. Clients may see beneficial effects of methotrexate therapy is as few as 2-4 weeks (not 3-5 days).
B)Clients who are on methotrexate therapy should be advised to take folic acid, as this can help control side effects such as gastric irritation and stomatitis. Methotrexate is typically taken once per week (not daily), and it can be safely used along with NSAIDs in the treatment of RA. Clients may see beneficial effects of methotrexate therapy is as few as 2-4 weeks (not 3-5 days).
C)Clients who are on methotrexate therapy should be advised to take folic acid, as this can help control side effects such as gastric irritation and stomatitis. Methotrexate is typically taken once per week (not daily), and it can be safely used along with NSAIDs in the treatment of RA. Clients may see beneficial effects of methotrexate therapy is as few as 2-4 weeks (not 3-5 days).
D)Clients who are on methotrexate therapy should be advised to take folic acid, as this can help control side effects such as gastric irritation and stomatitis. Methotrexate is typically taken once per week (not daily), and it can be safely used along with NSAIDs in the treatment of RA. Clients may see beneficial effects of methotrexate therapy is as few as 2-4 weeks (not 3-5 days).

Question 4

The client enters the outpatient clinic and states to the triage nurse, "I think I have the flu. I'm so tired, I have no appetite, and everything hurts." The triage nurse assesses the client and finds a butterfly rash over the bridge of the nose and on the cheeks. Based on this data, which diagnosis should the nurse anticipate?

Accepted Answer

A)A "butterfly rash" that covers the bridge of the nose and the cheeks is a characteristic manifestation of systemic lupus erythematosus (SLE). Although fibromyalgia, Lyme disease, and gout all share some symptoms with SLE (e.g., joint pain and/or fatigue), they are not associated with a rash over the nose and cheeks.
B)A "butterfly rash" that covers the bridge of the nose and the cheeks is a characteristic manifestation of systemic lupus erythematosus (SLE). Although fibromyalgia, Lyme disease, and gout all share some symptoms with SLE (e.g., joint pain and/or fatigue), they are not associated with a rash over the nose and cheeks.
C)A "butterfly rash" that covers the bridge of the nose and the cheeks is a characteristic manifestation of systemic lupus erythematosus (SLE). Although fibromyalgia, Lyme disease, and gout all share some symptoms with SLE (e.g., joint pain and/or fatigue), they are not associated with a rash over the nose and cheeks.
D)A "butterfly rash" that covers the bridge of the nose and the cheeks is a characteristic manifestation of systemic lupus erythematosus (SLE). Although fibromyalgia, Lyme disease, and gout all share some symptoms with SLE (e.g., joint pain and/or fatigue), they are not associated with a rash over the nose and cheeks.

Question 5

Which of the following complications is not associated with a diagnosis of rheumatoid arthritis (RA)?

Accepted Answer

A)All individuals with RA are at increased risk of plural effusion and uveitis, although the latter condition is most commonly associated with juvenile RA. Between 25% and 35% of clients with RA have mild anemia. However, pregnant women with RA are no more likely to undergo cesarean delivery than pregnant women without RA.
B)All individuals with RA are at increased risk of plural effusion and uveitis, although the latter condition is most commonly associated with juvenile RA. Between 25% and 35% of clients with RA have mild anemia. However, pregnant women with RA are no more likely to undergo cesarean delivery than pregnant women without RA.
C)All individuals with RA are at increased risk of plural effusion and uveitis, although the latter condition is most commonly associated with juvenile RA. Between 25% and 35% of clients with RA have mild anemia. However, pregnant women with RA are no more likely to undergo cesarean delivery than pregnant women without RA.
D)All individuals with RA are at increased risk of plural effusion and uveitis, although the latter condition is most commonly associated with juvenile RA. Between 25% and 35% of clients with RA have mild anemia. However, pregnant women with RA are no more likely to undergo cesarean delivery than pregnant women without RA.

Question 6

The nurse is completing a health screening for a school-age child with rheumatoid arthritis (RA). The parents ask the nurse to recommend activities that will promote exercise for their child. Which recommendation by the nurse is most appropriate?

Accepted Answer

A)Swimming exercises all the extremities without putting undue stress on joints. In contrast, softball, football, or basketball could all exacerbate joint discomfort.
B)Swimming exercises all the extremities without putting undue stress on joints. In contrast, softball, football, or basketball could all exacerbate joint discomfort.
C)Swimming exercises all the extremities without putting undue stress on joints. In contrast, softball, football, or basketball could all exacerbate joint discomfort.
D)Swimming exercises all the extremities without putting undue stress on joints. In contrast, softball, football, or basketball could all exacerbate joint discomfort.

Question 7

The nurse is caring for a client who is hospitalized due to an exacerbation of systemic lupus erythematosus (SLE). The nurse is reviewing the client's lab work and finds the white blood cell count (WBC)is shifted to the left. Based on this information, which of the following is a priority nursing diagnosis for this client?

Accepted Answer

A)All identified diagnoses are appropriate for a client with SLE. However, the shift to the left in the WBC count is indicative of a large number of immature cells, suggesting infection. Therefore, the priority diagnosis is Risk for Infection.
B)All identified diagnoses are appropriate for a client with SLE. However, the shift to the left in the WBC count is indicative of a large number of immature cells, suggesting infection. Therefore, the priority diagnosis is Risk for Infection.
C)All identified diagnoses are appropriate for a client with SLE. However, the shift to the left in the WBC count is indicative of a large number of immature cells, suggesting infection. Therefore, the priority diagnosis is Risk for Infection.
D)All identified diagnoses are appropriate for a client with SLE. However, the shift to the left in the WBC count is indicative of a large number of immature cells, suggesting infection. Therefore, the priority diagnosis is Risk for Infection.

Question 8

A nurse is caring for a pregnant client who has rheumatoid arthritis (RA). Based on this data, what should the nurse anticipate when providing care to this client?

Accepted Answer

A)The pregnant client with RA is at continued risk for anemia. Many pregnant clients with RA have prolonged gestations and often experience a remission during pregnancy and relapse after delivery. Due to remission, a decrease in medication is often necessitated.
B)The pregnant client with RA is at continued risk for anemia. Many pregnant clients with RA have prolonged gestations and often experience a remission during pregnancy and relapse after delivery. Due to remission, a decrease in medication is often necessitated.
C)The pregnant client with RA is at continued risk for anemia. Many pregnant clients with RA have prolonged gestations and often experience a remission during pregnancy and relapse after delivery. Due to remission, a decrease in medication is often necessitated.
D)The pregnant client with RA is at continued risk for anemia. Many pregnant clients with RA have prolonged gestations and often experience a remission during pregnancy and relapse after delivery. Due to remission, a decrease in medication is often necessitated.

Question 9

The nurse is collecting a health history for a client being seen in an outpatient clinic who complains of joint pain and swelling that have lasted for about 2 months. The client is diagnosed with rheumatoid arthritis (RA). Which of the following statements made by this client supports the nursing diagnosis of Activity Intolerance?

Accepted Answer

A)One hallmark symptom of RA is extreme fatigue. The client's statement regarding the need for a nap supports the inclusion of Activity Intolerance in the plan of care. Based on this diagnosis, the nurse would teach the client about the need for frequent rest periods during the day to conserve energy. The joints of RA clients are usually stiffest in the morning, but that would not interfere with activities later in the day. Also, taking ibuprofen for pain does not affect the client's ability to engage in activity.
B)One hallmark symptom of RA is extreme fatigue. The client's statement regarding the need for a nap supports the inclusion of Activity Intolerance in the plan of care. Based on this diagnosis, the nurse would teach the client about the need for frequent rest periods during the day to conserve energy. The joints of RA clients are usually stiffest in the morning, but that would not interfere with activities later in the day. Also, taking ibuprofen for pain does not affect the client's ability to engage in activity.
C)One hallmark symptom of RA is extreme fatigue. The client's statement regarding the need for a nap supports the inclusion of Activity Intolerance in the plan of care. Based on this diagnosis, the nurse would teach the client about the need for frequent rest periods during the day to conserve energy. The joints of RA clients are usually stiffest in the morning, but that would not interfere with activities later in the day. Also, taking ibuprofen for pain does not affect the client's ability to engage in activity.
D)One hallmark symptom of RA is extreme fatigue. The client's statement regarding the need for a nap supports the inclusion of Activity Intolerance in the plan of care. Based on this diagnosis, the nurse would teach the client about the need for frequent rest periods during the day to conserve energy. The joints of RA clients are usually stiffest in the morning, but that would not interfere with activities later in the day. Also, taking ibuprofen for pain does not affect the client's ability to engage in activity.

Question 10

A nurse is providing health education at several neighborhood community centers. The nurse adjusts the teaching plan based on the demographic characteristics of the clients that each center serves. For which of the following community centers should the nurse plan on providing information about signs and symptoms of systemic lupus erythematosus (SLE)?

Accepted Answer

A)SLE is more common among women than men, and it most often affects women of childbearing age. Furthermore, SLE is more common in African Americans, Hispanics, Native Americans, Native Hawaiians, and Asians than it is in Caucasians.
B)SLE is more common among women than men, and it most often affects women of childbearing age. Furthermore, SLE is more common in African Americans, Hispanics, Native Americans, Native Hawaiians, and Asians than it is in Caucasians.
C)SLE is more common among women than men, and it most often affects women of childbearing age. Furthermore, SLE is more common in African Americans, Hispanics, Native Americans, Native Hawaiians, and Asians than it is in Caucasians.
D)SLE is more common among women than men, and it most often affects women of childbearing age. Furthermore, SLE is more common in African Americans, Hispanics, Native Americans, Native Hawaiians, and Asians than it is in Caucasians.

Question 11

A female client with systemic lupus erythematosus (SLE)is being treated with immunosuppressant drugs and corticosteroids. When providing teaching to this client, which of the following points are appropriate for the nurse to include? Select all that apply.

Accepted Answer

A)Crowds may increase exposure to infection, which is potentially dangerous for clients who are taking immunosuppressants. Annual influenza vaccination is recommended, although clients with significant immunosuppression should not receive live vaccines. Immunosuppressive drugs may increase the risk of birth defects, so contraception is important. Aspirin products may increase the risk of bleeding, which would further impair immune function. Chills, fever, sore throat, fatigue, or malaise should be reported so related infections can be treated as quickly as possible.
B)Crowds may increase exposure to infection, which is potentially dangerous for clients who are taking immunosuppressants. Annual influenza vaccination is recommended, although clients with significant immunosuppression should not receive live vaccines. Immunosuppressive drugs may increase the risk of birth defects, so contraception is important. Aspirin products may increase the risk of bleeding, which would further impair immune function. Chills, fever, sore throat, fatigue, or malaise should be reported so related infections can be treated as quickly as possible.
C)Crowds may increase exposure to infection, which is potentially dangerous for clients who are taking immunosuppressants. Annual influenza vaccination is recommended, although clients with significant immunosuppression should not receive live vaccines. Immunosuppressive drugs may increase the risk of birth defects, so contraception is important. Aspirin products may increase the risk of bleeding, which would further impair immune function. Chills, fever, sore throat, fatigue, or malaise should be reported so related infections can be treated as quickly as possible.
D)Crowds may increase exposure to infection, which is potentially dangerous for clients who are taking immunosuppressants. Annual influenza vaccination is recommended, although clients with significant immunosuppression should not receive live vaccines. Immunosuppressive drugs may increase the risk of birth defects, so contraception is important. Aspirin products may increase the risk of bleeding, which would further impair immune function. Chills, fever, sore throat, fatigue, or malaise should be reported so related infections can be treated as quickly as possible.
E)Crowds may increase exposure to infection, which is potentially dangerous for clients who are taking immunosuppressants. Annual influenza vaccination is recommended, although clients with significant immunosuppression should not receive live vaccines. Immunosuppressive drugs may increase the risk of birth defects, so contraception is important. Aspirin products may increase the risk of bleeding, which would further impair immune function. Chills, fever, sore throat, fatigue, or malaise should be reported so related infections can be treated as quickly as possible.

Question 12

A client asks the nurse whether there are any conditions that can exacerbate systemic lupus erythematosus (SLE). Which response by the nurse is the most appropriate?

Accepted Answer

A)Pregnancy can be associated with an exacerbation of SLE due to the associated rise in estrogen levels. Hypotension, fever, and GI upset are not factors that risk exacerbation of SLE.
B)Pregnancy can be associated with an exacerbation of SLE due to the associated rise in estrogen levels. Hypotension, fever, and GI upset are not factors that risk exacerbation of SLE.
C)Pregnancy can be associated with an exacerbation of SLE due to the associated rise of estrogen levels. Hypotension, fever, and GI upset are not factors that risk exacerbation of SLE.
D)Pregnancy can be associated with an exacerbation of SLE due to the rise of estrogen levels. Hypotension, fever, and GI upset are not factors that risk exacerbation of SLE.

Question 13

The nurse is providing care to a client who is receiving nonsteroidal anti-inflammatory drugs (NSAIDs)in the treatment of rheumatoid arthritis. When providing care to this client, which actions by the nurse are appropriate? Select all that apply.

Accepted Answer

A)When providing care to a client who is receiving any medication, it is important to monitor for signs of allergic reaction. Taking NSAIDs with food may help reduce symptoms of GI distress that are often associated with these drugs. Clients who are on NSAIDs should be monitored for signs of renal problems, because these medications are potentially nephrotoxic. Clients should also avoid herbal supplements such as feverfew, garlic, ginger, and gingko, as these substances can increase the risk of bleeding associated with NSAID use. Because NSAIDs can cause blood pressure alterations, they may be dangerous for clients with cardiovascular disorders.
B)When providing care to a client who is receiving any medication, it is important to monitor for signs of allergic reaction. Taking NSAIDs with food may help reduce symptoms of GI distress that are often associated with these drugs. Clients who are on NSAIDs should be monitored for signs of renal problems, because these medications are potentially nephrotoxic. Clients should also avoid herbal supplements such as feverfew, garlic, ginger, and gingko, as these substances can increase the risk of bleeding associated with NSAID use. Because NSAIDs can cause blood pressure alterations, they may be dangerous for clients with cardiovascular disorders.
C)When providing care to a client who is receiving any medication, it is important to monitor for signs of allergic reaction. Taking NSAIDs with food may help reduce symptoms of GI distress that are often associated with these drugs. Clients who are on NSAIDs should be monitored for signs of renal problems, because these medications are potentially nephrotoxic. Clients should also avoid herbal supplements such as feverfew, garlic, ginger, and gingko, as these substances can increase the risk of bleeding associated with NSAID use. Because NSAIDs can cause blood pressure alterations, they may be dangerous for clients with cardiovascular disorders.
D)When providing care to a client who is receiving any medication, it is important to monitor for signs of allergic reaction. Taking NSAIDs with food may help reduce symptoms of GI distress that are often associated with these drugs. Clients who are on NSAIDs should be monitored for signs of renal problems, because these medications are potentially nephrotoxic. Clients should also avoid herbal supplements such as feverfew, garlic, ginger, and gingko, as these substances can increase the risk of bleeding associated with NSAID use. Because NSAIDs can cause blood pressure alterations, they may be dangerous for clients with cardiovascular disorders.
E)When providing care to a client who is receiving any medication, it is important to monitor for signs of allergic reaction. Taking NSAIDs with food may help reduce symptoms of GI distress that are often associated with these drugs. Clients who are on NSAIDs should be monitored for signs of renal problems, because these medications are potentially nephrotoxic. Clients should also avoid herbal supplements such as feverfew, garlic, ginger, and gingko, as these substances can increase the risk of bleeding associated with NSAID use. Because NSAIDs can cause blood pressure alterations, they may be dangerous for clients with cardiovascular disorders.

Question 14

Based on gender and age alone, which of the following clients is most likely to experience the new onset of rheumatoid arthritis (RA)?

Accepted Answer

A)RA is the most common form of autoimmune arthritis, affecting from 1% to 2% of the worldwide population. RA affects three times as many women as men, and while the typical age of onset is between 40 and 60 years, this disease strikes people of all ages.
B)RA is the most common form of autoimmune arthritis, affecting from 1% to 2% of the worldwide population. RA affects three times as many women as men, and while the typical age of onset is between 40 and 60 years, this disease strikes people of all ages.
C)RA is the most common form of autoimmune arthritis, affecting from 1% to 2% of the worldwide population. RA affects three times as many women as men, and while the typical age of onset is between 40 and 60 years, this disease strikes people of all ages.
D)RA is the most common form of autoimmune arthritis, affecting from 1% to 2% of the worldwide population. RA affects three times as many women as men, and while the typical age of onset is between 40 and 60 years, this disease strikes people of all ages.

Question 15

Which form of juvenile idiopathic arthritis (JIA)primarily affects the knees, ankles, and elbows?

Accepted Answer

A)There are three types of JIA: pauciarticular, systemic, and polyarticular. Pauciarticular arthritis primarily affects the knees, ankles, and elbows. Systemic arthritis involves high fever, polyarthritis, and rheumatoid rash and also affects internal organs. Polyarticular arthritis affects many joints (five or more), particularly the small joints of the hands and fingers. It also may affect the hips, knees, feet, ankles, and neck. Osteoarthritis is a separate condition, not a form of JIA.
B)There are three types of JIA: pauciarticular, systemic, and polyarticular. Pauciarticular arthritis primarily affects the knees, ankles, and elbows. Systemic arthritis involves high fever, polyarthritis, and rheumatoid rash and also affects internal organs. Polyarticular arthritis affects many joints (five or more), particularly the small joints of the hands and fingers. It also may affect the hips, knees, feet, ankles, and neck. Osteoarthritis is a separate condition, not a form of JIA.
C)There are three types of JIA: pauciarticular, systemic, and polyarticular. Pauciarticular arthritis primarily affects the knees, ankles, and elbows. Systemic arthritis involves high fever, polyarthritis, and rheumatoid rash and also affects internal organs. Polyarticular arthritis affects many joints (five or more), particularly the small joints of the hands and fingers. It also may affect the hips, knees, feet, ankles, and neck. Osteoarthritis is a separate condition, not a form of JIA.
D)There are three types of JIA: pauciarticular, systemic, and polyarticular. Pauciarticular arthritis primarily affects the knees, ankles, and elbows. Systemic arthritis involves high fever, polyarthritis, and rheumatoid rash and also affects internal organs. Polyarticular arthritis affects many joints (five or more), particularly the small joints of the hands and fingers. It also may affect the hips, knees, feet, ankles, and neck. Osteoarthritis is a separate condition, not a form of JIA.

Question 16

A nurse is caring for a client who is newly diagnosed with rheumatoid arthritis (RA). The client asks the nurse to explain the difference is between RA and osteoarthritis (OA). Which responses by the nurse are most appropriate? Select all that apply.

Accepted Answer

A)The onset of OA is gradual, whereas the onset of RA may be rapid. RA affects multiple joints symmetrically, but OA affects one joint at a time. The affected joints in OA feel cold to the touch, whereas the affected joints in RA are warm or hot to the touch. OA is slowly progressive, whereas RA has exacerbations and remissions. With RA, pain and stiffness occur with activity; with OA, pain and stiffness are predominant upon arising.
B)The onset of OA is gradual, whereas the onset of RA may be rapid. RA affects multiple joints symmetrically, but OA affects one joint at a time. The affected joints in OA feel cold to the touch, whereas the affected joints in RA are warm or hot to the touch. OA is slowly progressive, whereas RA has exacerbations and remissions. With RA, pain and stiffness occur with activity; with OA, pain and stiffness are predominant upon arising.
C)The onset of OA is gradual, whereas the onset of RA may be rapid. RA affects multiple joints symmetrically, but OA affects one joint at a time. The affected joints in OA feel cold to the touch, whereas the affected joints in RA are warm or hot to the touch. OA is slowly progressive, whereas RA has exacerbations and remissions. With RA, pain and stiffness occur with activity; with OA, pain and stiffness are predominant upon arising.
D)The onset of OA is gradual, whereas the onset of RA may be rapid. RA affects multiple joints symmetrically, but OA affects one joint at a time. The affected joints in OA feel cold to the touch, whereas the affected joints in RA are warm or hot to the touch. OA is slowly progressive, whereas RA has exacerbations and remissions. With RA, pain and stiffness occur with activity; with OA, pain and stiffness are predominant upon arising.
E)The onset of OA is gradual, whereas the onset of RA may be rapid. RA affects multiple joints symmetrically, but OA affects one joint at a time. The affected joints in OA feel cold to the touch, whereas the affected joints in RA are warm or hot to the touch. OA is slowly progressive, whereas RA has exacerbations and remissions. With RA, pain and stiffness occur with activity; with OA, pain and stiffness are predominant upon arising.

Question 17

A client with rheumatoid arthritis (RA)is being seen in the outpatient clinic for a progress checkup. Which of the following statements on the part of the client suggests that she has met a goal of treatment?

Accepted Answer

A)One technique for reducing stress on the joints is to delegate household tasks to family members; however, the client does not need to refrain from all household chores. Sleeping for 10 hours at night will not alleviate the need for frequent rest periods during the day. Increased joint pain would indicate that goals have not been met.
B)One technique for reducing stress on the joints is to delegate household tasks to family members; however, the client does not need to refrain from all household chores. Sleeping for 10 hours at night will not alleviate the need for frequent rest periods during the day. Increased joint pain would indicate that goals have not been met.
C)One technique for reducing stress on the joints is to delegate household tasks to family members; however, the client does not need to refrain from all household chores. Sleeping for 10 hours at night will not alleviate the need for frequent rest periods during the day. Increased joint pain would indicate that goals have not been met.
D)One technique for reducing stress on the joints is to delegate household tasks to family members; however, the client does not need to refrain from all household chores. Sleeping for 10 hours at night will not alleviate the need for frequent rest periods during the day. Increased joint pain would indicate that goals have not been met.

Question 18

A client who was recently diagnosed with rheumatoid arthritis (RA)asks the nurse if RA always causes crippling deformities. What information should the nurse include when teaching this client about ways to decrease the likelihood of crippling deformities? Select all that apply.

Accepted Answer

A)The client with RA should never attempt to push a joint beyond its ability. Pain is a warning signal, so the client with RA should immediately stop any activity that causes pain. The client should also use the strongest joints possible to complete tasks, and he or she should avoid activities (like writing)that require a strong grip. In addition, when performing tasks, the client should avoid stress in any current area of deformity to help prevent further deformities.
B)The client with RA should never attempt to push a joint beyond its ability. Pain is a warning signal, so the client with RA should immediately stop any activity that causes pain. The client should also use the strongest joints possible to complete tasks, and he or she should avoid activities (like writing)that require a strong grip. In addition, when performing tasks, the client should avoid stress in any current area of deformity to help prevent further deformities.
C)The client with RA should never attempt to push a joint beyond its ability. Pain is a warning signal, so the client with RA should immediately stop any activity that causes pain. The client should also use the strongest joints possible to complete tasks, and he or she should avoid activities (like writing)that require a strong grip. In addition, when performing tasks, the client should avoid stress in any current area of deformity to help prevent further deformities.
D)The client with RA should never attempt to push a joint beyond its ability. Pain is a warning signal, so the client with RA should immediately stop any activity that causes pain. The client should also use the strongest joints possible to complete tasks, and he or she should avoid activities (like writing)that require a strong grip. In addition, when performing tasks, the client should avoid stress in any current area of deformity to help prevent further deformities.
E)The client with RA should never attempt to push a joint beyond its ability. Pain is a warning signal, so the client with RA should immediately stop any activity that causes pain. The client should also use the strongest joints possible to complete tasks, and he or she should avoid activities (like writing)that require a strong grip. In addition, when performing tasks, the client should avoid stress in any current area of deformity to help prevent further deformities.

Question 19

A nurse is caring for a client with systemic lupus erythematosus (SLE). The client begins to cry, stating, "I am afraid I will be disfigured because of all of these lesions." Which interventions should the nurse plan to teach this client to minimize the risk of skin infections associated with SLE? Select all that apply.

Accepted Answer

A)Clients with SLE can live a normal life, but they should take a few extra precautions to minimize the risk of skin lesions. For example, because there is a relationship between sun exposure and infection, the client should be taught to use sunscreen with an SPF of at least 15 and to avoid the sun between 10:00 a.m. and 3:00 p.m. The client may swim but should reapply sunscreen after swimming. The client does not need to stay indoors on sunny days as long as the above precautions are taken. When indoors, the client should try to avoid fluorescent lighting, as exacerbations of SLE have been reported following exposure.
B)Clients with SLE can live a normal life, but they should take a few extra precautions to minimize the risk of skin lesions. For example, because there is a relationship between sun exposure and infection, the client should be taught to use sunscreen with an SPF of at least 15 and to avoid the sun between 10:00 a.m. and 3:00 p.m. The client may swim but should reapply sunscreen after swimming. The client does not need to stay indoors on sunny days as long as the above precautions are taken. When indoors, the client should try to avoid fluorescent lighting, as exacerbations of SLE have been reported following exposure.
C)Clients with SLE can live a normal life, but they should take a few extra precautions to minimize the risk of skin lesions. For example, because there is a relationship between sun exposure and infection, the client should be taught to use sunscreen with an SPF of at least 15 and to avoid the sun between 10:00 a.m. and 3:00 p.m. The client may swim but should reapply sunscreen after swimming. The client does not need to stay indoors on sunny days as long as the above precautions are taken. When indoors, the client should try to avoid fluorescent lighting, as exacerbations of SLE have been reported following exposure.
D)Clients with SLE can live a normal life, but they should take a few extra precautions to minimize the risk of skin lesions. For example, because there is a relationship between sun exposure and infection, the client should be taught to use sunscreen with an SPF of at least 15 and to avoid the sun between 10:00 a.m. and 3:00 p.m. The client may swim but should reapply sunscreen after swimming. The client does not need to stay indoors on sunny days as long as the above precautions are taken. When indoors, the client should try to avoid fluorescent lighting, as exacerbations of SLE have been reported following exposure.
E)Clients with SLE can live a normal life, but they should take a few extra precautions to minimize the risk of skin lesions. For example, because there is a relationship between sun exposure and infection, the client should be taught to use sunscreen with an SPF of at least 15 and to avoid the sun between 10:00 a.m. and 3:00 p.m. The client may swim but should reapply sunscreen after swimming. The client does not need to stay indoors on sunny days as long as the above precautions are taken. When indoors, the client should try to avoid fluorescent lighting, as exacerbations of SLE have been reported following exposure.

Question 20

Why are proton pump inhibitors often included as part of the pharmacologic treatment regimen for clients with rheumatoid arthritis (RA)?

Accepted Answer

A)NSAIDs are among the most common dugs used in the treatment of RA, although they may produce unpleasant gastric side effects like stomach lining irritation, erosions, and bleeding ulcers. Concurrent administration of proton pump inhibitors may reduce the risk for GI bleeding due to NSAIDs. Proton pump inhibitors do not affect the inflammation, immune reactions, and joint destruction associated with RA, nor do they reduce the body's autoimmune response. Furthermore, these drugs do not affect the risk of vision problems that accompanies use of antimalarial agents.
B)NSAIDs are among the most common dugs used in the treatment of RA, although they may produce unpleasant gastric side effects like stomach lining irritation, erosions, and bleeding ulcers. Concurrent administration of proton pump inhibitors may reduce the risk for GI bleeding due to NSAIDs. Proton pump inhibitors do not affect the inflammation, immune reactions, and joint destruction associated with RA, nor do they reduce the body's autoimmune response. Furthermore, these drugs do not affect the risk of vision problems that accompanies use of antimalarial agents.
C)NSAIDs are among the most common dugs used in the treatment of RA, although they may produce unpleasant gastric side effects like stomach lining irritation, erosions, and bleeding ulcers. Concurrent administration of proton pump inhibitors may reduce the risk for GI bleeding due to NSAIDs. Proton pump inhibitors do not affect the inflammation, immune reactions, and joint destruction associated with RA, nor do they reduce the body's autoimmune response. Furthermore, these drugs do not affect the risk of vision problems that accompanies use of antimalarial agents.
D)NSAIDs are among the most common dugs used in the treatment of RA, although they may produce unpleasant gastric side effects like stomach lining irritation, erosions, and bleeding ulcers. Concurrent administration of proton pump inhibitors may reduce the risk for GI bleeding due to NSAIDs. Proton pump inhibitors do not affect the inflammation, immune reactions, and joint destruction associated with RA, nor do they reduce the body's autoimmune response. Furthermore, these drugs do not affect the risk of vision problems that accompanies use of antimalarial agents.

Quiz 8: Immunity

Why are second-generation antihistamines often preferred to first-generation histamines in the treatment of hypersensitivity reactions?

Which of the following complications is not associated with a diagnosis of rheumatoid arthritis (RA) ?

The nurse is completing a health screening for a school-age child with rheumatoid arthritis (RA) . The parents ask the nurse to recommend activities that will promote exercise for their child. Which recommendation by the nurse is most appropriate?

A nurse is caring for a pregnant client who has rheumatoid arthritis (RA) . Based on this data, what should the nurse anticipate when providing care to this client?

A female client with systemic lupus erythematosus (SLE) is being treated with immunosuppressant drugs and corticosteroids. When providing teaching to this client, which of the following points are appropriate for the nurse to include? Select all that apply.

A client asks the nurse whether there are any conditions that can exacerbate systemic lupus erythematosus (SLE) . Which response by the nurse is the most appropriate?

The nurse is providing care to a client who is receiving nonsteroidal anti-inflammatory drugs (NSAIDs) in the treatment of rheumatoid arthritis. When providing care to this client, which actions by the nurse are appropriate? Select all that apply.

Based on gender and age alone, which of the following clients is most likely to experience the new onset of rheumatoid arthritis (RA) ?

Which form of juvenile idiopathic arthritis (JIA) primarily affects the knees, ankles, and elbows?

A nurse is caring for a client who is newly diagnosed with rheumatoid arthritis (RA) . The client asks the nurse to explain the difference is between RA and osteoarthritis (OA) . Which responses by the nurse are most appropriate? Select all that apply.

A client with rheumatoid arthritis (RA) is being seen in the outpatient clinic for a progress checkup. Which of the following statements on the part of the client suggests that she has met a goal of treatment?

A client who was recently diagnosed with rheumatoid arthritis (RA) asks the nurse if RA always causes crippling deformities. What information should the nurse include when teaching this client about ways to decrease the likelihood of crippling deformities? Select all that apply.

Why are proton pump inhibitors often included as part of the pharmacologic treatment regimen for clients with rheumatoid arthritis (RA) ?