Wk. 14 - Arthritis & Total Joint Arthroplasty Practice Questions

A patient with osteoarthritis reports increased joint stiffness in the morning. Which intervention is most appropriate for the nurse to recommend? A. Perform vigorous resistance exercises upon waking B. Apply moist heat to affected joints C. Avoid all physical activity during periods of stiffness D. Increase intake of purine-rich foods

B

Which assessment finding is most characteristic of osteoarthritis, not rheumatoid arthritis? A. Symmetric joint swelling B. Morning stiffness lasting >30 minutes C. Pain that worsens with activity and improves with rest D. Warm, boggy joints

C

The nurse is teaching a patient with OA about nonpharmacologic pain management. Which statements should the nurse include? (Select all that apply.) A. “Use paraffin dips as prescribed.” B. “Use cold therapy during acute inflammation.” C. “Avoid active exercise and use only passive ROM.” D. “Balance activity with rest periods.” E. “Avoid placing large pillows under your knees.”

A,B,D,E

A patient with OA is prescribed celecoxib. Which finding requires immediate notification of the provider? A. Dyspepsia B. Black, tarry stools C. Mild ankle swelling D. Occasional headache

B

True or False: Morning stiffness lasting longer than 30 minutes is a typical clinical manifestation of osteoarthritis.

False

A patient with RA reports severe morning stiffness. Which nursing intervention is most appropriate? A. Encourage total bed rest until symptoms resolve B. Recommend performing ROM exercises after a warm shower C. Instruct the patient to apply ice to all joints before rising D. Encourage high-impact exercise to loosen joints

B

The nurse reviews lab results for a patient with RA. Which results are commonly associated with the disease? (Select all that apply.) A. Elevated ESR B. Positive rheumatoid factor C. Elevated uric acid D. Low-grade anemia E. Elevated C-reactive protein

A,B,D,E

A patient taking methotrexate for RA requires which priority nursing instruction? A. “Take this medication with St. John’s wort.” B. “Report any signs of infection immediately.” C. “It is safe to continue using alcohol while on this medication.” D. “This medication commonly causes vision changes requiring annual eye exams.”

B

Which potential adverse effect is the greatest concern for a patient receiving long-term glucocorticoid therapy? A. Weight loss B. Risk for infection C. Bradycardia D. Hypoglycemia

B

A patient is receiving hydroxychloroquine for RA. The nurse should monitor for which side effects? (Select all that apply.) A. Retinal damage B. Ototoxicity C. Nausea D. Vision changes E. Alopecia

A,C,D

A patient is scheduled for total hip arthroplasty tomorrow. Which preoperative action is most important? A. Asking the patient to demonstrate hip flexion B. Teaching postoperative use of an abduction pillow C. Encouraging the patient to avoid coughing postoperatively D. Instructing the patient to remain on bed rest for 24 hours post-op

B

True or False: Avoiding hip flexion greater than 90 degrees is an essential postoperative hip arthroplasty precaution.

True

Which finding in a patient after total knee arthroplasty requires immediate intervention? A. Temperature of 99.0°F B. Pain rated 6/10 C. Absent pedal pulse on the operative leg D. Mild nausea following opioids

C

Which nursing actions reduce postoperative complications following hip or knee arthroplasty? (Select all that apply.) A. Applying SCDs B. Encouraging early ambulation C. Maintaining hip flexion >90° D. Performing frequent neurovascular checks E. Keeping heels directly on the bed surface

A,B,D

A patient with RA is receiving a biologic DMARD (adalimumab). Which assessment finding requires immediate intervention? A. Mild fatigue B. Nausea C. Fever of 101.5°F D. Localized redness at injection site

C

The nurse is teaching a patient about common symptoms of rheumatoid arthritis. Which should be included? (Select all that apply.) A. Symmetric joint involvement B. Morning stiffness >30 minutes C. Pain relieved completely by rest D. Warm, spongy joints E. Systemic fatigue and weight loss

A,B,D,E

A patient with osteoarthritis is prescribed ibuprofen. Which assessment finding would require the nurse to discontinue the medication and contact the provider? A. Mild headache B. Tarry stools C. Decreased appetite D. Slight ankle edema

B

The nurse is reviewing medication risks with a patient starting NSAIDs. Which side effects should the nurse include? (Select all that apply.) A. GI bleeding B. Hepatotoxicity C. Renal impairment D. Hyperglycemia E. Fluid retention

A,C,E

True or False: In rheumatoid arthritis, pannus formation contributes to cartilage destruction and joint deformity.

True

Which finding is most consistent with ineffective pain management in a patient with osteoarthritis? A. Uses moist heat daily B. Reports increased pain after prolonged sitting C. Has difficulty rising from a chair due to pain D. Participates in low-impact exercise program

C