Nokea
The nurse is assisting a patient with rheumatoid arthritis (RA) to plan a daily routine. Which of the following information should the nurse include when discussing the most helpful way to start the day?
- A. A warm bath followed by a short rest
- B. A short routine of isometric exercises
- C. Active range-of motion (ROM) exercises
- D. Stretching exercises to relieve joint stiffness
Correct Answer: A
Rationale: Taking a warm shower or bath is recommended to relieve joint stiffness, which is worse in the morning. Isometric exercises would place stress on joints and would not be recommended. Stretching and ROM should be done later in the day, when joint stiffness is decreased.
You may also like to solve these questions
Which of the following patients seen by the nurse in the outpatient clinic is most likely to require teaching about ways to reduce risk for osteoarthritis (OA)?
- A. A 56-year-old man who is a member of a construction crew
- B. A 24-year-old man who participates in a summer softball team
- C. A 49-year-old woman who works on an automotive assembly line
- D. A 36-year-old woman who is newly diagnosed with diabetes mellitus
Correct Answer: C
Rationale: OA is more likely to occur in women as a result of estrogen reduction at menopause and in individuals whose work involves repetitive movements and lifting. Moderate exercise, such as softball, reduces risk for OA. Diabetes is not a risk factor for OA. Working on a construction crew would involve nonrepetitive work and thus would not be as risky.
The home health nurse is doing a follow-up visit to a patient with recently diagnosed rheumatoid arthritis (RA). Which of the following assessments made by the nurse indicates that more patient teaching is needed?
- A. The patient requires a 2-hour midday nap.
- B. The patient has been taking 9 Aspirins daily.
- C. The patient sits on a stool when preparing meals.
- D. The patient sleeps with two pillows under the head.
Correct Answer: D
Rationale: The joints should be maintained in an extended position to avoid contractures, so patients should use a small, flat pillow for sleeping. The other information is appropriate for a patient with RA and indicates that teaching has been effective.
The nurse is caring for a patient with an exacerbation of rheumatoid arthritis (RA) and is taking prednisone 40 mg daily. Which of these assessment data obtained by the nurse indicate that the patient is experiencing an adverse effect of the medication?
- A. The patient's blood glucose is 9.2 mmol/L.
- B. The patient has no improvement in symptoms.
- C. The patient has experienced a recent 2 kg weight loss.
- D. The patient's erythrocyte sedimentation rate (ESR) has increased.
Correct Answer: A
Rationale: Corticosteroids have the potential to cause diabetes mellitus. The finding of an elevated blood glucose reflects this adverse effect of prednisone. Corticosteroids increase appetite and lead to weight gain. An elevated ESR and no improvement in symptoms would indicate that the prednisone was not effective but would not be adverse effects of the medication.
A patient who has rheumatoid arthritis is seen in the outpatient clinic and the nurse notes that rheumatoid nodules are present on the patient's elbows. Which of the following actions should the nurse take?
- A. Draw blood for rheumatoid factor analysis.
- B. Teach the patient about injection of the nodule.
- C. Assess the nodules for skin breakdown or infection.
- D. Discuss the need for surgical removal of the nodule.
Correct Answer: C
Rationale: Rheumatoid nodules can break down or become infected. They are not associated with changes in rheumatoid factor and injection is not needed. Rheumatoid nodules are usually not removed surgically because of a high probability of recurrence.
To determine whether a patient with joint swelling and pain has systemic lupus erythematosus, which test will be most useful for the nurse to review?
- A. Rheumatoid factor (RF)
- B. Antinuclear antibody (ANA)
- C. Anti-Smith antibody (Anti-Sm)
- D. Lupus erythematosus (LE) cell prep
Correct Answer: C
Rationale: The anti-Sm is an antibody found almost exclusively in SLE. The other blood tests also are used in screening but are not as specific to SLE.