Nokea
A patient has been admitted to a medical unit with a diagnosis of polymyalgia rheumatica (PMR). The nurse should be aware of what aspects of PMR? Select all that apply.
- A. PMR has an association with the genetic marker HLA-DR4.
- B. Immunoglobulin deposits occur in PMR.
- C. PMR is considered to be a wear-and-tear disease.
- D. Foods high in purines exacerbate the biochemical processes that occur in PMR.
- E. PMR occurs predominately in Caucasians.
Correct Answer: A,B,E
Rationale: The underlying mechanism involved with polymyalgia rheumatica is unknown. This disease occurs predominately in Caucasians and often in first-degree relatives. An association with the genetic marker HLA-DR4 suggests a familial predisposition. Immunoglobulin deposits in the walls of inflamed temporal arteries also suggest an autoimmune process. Purines are unrelated and it is not a result of physical degeneration.
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A clinic nurse is caring for a patient with suspected gout. While explaining the pathophysiology of gout to the patient, the nurse should describe which of the following?
- A. Autoimmune processes in the joints
- B. Chronic metabolic acidosis
- C. Increased uric acid levels
- D. Unstable serum calcium levels
Correct Answer: C
Rationale: Gout is caused by hyperuricemia (increased serum uric acid). Gout is not categorized as an autoimmune disease and it does not result from metabolic acidosis or unstable serum calcium levels.
A patient with rheumatic disease is complaining of stomatitis. The nurse caring for the patient should further assess the patient for the adverse effects of what medications?
- A. Corticosteroids
- B. Gold-containing compounds
- C. Antimalarials
- D. Salicylate therapy
Correct Answer: B
Rationale: Stomatitis is an adverse effect that is associated with gold therapy. Steroids, antimalarials, and salicylates do not normally have this adverse effect.
A nurse is working with a patient with rheumatic disease who is being treated with salicylate therapy. What statement would indicate that the patient is experiencing adverse effects of this drug?
- A. I have this ringing in my ears that just wont go away.
- B. I feel so foggy in the mornings and it takes me so long to wake up.
- C. When I eat a meal thats high in fat, I get really nauseous.
- D. I seem to have lost my appetite, which is unusual for me.
Correct Answer: A
Rationale: Tinnitus is associated with salicylate therapy. Salicylates do not normally cause drowsiness, intolerance of high-fat meals, or anorexia.
A nurse is caring for a 78-year-old patient with a history of osteoarthritis (OA). When planning the patients care, what goal should the nurse include?
- A. The patient will express satisfaction with her ability to perform ADLs.
- B. The patient will recover from OA within 6 months.
- C. The patient will adhere to the prescribed plan of care.
- D. The patient will deny signs or symptoms of OA.
Correct Answer: A
Rationale: Pain management and optimal functional ability are major goals of nursing interventions for OA. Cure is not a possibility and it is unrealistic to expect a complete absence of signs and symptoms. Adherence to the plan of care is highly beneficial, but this is not the priority goal of care.
A patient is suspected of having rheumatoid arthritis and her diagnostic regimen includes aspiration of synovial fluid from the knee for a definitive diagnosis. The nurse knows that which of the following procedures will be involved?
- A. Angiography
- B. Myelography
- C. Paracentesis
- D. Arthrocentesis
Correct Answer: D
Rationale: Arthrocentesis involves needle aspiration of synovial fluid. Angiography is an x-ray study of circulation with a contrast agent injected into a selected artery. Myelography is an x-ray of the spinal subarachnoid space taken after the injection of a contrast agent into the spinal subarachnoid space through a lumbar puncture. Paracentesis is removal of fluid (ascites) from the peritoneal cavity through a small surgical incision or puncture made through the abdominal wall under sterile conditions.