NRNP 6566 STUDY GUIDE KEY CONCEPTS
WEEK 1 TO 5 2026 EXAM PREPARATION
WORKBOOK COMPREHENSIVE QUESTIONS
AND ANSWERS HIGH SCORE A+
◉ Osteoarthritis findings and diagnostics. Answer: - Pain in weight
bearing joints
- stiffness after sitting, gets better when arising
- feeling of instability on stairs
- fine motor skills deficit
- larger affected joints
- Heberden nodules (bony bumps on the finger joint closest to the
fingernail)
- Bouchard's nodules (bony bumps on the middle joint of the finger)
- limited ROM with crepitus
- xr shows narrowing of joint space (need anteroposterior and
lateral knee films bilaterally)
- synovial fluid is clear and without WBC
◉ Osteoarthritis treatment. Answer: Goal is to relieve symptoms,
maintain/ improve function, and avoid drug toxicity
,Hand OA:
- rest/ joint protection, with splinting
- heat/ cold therapy
- topical capsaicin
- topical NSAID (trolamine salicylate) (especially for older than 75)
- Oral NSAIDS, incl COX2 inhibitors such as celecoxib (Celebrex)
(may cause cardiac problems)
- tramadol
- no opioids
Hip/ knee OA:
- weight reduction, cardiovascular exercises
- transcutanous external nerve stimulator
- acetaminophen
- Topical NSAIDS (knee)
- intraarticular corticosteroid injections
- surgery (joint replacement)
◉ Rheumatoid arthritis: what, who. Answer: chronic, systemic
autoimmune disease that causes inflammation of connective tissue,
first that of jionts them other soft tissues (renal, cardiovascular,
pulm). TNF-alpha plays a big role
,- more women than men
- unknown cause
- Epstein Barr virus
◉ Rheumatoid arthritis: Findings and diagnostics. Answer: -
symmetric joint/ muscle pain, worse in the morning then gets better
- weakness, fatigue
- anorexia, weight loss
- generalized malaise
- swollen joints/ boggy feeling of joints with deformity of joints
- warm, red skin on affected joints
later:
- pleural effusions and pulmonary nodules
- inflammation of sclerea (scleritis)
- pericarditis, myocarditis
- splenomegaly (Felty's syndrome)
- anemia (hypochromic, microcytic) with low ferritin
- possibly: positive rheumatoid factor
- XR: joint swelling, later cortical and space thinning
- synovial fluid: yellow, thick with elevated WBC up to 100.000
, ◉ Felty's syndrome. Answer: rheumatoid arthritis, splenomegaly,
neutropenia
◉ Rheumatoid arthritis treatment. Answer: - early treatment better
than stepwise
- early referral rheumatologist
- disease-modifying anti-rheumatic drugs (DMARDs):
- methotrexate ( no alcohol, monitor renal and liver, give with folic
acid)
- cyclosporine
- Gold preparations (can cause thrombocytopenia)
- Hydroxychloroquine: antimalarial drug (may cause visual changes,
monitor)
- sulfasalazine, moderate RA
- Leflunomide, moderate to severe RA
- Etanercept
- monitor liver function with DMARDs
- screen for TB (skin test) and Hep B
- surgery: joint debridement, joint replacement
◉ Gout: what, who. Answer: Inflammatory disorder in response to
high uric acid production/ levels in blood and synovial fluid causing
WEEK 1 TO 5 2026 EXAM PREPARATION
WORKBOOK COMPREHENSIVE QUESTIONS
AND ANSWERS HIGH SCORE A+
◉ Osteoarthritis findings and diagnostics. Answer: - Pain in weight
bearing joints
- stiffness after sitting, gets better when arising
- feeling of instability on stairs
- fine motor skills deficit
- larger affected joints
- Heberden nodules (bony bumps on the finger joint closest to the
fingernail)
- Bouchard's nodules (bony bumps on the middle joint of the finger)
- limited ROM with crepitus
- xr shows narrowing of joint space (need anteroposterior and
lateral knee films bilaterally)
- synovial fluid is clear and without WBC
◉ Osteoarthritis treatment. Answer: Goal is to relieve symptoms,
maintain/ improve function, and avoid drug toxicity
,Hand OA:
- rest/ joint protection, with splinting
- heat/ cold therapy
- topical capsaicin
- topical NSAID (trolamine salicylate) (especially for older than 75)
- Oral NSAIDS, incl COX2 inhibitors such as celecoxib (Celebrex)
(may cause cardiac problems)
- tramadol
- no opioids
Hip/ knee OA:
- weight reduction, cardiovascular exercises
- transcutanous external nerve stimulator
- acetaminophen
- Topical NSAIDS (knee)
- intraarticular corticosteroid injections
- surgery (joint replacement)
◉ Rheumatoid arthritis: what, who. Answer: chronic, systemic
autoimmune disease that causes inflammation of connective tissue,
first that of jionts them other soft tissues (renal, cardiovascular,
pulm). TNF-alpha plays a big role
,- more women than men
- unknown cause
- Epstein Barr virus
◉ Rheumatoid arthritis: Findings and diagnostics. Answer: -
symmetric joint/ muscle pain, worse in the morning then gets better
- weakness, fatigue
- anorexia, weight loss
- generalized malaise
- swollen joints/ boggy feeling of joints with deformity of joints
- warm, red skin on affected joints
later:
- pleural effusions and pulmonary nodules
- inflammation of sclerea (scleritis)
- pericarditis, myocarditis
- splenomegaly (Felty's syndrome)
- anemia (hypochromic, microcytic) with low ferritin
- possibly: positive rheumatoid factor
- XR: joint swelling, later cortical and space thinning
- synovial fluid: yellow, thick with elevated WBC up to 100.000
, ◉ Felty's syndrome. Answer: rheumatoid arthritis, splenomegaly,
neutropenia
◉ Rheumatoid arthritis treatment. Answer: - early treatment better
than stepwise
- early referral rheumatologist
- disease-modifying anti-rheumatic drugs (DMARDs):
- methotrexate ( no alcohol, monitor renal and liver, give with folic
acid)
- cyclosporine
- Gold preparations (can cause thrombocytopenia)
- Hydroxychloroquine: antimalarial drug (may cause visual changes,
monitor)
- sulfasalazine, moderate RA
- Leflunomide, moderate to severe RA
- Etanercept
- monitor liver function with DMARDs
- screen for TB (skin test) and Hep B
- surgery: joint debridement, joint replacement
◉ Gout: what, who. Answer: Inflammatory disorder in response to
high uric acid production/ levels in blood and synovial fluid causing
