NUR 502 MED SURG STUDY GUIDE QUESTIONS
MATURING FINAL EXAM
Chapter 65: Connective Tissue Diseases
1. A 60-year-old woman has pain on motion in her fingers and asks the nurse whether this is just a
result of aging. The
best response by the nurse should include what information?
a. Joint pain with functional limitation is a normal change that affects all people to some extent.
b. Joint pain that develops with age is usually related to previous trauma or infection of the joints.
c. This is a symptom of a systemic arthritis that eventually affects all joints as the disease progresses.
d. Changes in the cartilage and bones of joints may cause symptoms of pain and loss of function in
some people as they age.
2. Number in sequence from 1 to 6 the pathophysiologic processes that occur in osteoarthritis (OA).
a. Erosion of articular surfaces
b. Incongruity in joint surfaces
c. Reduction in motion
d. Joint cartilage becomes yellow and granular
e. Osteophytes form at joint margins
f. Cartilage becomes softer and less elastic
3. What is most likely to cause the pain experienced in the later stages of OA?
a. Crepitation
b. Bouchard’s nodes
c. Heberden’s nodes
d. Bone surfaces rubbing together
4. To preserve function and the ability to perform activities of daily living (ADLs), what should the
nurse teach the patient with OA?
a. Avoid exercise that involves the affected joints.
b. Plan and organize task performance to be less stressful to joints.
c. Maintain normal activities during an acute episode to prevent loss of function.
d. Use mild analgesics to control symptoms when performing tasks that cause pain.
,5. A patient with OA asks the nurse whether he could try glucosamine and chondroitin for control of
his symptoms. The best response by the nurse includes what information?
,a. Some patients find these supplements helpful for relieving arthritis pain and improving mobility.
b. Although these substances may not help, there is no evidence that they can cause any untoward effects.
c. These supplements are a fad that has not been shown to reduce pain or increase joint mobility
in patients with OA.
d. Only dosages of these supplements available by prescription are high enough to provide any benefit
in treatment of OA.
6. A patient taking ibuprofen (Motrin) for treatment of OA has good pain relief but is
experiencing increased dyspepsia and nausea with the drug’s use. The nurse consults the
patient’s primary care provider about doing what?
a. Adding misoprostol (Cytotec) to the patient’s drug regimen
b. Substituting naproxen (Naprosyn) for the ibuprofen (Motrin)
c. Returning to the use of acetaminophen but at a dose of 5 g/day instead of 4 g/day
d. Administering the ibuprofen with antacids to decrease the gastrointestinal (GI) irritation
7. Which description is most characteristic of osteoarthritis (OA) when compared to rheumatoid
arthritis (RA)?
a. Not systemic or symmetric
b. Rheumatoid factor (RF) positive
c. Most commonly occurs in women
d. Morning joint stiffness lasts one to several hours
8. What best describes the manifestations of OA?
a. Smaller joints are typically affected first.
b. There is joint stiffness after periods of inactivity.
c. Joint stiffness is accompanied by fatigue, anorexia, and weight loss.
d. Pain and immobility may be aggravated by falling barometric pressure.
9. During the physical assessment of the patient with early to moderate RA, what should the nurse
expect to find?
a. Hepatomegaly c. Spindle-shaped fingers
b. Heberden’s nodes d. Crepitus on joint movement
, 10. Laboratory findings that the nurse would expect to be present in the patient with RA include
a. polycythemia. c. decreased white blood cell (WBC) count.
b. increased immunoglobulin G (IgG). d. anti-citrullinated protein antibody (ACPA).
11. Which other extraarticular manifestation of RA is most likely to be seen in the patient with
rheumatoid nodules?
a. Lyme disease c. Sjögren’s syndrome
b. Felty syndrome d. Spondyloarthropathies
12. Which drug that prevents binding of the tumor necrosis factor and inhibits the inflammatory
response is used in the management of RA?
a. Anakinra (Kineret) c. Leflunomide (Arava)
b. Entanercept (Enbrel) d. Azathioprine (Imuran)
13. The patient has had RA for some time but has not had success with previous medications. Although
there is an increased risk for tuberculosis, which monoclonal antibody is used with methotrexate to
best treat symptoms?
a. Parenteral gold c. Tocilizumab (Actemra)
b. Certolizumab (Cimzia) d. Hydroxychloroquine (Paquenil)
14. A 70-year-old patient is being evaluated for symptoms of RA. The nurse recognizes what as the
major problem in the management of RA in the older adult?
a. RA is usually more severe in older adults.
b. Older patients are not as likely to comply with treatment regimens.
c. Drug interactions and toxicity are more likely to occur with multidrug therapy.
d. Laboratory and other diagnostic tests are not effective in identifying RA in older adults.
15. After teaching a patient with RA about the prescribed therapeutic regimen, the nurse determines
that further instruction is needed when the patient says what?
a. “It is important for me to perform my prescribed exercises every day.”
b. “I should perform most of my daily chores in the morning when my energy level is highest.”
MATURING FINAL EXAM
Chapter 65: Connective Tissue Diseases
1. A 60-year-old woman has pain on motion in her fingers and asks the nurse whether this is just a
result of aging. The
best response by the nurse should include what information?
a. Joint pain with functional limitation is a normal change that affects all people to some extent.
b. Joint pain that develops with age is usually related to previous trauma or infection of the joints.
c. This is a symptom of a systemic arthritis that eventually affects all joints as the disease progresses.
d. Changes in the cartilage and bones of joints may cause symptoms of pain and loss of function in
some people as they age.
2. Number in sequence from 1 to 6 the pathophysiologic processes that occur in osteoarthritis (OA).
a. Erosion of articular surfaces
b. Incongruity in joint surfaces
c. Reduction in motion
d. Joint cartilage becomes yellow and granular
e. Osteophytes form at joint margins
f. Cartilage becomes softer and less elastic
3. What is most likely to cause the pain experienced in the later stages of OA?
a. Crepitation
b. Bouchard’s nodes
c. Heberden’s nodes
d. Bone surfaces rubbing together
4. To preserve function and the ability to perform activities of daily living (ADLs), what should the
nurse teach the patient with OA?
a. Avoid exercise that involves the affected joints.
b. Plan and organize task performance to be less stressful to joints.
c. Maintain normal activities during an acute episode to prevent loss of function.
d. Use mild analgesics to control symptoms when performing tasks that cause pain.
,5. A patient with OA asks the nurse whether he could try glucosamine and chondroitin for control of
his symptoms. The best response by the nurse includes what information?
,a. Some patients find these supplements helpful for relieving arthritis pain and improving mobility.
b. Although these substances may not help, there is no evidence that they can cause any untoward effects.
c. These supplements are a fad that has not been shown to reduce pain or increase joint mobility
in patients with OA.
d. Only dosages of these supplements available by prescription are high enough to provide any benefit
in treatment of OA.
6. A patient taking ibuprofen (Motrin) for treatment of OA has good pain relief but is
experiencing increased dyspepsia and nausea with the drug’s use. The nurse consults the
patient’s primary care provider about doing what?
a. Adding misoprostol (Cytotec) to the patient’s drug regimen
b. Substituting naproxen (Naprosyn) for the ibuprofen (Motrin)
c. Returning to the use of acetaminophen but at a dose of 5 g/day instead of 4 g/day
d. Administering the ibuprofen with antacids to decrease the gastrointestinal (GI) irritation
7. Which description is most characteristic of osteoarthritis (OA) when compared to rheumatoid
arthritis (RA)?
a. Not systemic or symmetric
b. Rheumatoid factor (RF) positive
c. Most commonly occurs in women
d. Morning joint stiffness lasts one to several hours
8. What best describes the manifestations of OA?
a. Smaller joints are typically affected first.
b. There is joint stiffness after periods of inactivity.
c. Joint stiffness is accompanied by fatigue, anorexia, and weight loss.
d. Pain and immobility may be aggravated by falling barometric pressure.
9. During the physical assessment of the patient with early to moderate RA, what should the nurse
expect to find?
a. Hepatomegaly c. Spindle-shaped fingers
b. Heberden’s nodes d. Crepitus on joint movement
, 10. Laboratory findings that the nurse would expect to be present in the patient with RA include
a. polycythemia. c. decreased white blood cell (WBC) count.
b. increased immunoglobulin G (IgG). d. anti-citrullinated protein antibody (ACPA).
11. Which other extraarticular manifestation of RA is most likely to be seen in the patient with
rheumatoid nodules?
a. Lyme disease c. Sjögren’s syndrome
b. Felty syndrome d. Spondyloarthropathies
12. Which drug that prevents binding of the tumor necrosis factor and inhibits the inflammatory
response is used in the management of RA?
a. Anakinra (Kineret) c. Leflunomide (Arava)
b. Entanercept (Enbrel) d. Azathioprine (Imuran)
13. The patient has had RA for some time but has not had success with previous medications. Although
there is an increased risk for tuberculosis, which monoclonal antibody is used with methotrexate to
best treat symptoms?
a. Parenteral gold c. Tocilizumab (Actemra)
b. Certolizumab (Cimzia) d. Hydroxychloroquine (Paquenil)
14. A 70-year-old patient is being evaluated for symptoms of RA. The nurse recognizes what as the
major problem in the management of RA in the older adult?
a. RA is usually more severe in older adults.
b. Older patients are not as likely to comply with treatment regimens.
c. Drug interactions and toxicity are more likely to occur with multidrug therapy.
d. Laboratory and other diagnostic tests are not effective in identifying RA in older adults.
15. After teaching a patient with RA about the prescribed therapeutic regimen, the nurse determines
that further instruction is needed when the patient says what?
a. “It is important for me to perform my prescribed exercises every day.”
b. “I should perform most of my daily chores in the morning when my energy level is highest.”
