NSG 323 Final Exam review
1. Gold sodium thiomalate is prescribed to a client with rheumatoid arthritis. Which of the following side
effects indicates an overdosage of the medication?
A. Flushing.
B. Dizziness.
C. Joint pain.
D. Metallic taste. - 1. Answer: D. Metallic taste.
D: Gold sodium thiomalate toxicity signs are pruritus, diarrhea, dermatitis, stomatitis, and metallic taste.
A&B: Flushing and dizziness are the side effects that may occur soon after the injection.
C: Increased joint pain may occur 1-2 days after the injection.
2. Adalimumab (Humira) is given to a client for the treatment of rheumatoid arthritis. Which of the
following side effect is associated with the medication?
A. Numbness.
B. Diarrhea.
C. Urinary retention.
D. Weight gain. - Answer: A. Numbness.
A: Adalimumab (Humira) has been associated with neurological side effects such as numbness, tingling,
dizziness, visual disturbances, and weakness in the legs).
B, C, D: Options B, C, and D are not associated with the use of medication.
3. A client has just been prescribed with Methotrexate (Trexall) for the treatment of rheumatoid arthritis
who did not respond to any other treatment. An important reminder for the client is to?
A. Clay-colored stool is a normal response of the treatment.
B. Pregnancy is not contraindicated with the use of the medication.
C. Strict hand washing.
D. Get a daily source of sunlight during the day. - 3. Answer: C. Strict hand washing.
C: Clients taking Methotrexate are more likely to get infections or may worsen any current infections.
Therefore, hand washing will help to prevent the spread of infection.
A: Option A is a sign of a liver toxicity and the physician should be notified of it.
B: Pregnancy is not allowed during the treatment.
D: Photosensitivity may happen during the treatment so the client is advised to wear sunscreen or any
protective gear against the sunlight.
4. Mr. Mc Princeton who is diagnosed with rheumatoid arthritis (RA) complains about joints that always
hurt, saying, "I just feel like staying in bed all day." Which discharge instruction would be aimed at
maintaining as such function as possible?
A. "Refrain from exercise because it only aggravates the disease process."
B. "Apply elastic bandages to all joints to increase the pain threshold."
C. "Maintain a supine position most of the day to prevent the stress of weight bearing."
,D. "Promote aquatic (water) exercises to enhance joint mobility." - 4. Answer: D. "Promote aquatic
(water) exercises to enhance joint mobility."
D: Water exercises are excellent because water promotes buoyancy, which eases joint movement.
A: Persons with RA should maintain an active exercise program to strengthen and preserve muscle
movement.
B: Elastic bandage wraps would not be helpful.
C: Being active instead of just lying supine all day could help strengthen the muscles and joints.
5. The classic signs and symptoms of rheumatoid arthritis include which of the following?
A. Pain on weight-bearing, rash and low-grade fever.
B. Joint swelling, joint stiffness in the morning and bilateral joint movement.
C. Crepitus, development of Heberden's nodes and anemia.
D. Fatigue, leucopenia and joint pain. - 5. Answer: B. Joint swelling, joint stiffness in the morning and
bilateral joint movement.
B: Joint swelling, joint stiffness in the morning and bilateral joint movement are the classic signs of
rheumatoid arthritis. A, C, D: The other symptoms are not found on a patient with rheumatoid arthritis.
1. Your patient has arthritis that affects the weight-bearing joints such as the hands, knees, hips, and
spine. This type of arthritis is most likely:*
A. Rheumatoid arthritis
B. Osteoarthritis - The answer is B. Osteoarthritis is a form of arthritis that causes deterioration of the
articular hyaline cartilage of the bones. It affects the weight-bearing joints. This can include the hands,
knees, hips, and spine because these joints experience a lot of stress.
2. Select all the risk factors for developing osteoarthritis:*
A. Malnutrition
B. Obesity
C. Manual labor jobs
D. Premature birth
E. Older age
F. Diabetes - The answers are B, C, and E. These are risk factors for developing OA. In addition, repeated
joint injuries and genetics can play a role in developing OA.
3. ____________ affects the joints in a symmetrical fashion.*
A. Osteoarthritis
B. Rheumatoid arthritis - The answer is B. RA affects the joints in a symmetrical fashion. It is
UNsymmetrical in OA. RA most commonly affects the fingers and wrist but can also affect the neck,
shoulders, elbows, ankles, knee, and feet.
4. Which patient below is presenting with signs and symptoms of rheumatoid arthritis? Select all that
apply:*
A. A 35 year old patient who has severe morning stiffness for 45 minutes.
B. A 45 year old male with crepitus in the right knee.
C. A 30 year old female with warm, red, soft joints on the hands and wrist.
, D. A 40 year old male whose x-ray imaging results showed osteophytes formation and decreased joint
space in the left knee. - The answer is A and C. These are common findings in RA. However, options B
and D are found in OA.
5. You're explaining to a group of outpatients about the signs and symptoms that may present with
osteoarthritis. Select all the signs and symptoms that may present with this condition:*
A. Herberden's Node
B. Morning stiffness for less than 30 minutes
C. Soft, tender, warm joints
D. Fever
E. Anemia
F. Hard and bony joints
G. Crepitus
H. Bouchard's Node - The answers are A, B, F, G, and H. These are common findings found in
osteoarthritis. Options C, D, and E are found in rheumatoid arthritis.
6. ________________ is a form of arthritis that is an autoimmune condition that causes inflammation
within the joints, specifically the synovium.*
A. Rheumatoid arthritis
B. Osteoarthritis - The answer is A. Rheumatoid arthritis is an autoimmune condition that causes
inflammation of the synovium. Osteoarthritis is a type of arthritis that causes deterioration of the
articular hyaline cartilage of the bone.
7. Which statement is FALSE concerning rheumatoid arthritis?*
A. Rheumatoid arthritis most commonly affects the fingers and wrist.
B. Rheumatoid arthritis is different from osteoarthritis in that it doesn't affect other systems of the body.
C. Rheumatoid arthritis can occur at any age (20-60 year old most commonly).
D. Ankylosis can occur in severe cases of rheumatoid arthritis. - The answer is B. This statement is false.
It should say that, "Rheumatoid arthritis is different from osteoarthritis in that it DOES (not doesn't)
affect other systems of the body. RA is systemic, while OA only affects the joints. This is why a fever and
anemia can present in RA.
8. You are assessing the diagnostic testing results for a patient that has rheumatoid arthritis. What result
is NOT an indicator of this disease?*
A. Elevated erythrocyte sedimentation
B. X-ray imaging showing osteophyte formation
C. Positive c-reactive protein
D. Positive rheumatoid factor - The answer is B. This is found in osteoarthritis NOT rheumatoid arthritis.
Osteophytes (bones spurs) are only found in OA.
9. During a head-to-toe assessment of a patient with arthritis, you note bony outgrowths on the
proximal interphalangeal joint. These outgrowths are known as __________ and occur in
______________.*
A. Heberden's Node, osteoarthritis
, B. Bouchard's Node, rheumatoid arthritis
C. Heberden's Node, rheumatoid arthritis
D. Bouchard's Node, osteoarthritis - The answer is D. Bouchard's Node are bony outgrowths on the
proximal interphalangeal joint (middle joint of the finger and occur in osteoarthritis). Heberden's Node
occur on the distal interphalangeal joint (finger joint closet to the fingernail).
10. A patient is newly diagnosed with osteoarthritis. Which medication below is NOT ordered to treat
this condition?*
A. NSAIDs
B. Intra-articular corticosteroids
C. DMARDs
D. Glucosamine - The answer is C. DMARDs (disease-modifying antirheumatic drugs) are ordered in
rheumatoid arthritis NOT osteoarthritis. These drugs suppress the immune system from attacking the
joint along with helping slow down the destruction of the disease on the joints and bones. All the other
options are drugs that can be prescribed in OA.
1. Nurse Kaye is carrying out her operative teachings for an older client who will have cataract surgery
on the right eye. The nurse concludes that the client needs further understanding about the teachings if
he says:
A. "I will sleep on my left side after surgery."
B. "I will wipe my nose gently if it is congested after surgery."
C. "I will call my physician if I have sharp and sudden pain or a fever after surgery."
D. "I will bend below my waist frequently to increase circulation after surgery." - 1. Answer: D. "I will
bend below my waist frequently to increase circulation after surgery."
D: Immediately after the procedure, the client should avoid bending over, to prevent putting extra
pressure on the eye.
A: Sleeping on the left side avoids injuring the operated side.
B: Wiping the nose gently avoids increasing the intraocular pressure.
C: The patient must recognize any signs and symptoms of complications.
2. After cataract surgery, the patient is encouraged to:
A. Maintain bed rest for 1 week.
B. Lie on his or her stomach while sleeping.
C. Avoid bending his or her head below the waist.
D. Lift weights to increase muscle strength. - 2. Answer: C. Avoid bending his or her head below the
waist.
C & B: Bending the head below the waist and lying on the stomach increase the intraocular pressure and
affect the newly operated eye.
A: Bed rest for a week is unnecessary for post cataract surgery patients.
D: Lifting heavy objects ate contraindicated after a cataract surgery.
3. Upon assessment, the patient told the nurse that she was experiencing the three common symptoms
found with cataracts and these are listed below except for:
1. Gold sodium thiomalate is prescribed to a client with rheumatoid arthritis. Which of the following side
effects indicates an overdosage of the medication?
A. Flushing.
B. Dizziness.
C. Joint pain.
D. Metallic taste. - 1. Answer: D. Metallic taste.
D: Gold sodium thiomalate toxicity signs are pruritus, diarrhea, dermatitis, stomatitis, and metallic taste.
A&B: Flushing and dizziness are the side effects that may occur soon after the injection.
C: Increased joint pain may occur 1-2 days after the injection.
2. Adalimumab (Humira) is given to a client for the treatment of rheumatoid arthritis. Which of the
following side effect is associated with the medication?
A. Numbness.
B. Diarrhea.
C. Urinary retention.
D. Weight gain. - Answer: A. Numbness.
A: Adalimumab (Humira) has been associated with neurological side effects such as numbness, tingling,
dizziness, visual disturbances, and weakness in the legs).
B, C, D: Options B, C, and D are not associated with the use of medication.
3. A client has just been prescribed with Methotrexate (Trexall) for the treatment of rheumatoid arthritis
who did not respond to any other treatment. An important reminder for the client is to?
A. Clay-colored stool is a normal response of the treatment.
B. Pregnancy is not contraindicated with the use of the medication.
C. Strict hand washing.
D. Get a daily source of sunlight during the day. - 3. Answer: C. Strict hand washing.
C: Clients taking Methotrexate are more likely to get infections or may worsen any current infections.
Therefore, hand washing will help to prevent the spread of infection.
A: Option A is a sign of a liver toxicity and the physician should be notified of it.
B: Pregnancy is not allowed during the treatment.
D: Photosensitivity may happen during the treatment so the client is advised to wear sunscreen or any
protective gear against the sunlight.
4. Mr. Mc Princeton who is diagnosed with rheumatoid arthritis (RA) complains about joints that always
hurt, saying, "I just feel like staying in bed all day." Which discharge instruction would be aimed at
maintaining as such function as possible?
A. "Refrain from exercise because it only aggravates the disease process."
B. "Apply elastic bandages to all joints to increase the pain threshold."
C. "Maintain a supine position most of the day to prevent the stress of weight bearing."
,D. "Promote aquatic (water) exercises to enhance joint mobility." - 4. Answer: D. "Promote aquatic
(water) exercises to enhance joint mobility."
D: Water exercises are excellent because water promotes buoyancy, which eases joint movement.
A: Persons with RA should maintain an active exercise program to strengthen and preserve muscle
movement.
B: Elastic bandage wraps would not be helpful.
C: Being active instead of just lying supine all day could help strengthen the muscles and joints.
5. The classic signs and symptoms of rheumatoid arthritis include which of the following?
A. Pain on weight-bearing, rash and low-grade fever.
B. Joint swelling, joint stiffness in the morning and bilateral joint movement.
C. Crepitus, development of Heberden's nodes and anemia.
D. Fatigue, leucopenia and joint pain. - 5. Answer: B. Joint swelling, joint stiffness in the morning and
bilateral joint movement.
B: Joint swelling, joint stiffness in the morning and bilateral joint movement are the classic signs of
rheumatoid arthritis. A, C, D: The other symptoms are not found on a patient with rheumatoid arthritis.
1. Your patient has arthritis that affects the weight-bearing joints such as the hands, knees, hips, and
spine. This type of arthritis is most likely:*
A. Rheumatoid arthritis
B. Osteoarthritis - The answer is B. Osteoarthritis is a form of arthritis that causes deterioration of the
articular hyaline cartilage of the bones. It affects the weight-bearing joints. This can include the hands,
knees, hips, and spine because these joints experience a lot of stress.
2. Select all the risk factors for developing osteoarthritis:*
A. Malnutrition
B. Obesity
C. Manual labor jobs
D. Premature birth
E. Older age
F. Diabetes - The answers are B, C, and E. These are risk factors for developing OA. In addition, repeated
joint injuries and genetics can play a role in developing OA.
3. ____________ affects the joints in a symmetrical fashion.*
A. Osteoarthritis
B. Rheumatoid arthritis - The answer is B. RA affects the joints in a symmetrical fashion. It is
UNsymmetrical in OA. RA most commonly affects the fingers and wrist but can also affect the neck,
shoulders, elbows, ankles, knee, and feet.
4. Which patient below is presenting with signs and symptoms of rheumatoid arthritis? Select all that
apply:*
A. A 35 year old patient who has severe morning stiffness for 45 minutes.
B. A 45 year old male with crepitus in the right knee.
C. A 30 year old female with warm, red, soft joints on the hands and wrist.
, D. A 40 year old male whose x-ray imaging results showed osteophytes formation and decreased joint
space in the left knee. - The answer is A and C. These are common findings in RA. However, options B
and D are found in OA.
5. You're explaining to a group of outpatients about the signs and symptoms that may present with
osteoarthritis. Select all the signs and symptoms that may present with this condition:*
A. Herberden's Node
B. Morning stiffness for less than 30 minutes
C. Soft, tender, warm joints
D. Fever
E. Anemia
F. Hard and bony joints
G. Crepitus
H. Bouchard's Node - The answers are A, B, F, G, and H. These are common findings found in
osteoarthritis. Options C, D, and E are found in rheumatoid arthritis.
6. ________________ is a form of arthritis that is an autoimmune condition that causes inflammation
within the joints, specifically the synovium.*
A. Rheumatoid arthritis
B. Osteoarthritis - The answer is A. Rheumatoid arthritis is an autoimmune condition that causes
inflammation of the synovium. Osteoarthritis is a type of arthritis that causes deterioration of the
articular hyaline cartilage of the bone.
7. Which statement is FALSE concerning rheumatoid arthritis?*
A. Rheumatoid arthritis most commonly affects the fingers and wrist.
B. Rheumatoid arthritis is different from osteoarthritis in that it doesn't affect other systems of the body.
C. Rheumatoid arthritis can occur at any age (20-60 year old most commonly).
D. Ankylosis can occur in severe cases of rheumatoid arthritis. - The answer is B. This statement is false.
It should say that, "Rheumatoid arthritis is different from osteoarthritis in that it DOES (not doesn't)
affect other systems of the body. RA is systemic, while OA only affects the joints. This is why a fever and
anemia can present in RA.
8. You are assessing the diagnostic testing results for a patient that has rheumatoid arthritis. What result
is NOT an indicator of this disease?*
A. Elevated erythrocyte sedimentation
B. X-ray imaging showing osteophyte formation
C. Positive c-reactive protein
D. Positive rheumatoid factor - The answer is B. This is found in osteoarthritis NOT rheumatoid arthritis.
Osteophytes (bones spurs) are only found in OA.
9. During a head-to-toe assessment of a patient with arthritis, you note bony outgrowths on the
proximal interphalangeal joint. These outgrowths are known as __________ and occur in
______________.*
A. Heberden's Node, osteoarthritis
, B. Bouchard's Node, rheumatoid arthritis
C. Heberden's Node, rheumatoid arthritis
D. Bouchard's Node, osteoarthritis - The answer is D. Bouchard's Node are bony outgrowths on the
proximal interphalangeal joint (middle joint of the finger and occur in osteoarthritis). Heberden's Node
occur on the distal interphalangeal joint (finger joint closet to the fingernail).
10. A patient is newly diagnosed with osteoarthritis. Which medication below is NOT ordered to treat
this condition?*
A. NSAIDs
B. Intra-articular corticosteroids
C. DMARDs
D. Glucosamine - The answer is C. DMARDs (disease-modifying antirheumatic drugs) are ordered in
rheumatoid arthritis NOT osteoarthritis. These drugs suppress the immune system from attacking the
joint along with helping slow down the destruction of the disease on the joints and bones. All the other
options are drugs that can be prescribed in OA.
1. Nurse Kaye is carrying out her operative teachings for an older client who will have cataract surgery
on the right eye. The nurse concludes that the client needs further understanding about the teachings if
he says:
A. "I will sleep on my left side after surgery."
B. "I will wipe my nose gently if it is congested after surgery."
C. "I will call my physician if I have sharp and sudden pain or a fever after surgery."
D. "I will bend below my waist frequently to increase circulation after surgery." - 1. Answer: D. "I will
bend below my waist frequently to increase circulation after surgery."
D: Immediately after the procedure, the client should avoid bending over, to prevent putting extra
pressure on the eye.
A: Sleeping on the left side avoids injuring the operated side.
B: Wiping the nose gently avoids increasing the intraocular pressure.
C: The patient must recognize any signs and symptoms of complications.
2. After cataract surgery, the patient is encouraged to:
A. Maintain bed rest for 1 week.
B. Lie on his or her stomach while sleeping.
C. Avoid bending his or her head below the waist.
D. Lift weights to increase muscle strength. - 2. Answer: C. Avoid bending his or her head below the
waist.
C & B: Bending the head below the waist and lying on the stomach increase the intraocular pressure and
affect the newly operated eye.
A: Bed rest for a week is unnecessary for post cataract surgery patients.
D: Lifting heavy objects ate contraindicated after a cataract surgery.
3. Upon assessment, the patient told the nurse that she was experiencing the three common symptoms
found with cataracts and these are listed below except for:
