Nokea
A nurse is working with a community group promoting healthy aging. What recommendation is best to help prevent osteoarthritis (OA)?
- A. Avoid contact sports
- B. Get plenty of calcium
- C. Get plenty of calcium
- D. Engage in weight-bearing exercise
Correct Answer: C
Rationale: Obesity can lead to OA, and if the client is overweight, losing weight can help prevent OA or reduce symptoms once it occurs. Arthritis can be caused by contact sports, but this is less common than obesity. Calcium and weight-bearing exercise are both important for osteoporosis.
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A nurse is teaching a client with psoriatic arthritis about the medication golimumab (Simponi). What information is most important to include?
- A. Avoid large crowds or people who are ill
- B. Stay upright for 1 hour after taking this drug
- C. This drug may cause your hair to fall out
- D. You may double the dose if pain is severe
Correct Answer: A
Rationale: This drug has a Food and Drug Administration black box warning about opportunistic or other serious infections. Teach the client to avoid large crowds and people who are ill. The other instructions do not pertain to golimumab.
A client is scheduled to have a hip replacement. Preoperatively, the client is found to be mildly anemic and the surgeon states the client may need a blood transfusion during or after the surgery. What action by the preoperative nurse is most important?
- A. Administer preoperative medications as prescribed
- B. Ensure that a consent for transfusion is on the chart
- C. Teach the client about foods high in protein and iron
- D. Monitor the client's hemoglobin levels
Correct Answer: B
Rationale: The preoperative nurse should ensure that all valid consents are on the chart, including one for blood transfusions if this may be needed. This is critical for legal and ethical reasons.
A client is receiving an opioid analgesic for postoperative pain after joint replacement surgery. The client is also on celecoxib for arthritis in other joints. What action by the nurse is most appropriate?
- A. Consult the provider about continuing celecoxib
- B. Discontinue the opioid analgesic
- C. Increase the dose of celecoxib
- D. Monitor for gastrointestinal bleeding
Correct Answer: A
Rationale: The nurse should consult the provider about continuing celecoxib while the client is in the hospital, as it can help with postoperative pain and arthritis management.
Which clinical manifestations are seen in clients with connective tissue diseases? (Select all that apply.)
- A. Dry, scaly skin rash: Systemic lupus erythematosus
- B. Esophageal motility problems: Systemic sclerosis
- C. Vasculitis leading to organ damage: Rheumatoid arthritis
- D. Foot drop and paresthesias: Rheumatoid arthritis
- E. Gout caused by hyperuricemia
Correct Answer: A,B,C,D,E
Rationale: A dry, scaly skin rash is common in SLE. Systemic sclerosis can lead to esophageal motility problems. Vasculitis leads to organ damage in rheumatoid arthritis. Foot drop and paresthesias occur in rheumatoid arthritis. Gout is caused by hyperuricemia.
A nurse works in the rheumatology clinic and sees clients with rheumatoid arthritis (RA). Which client should the nurse see first?
- A. Client who reports jaw pain when eating
- B. Client with a red, hot, swollen right wrist
- C. Client who has a puffy-looking area behind the knee
- D. Client with a worse joint deformity since the last visit
Correct Answer: B
Rationale: All of the options are possible manifestations of RA. However, the presence of one joint that is much redder, hotter, or more swollen than other joints may indicate infection. The nurse needs to see this client first.