Chapter 22: Juvenile Idiopathic Arthritis (JIA)

Question 1

Which factors contribute to a favorable prognosis for a child with juvenile idiopathic arthritis (JIA)? (SATA)

A. Early onset of disease
B. Symmetrical joint involvement
C. Effective response to treatment
D. Long periods of remission
E. Presence of a positive rheumatoid factor

Answer 1

A. Early onset of disease
C. Effective response to treatment
D. Long periods of remission

Rationale: Early onset, effective response to treatment, and extended remission periods are associated with a better prognosis. Symmetrical joint involvement and a positive RF do not necessarily indicate a favorable outcome.

Question 2

A child with juvenile idiopathic arthritis (JIA) presents with joint swelling, pain, and limited mobility. The parents ask if the condition can affect their child’s life permanently. How should the nurse respond?

A. “JIA is always temporary and will not cause long-term effects.”

B. “JIA symptoms can sometimes lead to permanent joint and bone changes if unresponsive to treatment.”

C. “JIA only affects the joints temporarily and does not impact overall health.”

D. “JIA will not interfere with your child’s growth or development.”

Answer 2

B. “JIA symptoms can sometimes lead to permanent joint and bone changes if unresponsive to treatment.”

Rationale: JIA may cause lasting bone and joint changes if unresponsive to treatment, though remission is possible. It can also impact growth and development if not managed appropriately.

Question 3

What is the peak age of onset for juvenile idiopathic arthritis (JIA)?

A. Birth to 1 year
B. 1 to 3 years
C. 5 to 8 years
D. 10 to 12 years

Answer 3

B. 1 to 3 years

Rationale: JIA most commonly develops between 1 and 3 years of age, with females being affected twice as often as males.

Question 4

Which of the following systems may be affected by juvenile idiopathic arthritis (JIA) outside of the joints? (SATA)

A. Heart
B. Lungs
C. Liver
D. Eyes
E. Kidneys

Answer 4

A. Heart
B. Lungs
C. Liver
D. Eyes

Rationale: JIA can involve the heart, lungs, liver, and eyes. Kidney involvement is not a typical characteristic of JIA.

Question 5

A 3-year-old female is diagnosed with juvenile idiopathic arthritis (JIA). What is the most likely reason for the nurse to monitor her growth and development closely?

A. JIA causes increased growth spurts due to inflammation.
B. JIA primarily affects cognitive development rather than physical growth.
C. Steroid therapy for JIA promotes rapid bone growth.
D. Chronic pain and mobility limitations can interfere with normal growth and development.

Answer 5

D. Chronic pain and mobility limitations can interfere with normal growth and development.

Rationale: Chronic pain, impaired mobility, and treatment side effects can interfere with normal growth and development in children with JIA.

Question 6

Which of the following characteristics is essential for the diagnosis of juvenile idiopathic arthritis (JIA)?

A. Arthritis involving one or more joints lasting more than 6 weeks
B. Positive rheumatoid factor (RF)
C. Joint inflammation with an onset after 16 years of age
D. Symmetrical joint swelling and stiffness

Answer 6

A. Arthritis involving one or more joints lasting more than 6 weeks

Rationale: JIA is defined by arthritis affecting one or more joints for at least 6 weeks, with an onset before 16 years of age. A positive RF is not required for diagnosis, and symmetrical joint swelling is not always present.

Question 7

Which complication of juvenile idiopathic arthritis (JIA) is related to early closure of epiphyseal plates and small joint contractures?

A. Growth alterations
B. Uveitis
C. Rheumatoid nodules
D. Synovitis

Answer 7

A. Growth alterations

Rationale: Growth alterations in children with JIA can result from early closure of epiphyseal plates, joint contractures, and synovitis, which can limit normal development.

Question 8

A child with systemic arthritis presents with swollen joints, a high fever, and a maculopapular rash. Which additional symptoms should the nurse monitor for?

A. Inflammation of the middle layer of the eye
B. Limited range of motion and joint deformities
C. Changes in internal organ function
D. Weight loss and fatigue

Answer 8

C. Changes in internal organ function

Rationale: Systemic arthritis affects both joints and internal organs. Symptoms like uveitis are more typical of oligoarthritis, while long-term joint deformities and limited motion develop later in untreated cases.

Question 9

A child is diagnosed with oligoarthritis. The nurse knows that this form of juvenile idiopathic arthritis (JIA):

A. Affects one to four joints and is the most common type of JIA.
B. Always involves the presence of rheumatoid factor.
C. Includes symptoms of high fever and internal organ involvement.
D. Commonly progresses to polyarthritis within the first year.

Answer 9

A. Affects one to four joints and is the most common type of JIA.

Rationale: Oligoarthritis is the most common form of JIA, involving one to four joints. It does not always progress to polyarthritis, nor does it involve high fever or organ involvement, which are associated with systemic arthritis.

Question 10

Which statements are true regarding polyarthritis in juvenile idiopathic arthritis (JIA)? (SATA)

A. It involves five or more joints.
B. Rheumatoid factor is always positive in polyarthritis.
C. Uveitis can occur in both RF-negative and RF-positive polyarthritis.
D. It accounts for the largest percentage of JIA cases.
E. RF-negative polyarthritis is more common than RF-positive polyarthritis.

Answer 10

A. It involves five or more joints.
C. Uveitis can occur in both RF-negative and RF-positive polyarthritis.
E. RF-negative polyarthritis is more common than RF-positive polyarthritis.

Rationale: Polyarthritis involves five or more joints. Uveitis can occur in both RF-negative and RF-positive polyarthritis, though more commonly in RF-negative cases. RF-negative polyarthritis is more common than RF-positive polyarthritis.

Question 11

Which of the following is a hallmark feature of systemic arthritis in juvenile idiopathic arthritis (JIA)?

A. Uveitis
B. Involvement of one to four joints
C. Presence of rheumatoid factor
D. High fever and rash

Answer 11

D. High fever and rash

Rationale: Systemic arthritis is characterized by high fever, a rash, swollen and painful joints, and involvement of internal organs. Uveitis is more common in oligoarthritis and polyarthritis.

Question 12

Which of the following clinical manifestations is most commonly associated with juvenile idiopathic arthritis (JIA)?

A. Symmetric involvement of the small joints of the hand in younger children
B. Pain, stiffness, and swelling in large joints such as the knees
C. Rapid and symmetric growth of extremities
D. Persistent fever and rash localized to one area

Answer 12

B. Pain, stiffness, and swelling in large joints such as the knees

Rationale: Pain, stiffness, loss of motion, and swelling typically occur in large joints such as the knees in children with JIA. Symmetric involvement of small joints is more common in older children, and uneven, rather than rapid, growth of extremities may occur.

Question 13

A 7-year-old child with suspected JIA presents with splenomegaly, hepatomegaly, and a rash. The nurse also observes the child favoring their left leg. What should the nurse assess next?

A. Cognitive abilities
B. Presence of lymphadenopathy
C. Growth chart for symmetric development
D. Reflexes in the lower extremities

Answer 13

B. Presence of lymphadenopathy

Rationale: Systemic JIA can present with lymphadenopathy, in addition to splenomegaly, hepatomegaly, rash, and joint pain. Assessing for lymphadenopathy is crucial for a full clinical picture.

Question 14

Which findings would be expected in a child with systemic juvenile idiopathic arthritis (JIA)? (SATA)

A. Fever and rash
B. Symmetric growth of extremities
C. Splenomegaly and hepatomegaly
D. Limping or favoring an extremity
E. Persistent hypotension

Answer 14

A. Fever and rash
C. Splenomegaly and hepatomegaly
D. Limping or favoring an extremity

Rationale: Systemic JIA can present with fever, rash, splenomegaly, hepatomegaly, and limping. Growth of extremities may be uneven rather than symmetric, and hypotension is not a typical feature.

Question 15

A child with juvenile idiopathic arthritis reports morning stiffness and limited joint motion. Which additional symptom should the nurse prioritize when assessing the child?

A. Rash and fever
B. Fatigue after activity
C. Symmetric involvement of the knees
D. Reduced sensation in the extremities

Answer 15

A. Rash and fever

Rationale: Morning stiffness and joint limitation are common in JIA. If systemic symptoms such as rash and fever are present, systemic arthritis should be suspected. Fatigue after activity is common but less specific, and reduced sensation is not typically associated with JIA.

Question 16

Which characteristic differentiates the clinical course of juvenile idiopathic arthritis (JIA) from other joint disorders?

A. Persistent joint deformities
B. Rapid onset of systemic symptoms
C. Symptom-free periods alternating with exacerbations
D. Involvement of only small joints

Answer 16

C. Symptom-free periods alternating with exacerbations

Rationale: JIA is characterized by remissions and exacerbations. Persistent deformities may develop if untreated, but systemic symptoms and joint involvement vary depending on the type of JIA.

Question 17

During a physical exam, a nurse notices uneven growth of a child’s extremities and a limp favoring one leg. What should the nurse consider as the most likely cause of these findings?

A. Early onset of systemic lupus erythematosus
B. Trauma or injury to the affected leg
C. Untreated developmental dysplasia of the hip
D. Chronic inflammation from juvenile idiopathic arthritis

Answer 17

D. Chronic inflammation from juvenile idiopathic arthritis

Rationale: Uneven growth of extremities and limping can result from chronic inflammation associated with JIA. Trauma or developmental dysplasia would present differently, and systemic lupus erythematosus does not typically cause uneven growth.

Question 18

A child with systemic arthritis is prescribed prednisone to manage severe symptoms. What teaching should the nurse include for the family regarding this medication?

A. “Expect improvements in joint function within 48 hours.”

B. “Schedule frequent vision checks to monitor for side effects.”

C. “Monitor the child’s growth and report any signs of delay.”

D. “This medication may cause increased photosensitivity.”

Answer 18

C. “Monitor the child’s growth and report any signs of delay.”

Rationale: Prednisone can interfere with growth; therefore, growth monitoring is crucial. Frequent vision checks are more relevant for biologics like methotrexate or in cases of uveitis. Photosensitivity is not a common side effect of prednisone.

Question 19

What factor contributes to growth interference in children with juvenile idiopathic arthritis?

A. Early onset of systemic symptoms
B. Administration of corticosteroids
C. Positive rheumatoid factor (RF)
D. Use of biologic response modifiers

Answer 19

B. Administration of corticosteroids

Rationale: Corticosteroids, often used to manage severe inflammation in JIA, can interfere with growth. Other factors include bone growth disturbances from joint inflammation.

Question 20

Which are goals of therapy in juvenile idiopathic arthritis (JIA)? (SATA)

A. Relieve pain
B. Achieve remission
C. Minimize inflammation
D. Promote weight loss
E. Preserve joint function

Answer 20

A. Relieve pain
B. Achieve remission
C. Minimize inflammation
E. Preserve joint function

Rationale: Goals of JIA therapy include relieving pain, achieving remission, minimizing inflammation, and preserving joint function. Promoting weight loss is not a therapeutic goal for JIA.

Question 21

A 12-year-old child with polyarthritis undergoes an eye examination and is found to have mild uveitis. What is the best recommendation for managing this complication?

A. Increase NSAID dosage
B. Discontinue methotrexate therapy
C. Refer to an ophthalmologist for treatment
D. Prescribe corticosteroid injections for affected joints

Answer 21

C. Refer to an ophthalmologist for treatment

Rationale: Referral to an ophthalmologist is essential for managing uveitis, as specialized care may be needed to prevent complications.

Question 22

Which complication is most closely associated with oligoarthritis and polyarthritis in JIA?

A. Splenomegaly
B. High fever and rash
C. Growth acceleration
D. Chronic uveitis

Answer 22

D. Chronic uveitis

Rationale: Chronic uveitis is a common complication in children with oligoarthritis and polyarthritis, especially those with positive ANA.

Question 23

A 10-year-old child with JIA is being treated with methotrexate but continues to have significant joint inflammation. Which medication might be added to the treatment plan to better control inflammation?

A. Etanercept
B. Diclofenac
C. Acetaminophen
D. Amoxicillin

Answer 23

A. Etanercept

Rationale: Etanercept, a biologic response modifier, may be added when DMARDs like methotrexate are insufficient in controlling inflammation. NSAIDs like diclofenac are first-line treatments but may not suffice in more severe cases.

Question 24

What is the primary purpose of radiographs in managing juvenile idiopathic arthritis (JIA)?

A. Diagnosing the condition definitively
B. Monitoring for joint damage and bone development
C. Identifying levels of inflammation
D. Excluding systemic complications

Answer 24

B. Monitoring for joint damage and bone development

Rationale: Radiographs are primarily used to monitor joint damage and bone development in JIA, as well as to exclude other causes such as fractures.

Question 25

A child with systemic juvenile idiopathic arthritis presents with a high fever, swollen joints, and a rash. Which medication would be most appropriate to manage these severe symptoms?

A. Naproxen
B. Methotrexate
C. Prednisone
D. Etanercept

Answer 25

C. Prednisone

Rationale: Corticosteroids like prednisone are often used in children with severe symptoms, such as systemic JIA, to quickly control inflammation and other systemic manifestations.

Question 26

Which medications are commonly used to manage juvenile idiopathic arthritis (JIA)? (SATA)

A. Methotrexate
B. Prednisone
C. Acetaminophen
D. Etanercept
E. Naproxen

Answer 26

A. Methotrexate
B. Prednisone
D. Etanercept
E. Naproxen

Rationale: Methotrexate (DMARD), prednisone (steroid), etanercept (biologic), and naproxen (NSAID) are used to manage JIA. Acetaminophen is not an anti-inflammatory and is not used for this condition.

Question 27

A child with oligoarthritis has tested positive for ANA. How often should the child undergo eye examinations to monitor for complications such as uveitis?

A. Every 12 months
B. Every 3 to 4 months
C. Every 6 to 8 months
D. Only if symptoms develop

Answer 27

B. Every 3 to 4 months

Rationale: Children with oligoarthritis and positive ANA should undergo eye examinations every 3 to 4 months to monitor for uveitis. The frequency is higher in this population compared to those with systemic arthritis.

Question 28

Which of the following laboratory tests would most likely indicate active inflammation in a child with juvenile idiopathic arthritis (JIA)?

A. Rheumatoid factor (RF)
B. Complete blood count (CBC) with anemia
C. Antinuclear antibody (ANA) test
D. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)

Answer 28

D. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)

Rationale: CRP and ESR are inflammatory markers that help assess the level of inflammation in JIA. While RF and ANA may support the diagnosis, they are not specific to active inflammation.

Question 29

When planning care for a child with JIA, which of the following interventions would best address the nursing diagnosis “Body Image, Disturbed”?

A. Providing education on joint protection techniques
B. Assisting the child in joining a support group with peers
C. Encouraging the child to participate in physical therapy
D. Promoting activities that encourage independence

Answer 29

B. Assisting the child in joining a support group with peers

Rationale: Assisting the child in joining a support group with peers helps address disturbed body image by providing emotional support and opportunities for social interaction with others facing similar challenges.

Question 30

A nurse is assessing a 7-year-old child with juvenile idiopathic arthritis who has visible joint deformities and complains of morning stiffness. Which nursing diagnosis is most appropriate for this child?

A. Risk for Impaired Social Interaction
B. Impaired Physical Mobility
C. Risk for Infection
D. Disturbed Thought Processes

Answer 30

B. Impaired Physical Mobility

Rationale: Impaired Physical Mobility is the most appropriate nursing diagnosis for a child with visible joint deformities and morning stiffness due to JIA, which directly affects the child’s mobility.

Question 31

When performing a nursing assessment for a child with juvenile idiopathic arthritis (JIA), which of the following symptoms should the nurse be alert for? (SATA)

A. Joint swelling and deformities
B. Growth delays
C. Hyperactivity
D. Enlarged lymph nodes
E. Decreased appetite

Answer 31

A. Joint swelling and deformities
B. Growth delays
D. Enlarged lymph nodes

Rationale: Joint swelling and deformities, growth delays, and enlarged lymph nodes are common findings in JIA. Hyperactivity and decreased appetite are not typical symptoms associated with the condition.

Question 32

Which intervention is most important for managing the nursing diagnosis “Pain, Chronic” in a child with juvenile idiopathic arthritis (JIA)?

A. Administering nonsteroidal anti-inflammatory drugs (NSAIDs)
B. Encouraging daily stretching exercises
C. Applying warm compresses to affected joints
D. Promoting bed rest for the child

Answer 32

A. Administering nonsteroidal anti-inflammatory drugs (NSAIDs)

Rationale: Administering NSAIDs is crucial in managing chronic pain related to JIA, as these medications reduce inflammation and alleviate pain. Other interventions such as warm compresses or exercise may support joint mobility but are secondary to pharmacological pain management.

Question 33

Which of the following nursing diagnoses would be most appropriate for a child with juvenile idiopathic arthritis (JIA) who is experiencing joint stiffness, pain, and difficulty moving in the morning?

A. Impaired Skin Integrity
B. Risk for Infection
C. Knowledge Deficit
D. Activity Intolerance

Answer 33

D. Activity Intolerance

Rationale: The nursing diagnosis of Activity Intolerance is appropriate for a child with JIA experiencing joint stiffness and pain, which impact their ability to engage in physical activities.

Question 34

A 12-year-old child with juvenile idiopathic arthritis (JIA) is experiencing fatigue and is often reluctant to attend school. The nurse should:

A. Encourage the child to stay home from school until symptoms improve
B. Reinforce the importance of school attendance, while allowing for rest periods when needed
C. Suggest that the child should avoid socializing with peers to prevent fatigue
D. Recommend that the child participate in less physical activity to conserve energy

Answer 34

B. Reinforce the importance of school attendance, while allowing for rest periods when needed

Rationale: Reinforcing the importance of school attendance while allowing rest periods supports the child’s social development and education, while also managing fatigue.

Question 35

Which of the following interventions would be most effective in promoting mobility in a child with juvenile idiopathic arthritis (JIA)?

A. Encouraging periods of complete bed rest
B. Teaching the child to avoid any physical activity
C. Promoting regular range-of-motion exercises and swimming
D. Encouraging the child to use a wheelchair for mobility

Answer 35

C. Promoting regular range-of-motion exercises and swimming

Rationale: Promoting regular range-of-motion exercises and swimming helps to maintain joint function, strengthen muscles, and prevent contractures, which are key goals in promoting mobility in a child with JIA.

Question 36

Which of the following should be emphasized to the parents of a child with juvenile idiopathic arthritis (JIA) during the planning and implementation phase of care?

A. The importance of encouraging the child to avoid all physical activities to prevent pain

B. The importance of providing a high-calorie diet to support the child’s reduced mobility

C. The need for regular visits to healthcare offices and clinics, with occasional hospitalization during exacerbations

D. The importance of isolating the child from peers to reduce the risk of infection

Answer 36

C. The need for regular visits to healthcare offices and clinics, with occasional hospitalization during exacerbations

Rationale: The care plan for JIA emphasizes regular healthcare visits and occasional hospitalization during exacerbations, rather than isolation or avoiding all physical activity.

Question 37

Which of the following interventions should a nurse prioritize when promoting adequate nutrition for a child with juvenile idiopathic arthritis (JIA)?

A. Encourage a low-calorie diet to prevent weight gain
B. Monitor the child’s growth and plot percentiles to assess nutritional needs
C. Limit fluid intake to prevent joint swelling
D. Increase the child’s protein intake to prevent muscle atrophy

Answer 37

B. Monitor the child’s growth and plot percentiles to assess nutritional needs

Rationale: Monitoring the child’s growth and plotting percentiles is critical for assessing nutritional needs, particularly in children with decreased mobility.

Question 38

When teaching parents and the child about managing juvenile idiopathic arthritis (JIA), which of the following should the nurse emphasize?

A. The need for regular exercise, including stretching and swimming

B. Encouraging periods of rest during exacerbations to prevent fatigue

C. Encouraging the child to avoid physical activities to prevent pain

D. The importance of maintaining a well-balanced diet to support overall health

E. The need for the child to attend school regularly, even during exacerbations

Answer 38

A. The need for regular exercise, including stretching and swimming

B. Encouraging periods of rest during exacerbations to prevent fatigue

D. The importance of maintaining a well-balanced diet to support overall health

E. The need for the child to attend school regularly, even during exacerbations

Rationale: Regular exercise, periods of rest during exacerbations, a well-balanced diet, and maintaining school attendance are all important aspects of managing JIA and promoting the child’s health and development.

Question 39

Which of the following is a key goal of physical therapy in the management of juvenile idiopathic arthritis (JIA)?

A. To relieve the child’s pain through nonpharmacological methods only
B. To prevent joint deformities and maintain joint function
C. To ensure the child does not engage in any form of exercise
D. To promote the child’s independence by avoiding assisted mobility

Answer 39

B. To prevent joint deformities and maintain joint function

Rationale: The goal of physical therapy in JIA is to prevent joint deformities and maintain joint function, helping the child preserve mobility and quality of life.

Question 40

When educating parents about the potential complications of juvenile idiopathic arthritis (JIA), which of the following should the nurse include?

A. Early closure of epiphyseal plates and small joint contractures
B. Severe metabolic syndrome and hyperglycemia
C. Increased risk of infection from immunosuppressive treatments
D. Development of severe cardiovascular disease

Answer 40

A. Early closure of epiphyseal plates and small joint contractures

Rationale: Early closure of epiphyseal plates and small joint contractures are common complications of JIA, affecting growth and mobility.

Question 41

A 10-year-old child with juvenile idiopathic arthritis (JIA) expresses frustration with the disease and its impact on their daily activities. What should the nurse prioritize during this emotional adjustment?

A. Ignoring the child’s frustrations and encouraging them to focus on therapy
B. Providing distractions such as television to avoid focusing on the disease
C. Reassuring the child that there is no need to discuss the disease further
D. Allowing the child to express their feelings and providing support for coping with frustration

Answer 41

D. Allowing the child to express their feelings and providing support for coping with frustration

Rationale: It is important to allow the child to express their feelings and provide emotional support, as adjusting to a chronic illness like JIA can be difficult for both the child and their family.

Question 42

Which of the following strategies is most effective in managing the pain and inflammation in a child with juvenile idiopathic arthritis (JIA)?

A. Using a heating pad for the affected joints
B. Restricting all physical activity and encouraging bed rest
C. Providing cold compresses to reduce inflammation
D. Providing analgesic medications as prescribed and applying warm compresses

Answer 42

D. Providing analgesic medications as prescribed and applying warm compresses

Rationale: Analgesic medications and warm compresses are effective in managing pain and inflammation associated with JIA. Physical activity, while moderated during exacerbations, is generally encouraged for mobility.

Question 43

What is the role of the nurse in supporting a child with juvenile idiopathic arthritis (JIA) during physical therapy?

A. To ensure that the child avoids any exercise to prevent further pain
B. To provide medications for pain management during exercises only
C. To discourage the child from participating in physical therapy to avoid stress on the joints
D. To encourage the child to perform range-of-motion exercises to prevent deformities

Answer 43

D. To encourage the child to perform range-of-motion exercises to prevent deformities

Rationale: Encouraging the child to perform range-of-motion exercises is key to preventing joint deformities and maintaining mobility, which is crucial in managing JIA.

Question 44

Which of the following is an expected outcome for nursing care in a child with juvenile idiopathic arthritis (JIA)?

A. The child experiences complete remission without further interventions
B. The child maintains joint mobility and absence of joint deformity
C. The child avoids all forms of physical activity to prevent joint pain
D. The child exhibits no signs of infection after discontinuing all medications

Answer 44

B. The child maintains joint mobility and absence of joint deformity

Rationale: The expected outcome for nursing care is that the child maintains joint mobility and the absence of joint deformity, which is essential for preventing long-term complications of JIA.

Question 45

Which of the following nursing interventions is most likely to help achieve the expected outcome of “absence of pain” in a child with juvenile idiopathic arthritis (JIA)?

A. Encourage the child to engage in strenuous physical activity to strengthen muscles
B. Limit the child’s participation in physical therapy to reduce joint movement
C. Administer prescribed medications such as NSAIDs and corticosteroids to reduce inflammation
D. Recommend the child to avoid any social activities to prevent stress

Answer 45

C. Administer prescribed medications such as NSAIDs and corticosteroids to reduce inflammation

Rationale: Administering prescribed medications such as NSAIDs and corticosteroids helps to reduce inflammation and pain, promoting pain relief in children with JIA.

Question 46

Which of the following is an appropriate evaluation criterion for assessing the expected outcome of “positive body image” in a child with juvenile idiopathic arthritis (JIA)?

A. The child demonstrates acceptance of physical limitations and appearance
B. The child expresses frustration with the chronic nature of the disease
C. The child avoids participating in physical therapy due to fear of pain
D. The child prefers to stay isolated from peers to avoid embarrassment

Answer 46

A. The child demonstrates acceptance of physical limitations and appearance

Rationale: A positive body image is demonstrated when the child accepts their physical limitations and appearance, which supports their emotional well-being and adjustment to the disease.

Question 47

A school-age child diagnosed with rheumatoid arthritis asks the nurse to recommend an exercise activity. Which activity is most appropriate for this child?

1. Softball
2. Football
3. Swimming
4. Basketball

Answer 47

3. Swimming

Swimming helps to exercise all of the extremities without putting undue stress on joints. Softball, football, and basketball could exacerbate joint discomfort.

Question 48

A nurse is providing discharge teaching with the parents of a school-age child who has JIA. Which of the following instructions should the nurse include?

A. provide extra time for their child to complete ADLs
B. apply cold compresses to affected joints
C. take ibuprofen on an empty stomach
D. remain home from school during periods of exacerbation
E. perform ROM exercises

Answer 48

A. provide extra time for their child to complete ADLs
E. perform ROM exercises