NURS 3540: NURSING MANAGEMENT: ARTHRITIS AND
CONNECTIVE TISSUE DISEASES EXAM Q & A
Chapter
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
i. 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
,2. Which assessment finding about a patient who has been using naproxen (Naprosyn) for 6
weeks to treat osteoarthritis is most
important for the nurse to report to the health care provider?
a. The patient has gained 3 pounds
b. The patient has dark-colored stools
c. The patient’s pain has become more severe
d. The patient is using capsaicin cream (Zostrix)
i. B-Dark-colored stools may indicate that the patient is experiencing
gastrointestinal bleeding caused by the naproxen. The information about
the patient’s ongoing pain and weight gain also will be reported and may
indicate a need for a different treatment and/or counseling about avoiding
weight gain, but these are not as large a concern as the possibility of
gastrointestinal bleeding. Use of capsaicin cream with oral medications is
appropriate
3. After the nurse has finished teaching a 68-year-old patient with osteoarthritis (OA) of
the right hip about how to manage the OA, which patient statement indicates a need
for more teaching?
a. “I can take glucosamine to help decrease my knee pain.”
b. “I will take 1 g of acetaminophen (Tylenol) every 4 hours.”
c. “I will take a shower in the morning to help relieve stiffness.”
d. “I can use a cane to decrease the pressure and pain in my hip.”
i. B-No more than 4 g of acetaminophen should be taken daily to avoid
liver damage. The other patient statements are correct and indicate
good understanding of OA management
4. The nurse will anticipate the need to teach a 57-year-old patient who has osteoarthritis
(OA) about which medication?
, a. Adalimumab (Humira)
b. Prednisone (Deltasone)
c. Capsaicin cream (Zostrix)
d. Sulfasalazine (Azulfidine)
i. C-Capsaicin cream blocks the transmission of pain impulses and is
helpful for some patients in treating OA. The other medications would
be used for patients with RA
5. A patient with rheumatoid arthritis being seen in the clinic has rheumatoid nodules on the
elbows. Which action will the nurse take?
a. Draw blood for rheumatoid factor analysis
b. Teach the patient about injections for the nodules
c. Assess the nodules for skin breakdown or infection
d. Discuss the need for surgical removal of the nodules
i. C-Rheumatoid nodules can break down or become infected. They are
not associated with changes in rheumatoid factor, and injection is not
needed. Rheumatoid nodules are usually not removed surgically because
of a high probability of recurrence
6. Which action will the nurse include in the plan of care for a 33-year-old patient with a new
diagnosis of rheumatoid arthritis?
a. Instruct the patient to purchase a soft mattress
b. Suggest that the patient take a nap in the afternoon
c. Teach the patient to use lukewarm water when bathing
d. Suggest exercise with light weights several times daily
i. B-Adequate rest helps decrease the fatigue and pain that are associated
with rheumatoid arthritis. 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
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
d. Ask the health care provider about discontinuing methotrexate (Rheumatrex)
i. 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
8. Which information will the nurse include when preparing teaching materials for patients
with exacerbations of rheumatoid arthritis?
a. Affected joints should not be exercised when pain is present
b. Application of cold packs before exercise may decrease joint pain
c. Exercises should be performed passively by someone other than the patient
d. Walking may substitute for range-of-motion (ROM) exercises on some days
CONNECTIVE TISSUE DISEASES EXAM Q & A
Chapter
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
i. 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
,2. Which assessment finding about a patient who has been using naproxen (Naprosyn) for 6
weeks to treat osteoarthritis is most
important for the nurse to report to the health care provider?
a. The patient has gained 3 pounds
b. The patient has dark-colored stools
c. The patient’s pain has become more severe
d. The patient is using capsaicin cream (Zostrix)
i. B-Dark-colored stools may indicate that the patient is experiencing
gastrointestinal bleeding caused by the naproxen. The information about
the patient’s ongoing pain and weight gain also will be reported and may
indicate a need for a different treatment and/or counseling about avoiding
weight gain, but these are not as large a concern as the possibility of
gastrointestinal bleeding. Use of capsaicin cream with oral medications is
appropriate
3. After the nurse has finished teaching a 68-year-old patient with osteoarthritis (OA) of
the right hip about how to manage the OA, which patient statement indicates a need
for more teaching?
a. “I can take glucosamine to help decrease my knee pain.”
b. “I will take 1 g of acetaminophen (Tylenol) every 4 hours.”
c. “I will take a shower in the morning to help relieve stiffness.”
d. “I can use a cane to decrease the pressure and pain in my hip.”
i. B-No more than 4 g of acetaminophen should be taken daily to avoid
liver damage. The other patient statements are correct and indicate
good understanding of OA management
4. The nurse will anticipate the need to teach a 57-year-old patient who has osteoarthritis
(OA) about which medication?
, a. Adalimumab (Humira)
b. Prednisone (Deltasone)
c. Capsaicin cream (Zostrix)
d. Sulfasalazine (Azulfidine)
i. C-Capsaicin cream blocks the transmission of pain impulses and is
helpful for some patients in treating OA. The other medications would
be used for patients with RA
5. A patient with rheumatoid arthritis being seen in the clinic has rheumatoid nodules on the
elbows. Which action will the nurse take?
a. Draw blood for rheumatoid factor analysis
b. Teach the patient about injections for the nodules
c. Assess the nodules for skin breakdown or infection
d. Discuss the need for surgical removal of the nodules
i. C-Rheumatoid nodules can break down or become infected. They are
not associated with changes in rheumatoid factor, and injection is not
needed. Rheumatoid nodules are usually not removed surgically because
of a high probability of recurrence
6. Which action will the nurse include in the plan of care for a 33-year-old patient with a new
diagnosis of rheumatoid arthritis?
a. Instruct the patient to purchase a soft mattress
b. Suggest that the patient take a nap in the afternoon
c. Teach the patient to use lukewarm water when bathing
d. Suggest exercise with light weights several times daily
i. B-Adequate rest helps decrease the fatigue and pain that are associated
with rheumatoid arthritis. 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
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
d. Ask the health care provider about discontinuing methotrexate (Rheumatrex)
i. 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
8. Which information will the nurse include when preparing teaching materials for patients
with exacerbations of rheumatoid arthritis?
a. Affected joints should not be exercised when pain is present
b. Application of cold packs before exercise may decrease joint pain
c. Exercises should be performed passively by someone other than the patient
d. Walking may substitute for range-of-motion (ROM) exercises on some days
