Chapter 65 Nursing Management Arthritis And Connective Tiss

5879 Words Feb 16th, 2015 24 Pages
Chapter 65: Nursing Management: Arthritis and Connective Tissue Diseases
Test Bank
MULTIPLE CHOICE
1. Which finding will the nurse expect when assessing a 58-year-old patient who has

osteoarthritis (OA) of the knee?
a. Discomfort with joint movement
b. Heberden’s and Bouchard’s nodes
c. Redness and swelling of the knee joint
d. Stiffness that increases with movement
ANS: A

Initial symptoms of OA include pain with joint movement. Heberden’s nodules occur on the fingers. Redness of the joint is more strongly associated with rheumatoid arthritis (RA).
Stiffness in OA is worse right after the patient rests and decreases with joint movement.
DIF: Cognitive Level: Understand (comprehension)
REF: 1562
TOP: Nursing Process: Assessment
MSC:
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Patients are taught to avoid stressing joints, to use warm baths to relieve stiffness, and to use a firm mattress. When stabilized, a therapeutic exercise program is usually developed by a physical therapist to include exercises that improve the flexibility and strength of the affected joints, and the patient’s overall endurance.
DIF: Cognitive Level: Apply (application)
REF:
1575
TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity
7. A patient with rheumatoid arthritis (RA) complains to the clinic nurse about having

chronically dry eyes. Which action by the nurse is most appropriate?
a. Teach the patient about adverse effects of the RA medications.
b. Suggest that the patient use over-the-counter (OTC) artificial tears.
c. Reassure the patient that dry eyes are a common problem with RA.

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d. Ask the health care provider about discontinuing methotrexate (Rheumatrex) .
ANS: B

The patient’s dry eyes are consistent with Sjögren’s syndrome, a common extraarticular manifestation of RA. Symptomatic therapy such as OTC eye drops is recommended. Dry eyes are not a side effect of methotrexate. Although dry eyes are common in RA, it is more helpful to offer a suggestion to relieve these symptoms than to offer reassurance. The dry eyes are not caused by RA treatment, but by the disease itself.
DIF: Cognitive Level: Apply (application)
REF:
1590
TOP: Nursing
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