N4 test Chapter 63 Joints

NCLEX Examination Review Questions Chapter 63
Med Surg book

1. In assessing the joints of a patient with rheumatoid arthritis, the nurse understands that the joints are damaged by
A. the development of Heberden’s nodes in the joint capsule.
B. the deterioration of cartilage by the enzyme hyaluronidase.
C. invasion of pannus into the joint capsule and subchondral bone.
D. bony ankylosis following inflammation of the joints in HLA-B27–positive individuals.

2. Assessment data noted by the nurse in the patient with osteoarthritis commonly include
A. elevated ESR.
B. evening but no morning stiffness.
C. progressive joint pain with activity.
D. symmetric swelling of metacarpophalangeal joints.

3. An important nursing intervention in caring for the patient with ankylosing spondylitis is to teach the patient
A.thoracic stretching and ROM exercises to prevent deformity.
B. to sleep on the side with the legs flexed and supported with pillows.
C. to prevent enteric and venereal infections that precipitate recurring attacks.
D. that continuous therapeutic blood levels of NSAIDs can limit the progression of the disease.

4. When teaching the patient with gout, the nurse should instruct the patient to
A. avoid foods high in fat and calories.
B. drink plenty of fluids on a daily basis.
C. apply ice packs to decrease joint pain.
D. have CBC and WBC levels monitored regularly.

5. In teaching a patient with SLE about the disorder, the nurse uses the knowledge that the pathophysiology of SLE includes
A. production of autoantibodies directed against constituents of cellular DNA.
B. an autoimmune reaction resulting in degeneration, necrosis, and fibrosis of muscle fibers.
C. deposition in tissues of immune complexes formed from IgG autoantibodies reacting with IgG.
D. chronic inflammation and cytokine activity, which results in synovial proliferation and cartilage and bone damage.

6. The nurse planning teaching for the patient with rheumatoid arthritis who is receiving multiple drug therapy includes information related to the need to
A. use aspirin only on an as-needed basis for pain relief.
B. use birth control during and 3 months following gold therapy.
C. have frequent laboratory monitoring while taking methotrexate.
D. stop taking any corticosteroids as soon as symptoms are relieved.

7. In teaching a patient with fibromyalgia (FMS) about this disorder, the nurse understands that
A. more men than women are affected.
B. trigger points are a definitive diagnostic test.
C. many symptoms are similar to chronic fatigue syndrome.
D. FMS is characterized by progression of worsening inflammation.