Deck 41: Connective Tissue Disorders

Question 1

The nurse clarifies that a connective tissue disease is one that affects:

A) Bones, ligaments, cartilage, and tendons
B) Bones, ligaments, and tendons
C) Spurs, ligaments, cartilage, and tendons
D) Tendons, cartilage, and tophi

Answer 1

Bones, ligaments, cartilage, and tendons

Question 2

For the osteoporotic patient taking alendronate (Fosamax),the nurse would stress that the drug requires that the patient:

A) Take the drug after breakfast.
B) Avoid the use of supplemental vitamin D.
C) Decrease fluid intake.
D) Sit or stand for 30 minutes after administration.

Answer 2

Sit or stand for 30 minutes after administration.

Question 3

The nurse recommends that to control chronic pain for the patient with osteoarthritis,the patient should:

A) Administer analgesics only when needed.
B) Administer analgesics as prescribed on a routine basis.
C) Plan activities with no rest periods to complete the activities quickly.
D) Wear high-heeled shoes to keep the body in alignment.

Answer 3

Administer analgesics as prescribed on a routine basis.

Question 4

The nurse recognizes a characteristic that is diagnostic of rheumatoid arthritis,which is:

A) Absence of pain
B) Symmetric bilateral joint swelling
C) Evening stiffness that improves with activity
D) Increased appetite

Question 5

The home health care nurse suggests to the patient who has had a total hip replacement that to protect the new joint,the patient should:

A) Put an extension on the toilet seat.
B) Keep the legs crossed when at rest.
C) Frequently change positions from side to side.
D) Slowly pull the knee to the chest twice a day to stretch the hip abductors.

Question 6

The nurse recognizes that the patient who is most likely to develop a connective tissue disease is a:

A) Teenage girl who swims
B) 30-year-old woman who plays tennis
C) 35-year-old male golfer
D) 40-year-old male computer analyst

Question 7

The nurse,in conjunction with the patient,establishes a plan to treat the pain associated with arthritis.The most effective strategy is to:

A) Avoid exercise to spare painful joints.
B) Use narcotics for pain relief.
C) Apply warm, moist compresses before doing activity.
D) Avoid assistive devices that encourage dependence.

Question 8

After knee replacement,the 87-year-old patient rejects the use of the continuous passive motion machine (CPM)saying,"I did not march when I was a child,and I am not marching now." The nurse points out that one of the CPM's benefits is a(n):

A) Decrease in pain
B) Increase in circulation in the new joint
C) Increase in leg strength
D) Increase in flexibility for the new joint

Question 9

The nurse explains to a 51-year-old professional tennis instructor who is diagnosed with osteoarthritis that the disease is best understood as the:

A) Presence of antibodies in the synovial fluid
B) Dislocation of the patella over the tibia
C) Degeneration of articular cartilage
D) Body's autoimmune response

Question 10

When the patient asks why systemic glucocorticoids medications are used as the last choice for the treatment of rheumatoid arthritis,the nurse's most informative reply would be:

A) "The other drugs are just as effective and work in similar ways."
B) "They are used as a last choice or for short periods because they have many side effects."
C) "Those drugs are given three or four times daily, which is more difficult for patients to remember."
D) "A higher incidence of vomiting occurs with prolonged use."

Question 11

The nurse would recognize that further nutritional teaching about a low-purine diet would be necessary when the patient with gout chooses:

A) Pizza with pepperoni
B) Seafood platter with scallops and mussels
C) Chicken salad with nuts
D) Tuna sandwich with potato chips

Question 12

The nurse explains that connective tissue function:

A) Helps provide a source of storage for calcium.
B) Stores hormones in the pores of bone tissue.
C) Controls the distribution of minerals.
D) Provides protection to body parts.

Question 13

The older patient with osteoarthritis complains of stomach discomfort and shortness of breath after years of taking aspirin for pain relief.The home health care nurse suggests that she change her pain control method to:

A) Nonsteroidal antiinflammatory drugs (NSAIDs)
B) Oral corticosteroids
C) Mild exercise
D) Warm baths

Question 14

The nurse points out that the best physiologic reason for a patient with osteoporosis to maintain a regular exercise regimen is because exercise:

A) Involves the patient in her or his own care.
B) Increases cardiac output.
C) Promotes better mental health.
D) Promotes bone formation and improves strength.

Question 15

The nurse includes in the teaching plan for a patient with gout the need to be alert for the signs of:

A) Kidney stones
B) Tophi
C) Visual disturbances
D) Facial lesions

Question 16

In collecting a health history from the patient with a connective tissue disease,the nurse will be certain to inquire about the:

A) Family history of atherosclerosis
B) Last time the patient had his or her blood tested
C) History of a prior injury to a specific body part
D) Family history of a fracture

Question 17

For the patient with Behçet syndrome,the nurse would choose the nursing diagnosis of:

A) Activity intolerance, related to unsteady gait
B) Risk for injury, related to falls
C) Imbalance in nutrition: Less than body requirements, related to anorexia
D) Sexual Dysfunction, related to pain in genital area

Question 18

A patient with osteoarthritis in both knees and shoulders states that she cannot manage her household tasks without pain.The most appropriate nursing diagnosis for this patient is:

A) Ineffective coping, related to pain
B) Risk for disuse syndrome
C) Impaired physical mobility, related to pain
D) Activity intolerance, related to pain

Question 19

Immediately after surgery,the nurse caring for the patient who had a total knee replacement makes careful documentation on the patient's:

A) Quality of pulses in the affected limb
B) Degree of nausea and vomiting
C) Understanding of the procedure
D) Amount of pain

Question 20

The nurse explains to a patient with rheumatoid arthritis that the drug,leflunomide (Arava)is a disease-modifying antirheumatic drug (DMARD),which will:

A) Retard the progress of the disease.
B) Builds new bone.
C) Decreases inflammation.
D) Increases flexibility.

Question 21

Imbalanced nutrition: Less than body requirements is the nursing diagnosis applicable to the patient with progressive systemic sclerosis (PSS).The nurse selects the most important point to teach,which is:

A) Eat three large meals spaced throughout the day.
B) Schedule rest periods to prevent overtiring.
C) Severe stress can trigger vasospasm.
D) Eat smaller, more frequent meals.

Question 22

The diagnostic test result that the nurse would expect for a patient with polymyositis is:

A) Muscle biopsy, positive for muscle degeneration
B) Positive antinuclear antibody (ANA) blood test
C) Positive 24-hour urine test for urate crystals
D) Urate crystals in the synovial fluid

Question 23

The nurse clarifies to the patient with gout that the medication,probenecid (Benemid),is prescribed to:

A) Reduce inflammation in the affected joint
B) Relieve pain
C) Diminish swelling
D) Increase excretion of uric acid

Question 24

To decrease osteoporosis,the nurse explains that women can benefit from ____________________ for 15 years after the onset of menopause.

Question 25

The nurses assesses ischemic spots around the nail beds of a patient with rheumatoid arthritis and recognizes that these are a complication of medical diagnosis,Rheumatoid arthritis,related to______________.

Question 26

The nurse recommends to patients with osteoarthritis that they consider physical therapy for assistance with: (Select all that apply.)

A) Isotonic exercises
B) Moist heat application
C) Instruction with a transcutaneous electrical nerve stimulation (TENS) unit
D) Measures to increase range of motion
E) Measures to increase strength

Question 27

The rehabilitation nurse clarifies that the goals of therapy for patients with rheumatic arthritis are to: (Select all that apply.)

A) Decrease inflammation.
B) Balance activity and rest.
C) Promote adaptation to limitations.
D) Plan frequent periods of bedrest
E) Supply patient education and support.

Question 28

The nurse clarifies that a postmenopausal woman who is not taking hormone replacement therapy should take ____ mg elemental calcium on a daily basis.

A) 1000
B) 1500
C) 10,000
D) 15,000

Question 29

The anonym CREST represents the five characteristic signs of progressive systemic sclerosis,which are: (Select all that apply.)

A) Calcinosis
B) Rash
C) Esophageal dysfunction
D) Sore joints
E) Telangiectasis

Question 30

The patient with bursitis of the shoulder can benefit by:

A) Lifting a 5-pound weight as a daily exercise.
B) Walking the fingers of the affected arm up the wall.
C) Splinting the affected arm to keep the shoulder immobile.
D) Performing gentle push-ups on the floor.

Question 31

Two days after a total hip replacement,the patient is being discharged.The statement indicating that the patient understands the discharge teaching is:

A) "I can sit comfortably with my legs crossed."
B) "I will ask my husband to tie my shoes for me."
C) "I am glad I won't have to use that bulky pillow between my legs at night."
D) "My straight dining room chair will be helpful when I do the hip flexion exercises."

Question 32

The nurse questions an older patient about the age-related changes she has experienced in her connective tissue,which have lessened her mobility.These changes most commonly include: (Select all that apply.)

A) Loss of bone, which may cause fragile bones
B) Thickening of the tendons, causing loss of strength
C) Bony deposits in the joints, causing pain and altered movement
D) Hardening of cartilage, causing more friction in joints
E) Diminished energy, causing decreased activity

Question 33

The nurse would include in a teaching plan for a patient with carpal tunnel syndrome instructions about:

A) Anticoagulants and glucocorticoids
B) Methotrexate
C) Lubricating ointments
D) Splinting to prevent flexion and hyperextension