Pearson Exemplar - 8.C Rheumatoid Arthritis (RA)

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

A) Increased risk of cesarean delivery

B) Increased risk of pleural effusion

C) Increased likelihood of uveitis

D) Increased risk of anemia

A

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.

A) Ignore pain as a warning signal.

B) Type instead of hand-writing items if possible.

C) Use the strongest joints possible to complete most tasks.

D) Avoid stress to any current area of deformity.

E) Stop an activity immediately if it is beyond your ability to perform.

B C D E

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

A) A 31-year-old man

B) A 42-year-old woman

C) A 65-year-old woman

D) An 18-year-old man

B

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?

A) "I seem to get tired early in the day and require a nap."

B) "My joints are stiffest at night before I go to sleep."

C) "I find it difficult to move when I first get up in the morning."

D) "I take ibuprofen for the pain as needed."

A

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) Swimming

B) Football

C) Softball

D) Basketball

A

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) "I sleep for 10 hours at night."

B) "I have increased pain in my joints all the time now."

C) "I have delegated many household chores to my children and spouse."

D) "I do not perform household chores at all anymore."

C

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?

A) "It's not safe for me to take nonsteroidal anti-inflammatory drugs (NSAIDs) while on methotrexate therapy."

B) "I can help control the side effects of methotrexate by taking folic acid."

C) "I should expect to see beneficial results within 3 to 5 days of starting methotrexate therapy."

D) "It's important that I take my methotrexate at the same time every day."

B

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.

A) Discourage any position changes.

B) Encourage relaxation techniques.

C) Immobilize the extremity.

D) Offer heat and/or cold packs.

E) Provide distraction activities.

B D E

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) A higher risk for preterm delivery

B) An increased need for medication

C) An acute exacerbation of symptoms

D) A continued risk for anemia

D

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) "The onset of OA is gradual, whereas the onset of RA may be rapid."

B) "With OA, multiple joints are symmetrically affected; RA affects one joint at a time."

C) "The affected joints in RA feel cold to the touch, whereas the affected joints in OA are warm or hot to the touch."

D) "OA is slowly progressive, whereas RA is characterized by exacerbations and remissions."

E) "With RA, pain and stiffness occur with activity; with OA, pain and stiffness are predominant upon arising."

A D

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.

A) Monitoring for signs of allergic reaction

B) Assuring the client that NSAIDs are safe for clients with cardiovascular disease

C) Encouraging the client to take NSAIDs with a small snack to help avoid GI distress

D) Monitoring for signs of renal problems

E) Inquire about the use of herbal supplements such as feverfew, garlic, ginger, or ginkgo

A C D E

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

A) Pauciarticular arthritis

B) Polyarticular arthritis

C) Systemic arthritis

D) Osteoarthritis

A

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

A) Proton pump inhibitors help reduce the unpleasant GI-related side effects of NSAIDs, which are the most common class of medications used in the treatment of RA.

B) Proton pump inhibitors can dramatically decrease both inflammation and immune reactions and appear to slow the progression of joint destruction in RA.

C) Proton pump inhibitors help reduce the body's autoimmune response, thereby limiting the effects of the autoimmune disease process that underlies RA.

D) Proton pump inhibitors help reduce the risk of retinitis and vision loss in clients who are taking antimalarial agents as part of their therapeutic regimen for RA.

A