©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
Chapter 64: Arthritis and Connective
Tissue Diseases Lewis: Medical-Surgical
Nursing, 10th Edition Exam Practice
Questions and Answers
Which finding will the nurse expect when assessing a patient who has osteoarthritis (OA) of the knee?
a. Presence of Heberden's nodules
b. Discomfort with joint movement
c. Redness and swelling of the knee joint
d. Stiffness that increases with movement - Ans:✔✔-ANS: B
Initial symptoms of OA include pain with joint movement. Heberden's nodules occur on the
fingers. Redness of the joint is associated with inflammatory arthritis such as rheumatoid
arthritis. Stiffness in OA is worse right after the patient rests and decreases with joint
movement.
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, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
DIF: Cognitive Level: Understand (comprehension) REF: 1518
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
Which assessment finding for a patient using naproxen (Naprosyn) to treat osteoarthritis is
likely to require a change in medication?
a. The patient has gained 3 lb.
b. The patient has dark-colored stools.
c. The patient's pain affects multiple joints.
d. The patient uses capsaicin cream (Zostrix). - Ans:✔✔-ANS: B
Dark-colored stools may indicate the patient is experiencing gastrointestinal bleeding caused
by the naproxen. The patient's ongoing pain and weight gain will also 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.
DIF: Cognitive Level: Apply (application) REF: 1521
Page 2/40
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
After the nurse has finished teaching a 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 exercise every day to help maintain joint motion."
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." - Ans:✔✔-ANS: B
No more than 4 g of acetaminophen (1 g every 6 hours) should be taken daily to decrease the
risk for liver damage. Regular exercise, moist heat, and supportive equipment are
recommended for OA management.
DIF: Cognitive Level: Apply (application) REF: 1523
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity
The nurse will anticipate the need to teach a patient who has osteoarthritis (OA) about which
Page 3/40
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
medication?
a. Prednisone
b. Adalimumab (Humira)
c. Capsaicin cream (Zostrix)
d. Sulfasalazine (Azulfidine) - Ans:✔✔-ANS: 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 rheumatoid arthritis.
DIF: Cognitive Level: Apply (application) REF: 1520
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
A patient 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.
Page 4/40
FIRST PUBLISH OCTOBER 2024
Chapter 64: Arthritis and Connective
Tissue Diseases Lewis: Medical-Surgical
Nursing, 10th Edition Exam Practice
Questions and Answers
Which finding will the nurse expect when assessing a patient who has osteoarthritis (OA) of the knee?
a. Presence of Heberden's nodules
b. Discomfort with joint movement
c. Redness and swelling of the knee joint
d. Stiffness that increases with movement - Ans:✔✔-ANS: B
Initial symptoms of OA include pain with joint movement. Heberden's nodules occur on the
fingers. Redness of the joint is associated with inflammatory arthritis such as rheumatoid
arthritis. Stiffness in OA is worse right after the patient rests and decreases with joint
movement.
Page 1/40
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
DIF: Cognitive Level: Understand (comprehension) REF: 1518
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
Which assessment finding for a patient using naproxen (Naprosyn) to treat osteoarthritis is
likely to require a change in medication?
a. The patient has gained 3 lb.
b. The patient has dark-colored stools.
c. The patient's pain affects multiple joints.
d. The patient uses capsaicin cream (Zostrix). - Ans:✔✔-ANS: B
Dark-colored stools may indicate the patient is experiencing gastrointestinal bleeding caused
by the naproxen. The patient's ongoing pain and weight gain will also 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.
DIF: Cognitive Level: Apply (application) REF: 1521
Page 2/40
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
After the nurse has finished teaching a 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 exercise every day to help maintain joint motion."
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." - Ans:✔✔-ANS: B
No more than 4 g of acetaminophen (1 g every 6 hours) should be taken daily to decrease the
risk for liver damage. Regular exercise, moist heat, and supportive equipment are
recommended for OA management.
DIF: Cognitive Level: Apply (application) REF: 1523
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity
The nurse will anticipate the need to teach a patient who has osteoarthritis (OA) about which
Page 3/40
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
medication?
a. Prednisone
b. Adalimumab (Humira)
c. Capsaicin cream (Zostrix)
d. Sulfasalazine (Azulfidine) - Ans:✔✔-ANS: 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 rheumatoid arthritis.
DIF: Cognitive Level: Apply (application) REF: 1520
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
A patient 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.
Page 4/40
