Deck 19: Coordinating Care for Patients With Connective Tissue Disorders

Question 1

A patient asks the nurse if there are any conditions that can exacerbate systemic lupus erythematosus (SLE).Which response by the nurse is the most appropriate?

A) "Conditions causing hypotension can often exacerbate SLE."
B) "GI upset is often associated with SLE exacerbation."
C) "Pregnancy is often associated with an SLE exacerbation."
D) "Fever is a known trigger for an SLE exacerbation."

Answer 1

"Pregnancy is often associated with an SLE exacerbation."

Question 2

An Asian male accompanies his spouse to the clinic and states,"I want you to fix my wife and tell her that there is nothing wrong with her." The patient reports pain,sleep disorders,and stiffness.Which would be most appropriate for the nurse to include in a plan of care for this family?

A) Medications used to treat fibromyalgia
B) An exercise program to increase energy
C) Information and literature on fibromyalgia
D) Suggested dietary changes to help with the pain

Answer 2

Information and literature on fibromyalgia

Question 3

The nurse is collecting a health history for a patient in an outpatient clinic who reports joint pain and swelling for the last two months.The patient is diagnosed with rheumatoid arthritis (RA).When planning care for this patient,which statement supports the nursing diagnosis of Activity Intolerance?

A) "I seem to get tired early in the day and require a nap."
B) "My joints are stiffest at night before I go to sleep."
C) "I find it difficult to move when I first get up in the morning."
D) "I take ibuprofen for the pain as needed."

Answer 3

"I seem to get tired early in the day and require a nap."

Question 4

A patient with systemic lupus erythematosus (SLE)is being treated with immunosuppressant drugs and corticosteroids.Which patient statement indicates the need for further education after teaching?

A) "I can go to events with large crowds."
B) "I should avoid getting the flu shot."
C) "I will use contraception to avoid pregnancy."
D) "I will report any symptoms of infection immediately."

Question 5

The nurse is providing care for a newly married woman with systemic lupus erythematosus (SLE).Which patient statement indicates an appropriate understanding of the plan of care?

A) "I will take birth control pills while I am taking cytotoxic medications."
B) "I do not need to contact the doctor if I develop a fever or rash."
C) "I plan to go to the movies this weekend so that I get out of the house."
D) "I can take aspirin as indicated for pain."

Question 6

The nurse is caring for a patient who was diagnosed with rheumatoid arthritis (RA)last year.The patient has recently been placed on prednisone for treatment.Which patient statement indicates that the medication teaching was successful?

A) "I will not have to limit my consumption of canned vegetables."
B) "I will take this medication on a full stomach to enhance absorption."
C) "I will not need to monitor my blood sugar more frequently while on this medication."
D) "I will take the ordered dose at the same time every day."

Question 7

An adult patient is diagnosed with fibromyalgia.The patient asks the nurse whether a recent of infection with the Coxsackie B virus could have caused fibromyalgia.Which response by the nurse is the most appropriate?

A) "The Coxsackie B virus has nothing to do with fibromyalgia."
B) "The Coxsackie B virus may have triggered the fibromyalgia."
C) "The Coxsackie virus definitely caused the fibromyalgia."
D) "Fibromyalgia is a psychiatric disorder."

Question 8

The nurse identifies the nursing diagnosis of chronic pain as being appropriate for a patient with fibromyalgia.Which manifestation did the patient most likely report that caused the nurse to select this diagnosis?

A) Acute chest pain
B) Pain from eyestrain
C) Tender points in the knees
D) Pain from a severe skin rash

Question 9

A nurse is caring for a patient with systemic lupus erythematosus (SLE).The patient begins to cry stating,"I am afraid I will be disfigured because of all of these lesions." Which intervention does the nurse plan to teach this patient to minimize skin infections associated with SLE?

A) Use sunscreen with an SPF of 15 or greater
B) Remain indoors on sunny days
C) Avoid swimming in a pool or the ocean
D) Decrease sun exposure between 3:00 p.m.and 5:00 p.m.

Question 10

The nurse is caring for a patient who is hospitalized due to an exacerbation of systemic lupus erythematosus (SLE).The nurse is reviewing the patient's lab work and finds the white blood cell count (WBC)is shifted to the left.Based on this information,which is a priority nursing diagnosis for this patient?

A) Risk for Infection
B) Ineffective Individual Coping
C) Risk for Impaired Skin Integrity
D) Ineffective Health Maintenance

Question 11

A nurse is caring for a patient with systemic lupus erythematous (SLE)who is taking hydroxychloroquine (Plaquenil).When providing care for this patient,the nurse monitors for which adverse effect associated with the prescribed medication?

A) Renal toxicity
B) Retinal toxicity
C) Cushingoid effects
D) Pulmonary fibrosis

Question 12

The patient enters the outpatient clinic and states to the triage nurse,"I think I have the flu.I'm so tired,I have no appetite,and everything hurts." The triage nurse assesses the patient and finds a butterfly rash over the bridge of nose and on the cheeks.Based on this data,which diagnosis does the nurse anticipate?

A) Gout
B) Lyme disease
C) Fibromyalgia
D) Systemic lupus erythematosus

Question 13

A patient recently diagnosed with rheumatoid arthritis (RA)asks the nurse if the disease is caused by ethnicity.Which response by the nurse is the most appropriate?

A) "RA affects all races at the same rate."
B) "RA is most prevalent in Caucasian females."
C) "RA affects those of German descent most often."
D) "RA is most prevalent in men under the age of 20 years."

Question 14

A patient with rheumatoid arthritis (RA)is being seen in the outpatient clinic for a progress check-up.The nurse is reviewing the patient's plan of care and determines that the patient has met a goal of treatment when the patient makes which statement?

A) "I sleep for 10 hours at night."
B) "I have increased pain in my joints all the time now."
C) "I have delegated many household chores to my children and spouse."
D) "I do not perform household chores at all anymore."

Question 15

The nurse is caring for a patient diagnosed with discoid lupus erythematosus.The nurse is collaborating with the patient to set goals for the nursing plan of care.Which is an appropriate goal for this patient?

A) Work through the stages of death and dying
B) Compliance with a sun protection plan
C) Gain weight to within 10 pounds of normal for height
D) Report pain no higher than 4 on a scale of 1-10

Question 16

The nurse is completing a health screening for a school-age child with rheumatoid arthritis (RA).The parents ask the nurse to recommend activities that will promote exercise for their child.Which recommendation by the nurse is the most appropriate?

A) Running
B) Softball
C) Football
D) Swimming

Question 17

A nurse is caring for a patient who is newly diagnosed with rheumatoid arthritis (RA).The patient asks the nurse what the difference is between RA and osteoarthritis (OA).Which response by the nurse is most appropriate?

A) "The onset of OA is gradual while the onset of RA may be rapid."
B) "With OA,multiple joints are symmetrically affected;RA affects one joint at a time."
C) "The affected joints in RA feel cold to the touch while the joints affected by OA are warm or hot to the touch."
D) "The pain and stiffness with RA is with activity;OA pain and stiffness is predominant upon arising."

Question 18

The nurse is planning care for an adolescent patient who has systemic lupus erythematosus (SLE).Which action by the patient indicates the implemented plan of care is appropriate?

A) Refusing to attend school
B) Discussing skin changes with a good friend
C) Refraining from attending any social functions
D) Discussing skin changes with the health-care provider

Question 19

The nurse is providing health education to a diverse group at a neighborhood community center.Why does the nurse plan to include signs and symptoms of systemic lupus erythematosus (SLE)?

A) The neighborhood is composed of many young female children.
B) The audience has asked the nurse to include the information.
C) The audience is mainly composed of Caucasian women.
D) The audience is mainly females of Asian-American descent.

Question 20

A nurse is caring for a pregnant patient who has rheumatoid arthritis (RA).Based on this data,which does the nurse anticipate when providing care to this patient?

A) A higher risk for preterm delivery
B) An increased need for medication
C) An acute exacerbation of symptoms
D) A continued risk for anemia

Question 21

During a home visit,the family of a patient with fibromyalgia asks the nurse what they can do to help the patient with painful episodes.What should the nurse suggest to the patient and family?

A) Plan a family reunion
B) Keep the patient in bed
C) Protect the patient from injury
D) Divide household chores among each member of the family

Question 22

The nurse is discussing goals to relieve pain and fatigue with a patient newly diagnosed with fibromyalgia.Which goal statement would be realistic for this patient to achieve within 30 days?

A) Join an exercise group
B) Get a job outside the home
C) Walk her son to school daily
D) Cook dinner five nights a week

Question 23

The mother of three teenagers is diagnosed with fibromyalgia and asks the nurse how to keep up with all of the children's activities.Which suggestion by the nurse is the most appropriate?

A) Ask the children to limit their activities.
B) Attempt to attend the all the functions of the children.
C) Avoid attending any afterschool functions for the children.
D) Negotiate with the children to alternate attending their functions.

Question 24

The nurse is counseling an adult patient with fibromyalgia.What are some elements of counseling that can help this patient develop effective coping skills?

A) Remind the patient that the patient has a progressive disease.
B) Suggest to the patient that some symptoms may be psychosomatic.
C) Inform the patient that the patient does not need to see a specialist.
D) Teach the patient strategies including distractions,relaxation techniques,or journaling.