Nokea
The nurse is preparing to care for a patient who has scleroderma. The nurse refers to resources that describe CREST syndrome. Which of the following is a component of CREST syndrome?
- A. Raynauds phenomenon
- B. Thyroid dysfunction
- C. Esophageal varices
- D. Osteopenia
Correct Answer: A
Rationale: The R in CREST stands for Raynauds phenomenon. Thyroid dysfunction, esophageal varices, and osteopenia are not associated with scleroderma.
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A patient with systemic lupus erythematosus (SLE) is preparing for discharge. The nurse knows that the patient has understood health education when the patient makes what statement?
- A. Ill make sure I get enough exposure to sunlight to keep up my vitamin D levels.
- B. Ill try to be as physically active as possible between flare-ups.
- C. Ill make sure to monitor my body temperature on a regular basis.
- D. Ill stop taking my steroids when I get relief from my symptoms.
Correct Answer: C
Rationale: Fever can signal an exacerbation and should be reported to the physician. Sunlight and other sources of ultraviolet light may precipitate severe skin reactions and exacerbate the disease. Fatigue can cause a flare-up of SLE. Patients should be encouraged to pace activities and plan rest periods. Corticosteroids must be gradually tapered because they can suppress the function of the adrenal gland. As well, these drugs should not be independently adjusted by the patient.
A patient is undergoing diagnostic testing to determine the etiology of recent joint pain. The patient asks the nurse about the difference between osteoarthritis (OA) and rheumatoid arthritis (RA). What is the best response by the nurse?
- A. OA is a considered a noninflammatory joint disease. RA is characterized by inflamed, swollen joints.
- B. OA and RA are very similar. OA affects the smaller joints such as the fingers, and RA affects the larger, weight-bearing joints like the knees.
- C. OA originates with an infection. RA is a result of your bodys cells attacking one another.
- D. OA is associated with impaired immune function; RA is a consequence of physical damage.
Correct Answer: A
Rationale: OA is a degenerative arthritis with a noninflammatory etiology, characterized by the loss of cartilage on the articular surfaces of weight-bearing joints, with spur development. RA is characterized by inflammation of synovial membranes and surrounding structures. The diseases are not distinguished by the joints affected and neither has an infectious etiology.
A patient is diagnosed with giant cell arteritis (GCA) and is placed on corticosteroids. A concern for this patient is that he will stop taking the medication as soon as he starts to feel better. Why must the nurse emphasize the need for continued adherence to the prescribed medication?
- A. To avoid complications such as venous thromboembolism
- B. To avoid the progression to osteoporosis
- C. To avoid the progression of GCA to degenerative joint disease
- D. To avoid complications such as blindness
Correct Answer: D
Rationale: The nurse must emphasize to the patient the need for continued adherence to the prescribed medication regimen to avoid complications of giant cell arteritis, such as blindness. VTE, OP, and degenerative joint disease are not among the most common complications for GCA.
A nurses plan of care for a patient with rheumatoid arthritis includes several exercise-based interventions. Exercises for patients with rheumatoid disorders should have which of the following goals?
- A. Maximize range of motion while minimizing exertion
- B. Increase joint size and strength
- C. Limit energy output in order to preserve strength for healing
- D. Preserve and increase range of motion while limiting joint stress
Correct Answer: D
Rationale: Exercise is vital to the management of rheumatic disorders. Goals should be preserving and promoting mobility and joint function while limiting stress on the joint and possible damage. Cardiovascular exertion should remain within age-based limits and individual ability, but it is not a goal to minimize exertion. Increasing joint size is not a valid goal.
A nurse is performing the initial assessment of a patient who has a recent diagnosis of systemic lupus erythematosus (SLE). What skin manifestation would the nurse expect to observe on inspection?
- A. Petechiae
- B. Butterfly rash
- C. Jaundice
- D. Skin sloughing
Correct Answer: B
Rationale: An acute cutaneous lesion consisting of a butterfly-shaped rash across the bridge of the nose and cheeks occurs in SLE. Petechiae are pinpoint skin hemorrhages, which are not a clinical manifestation of SLE. Patients with SLE do not typically experience jaundice or skin sloughing.