Unit 6 Quiz Flashcards
After numerous trips to the physician’s office, a client is diagnosed with diffuse scleroderma based on which of the following clinical manifestations? Select all that apply.
a) protruding eyeball with very red, inflamed eyes and associated photophobia
b) hands turn bluish purple when getting items out of the freezer
c) spider veins on the face and chest
d) inability to walk long distances with severe leg cramping in calf muscles
e) difficulty swallowing resulting in weight loss due to malabsorption
B, C, E
An elderly female complains about waking up one morning with pain/stiffness in her neck/shoulders. Lab work reveals an elevated erythrocyte sedimentation rate (ESR). The physician gives the client a 3-day trial of prednisone, which significantly improves the pain. The health care provider correlates this information and diagnoses which of the following disorders?
a) anklyosing spondylitis
b) reiter syndrome
c) psoriatic arthritis
d) polymyalgia rheumatica
D
A client presents to the orthopedic clinic for evaluation since the primary care provider thinks the client may have rheumatoid arthritis (RA). Which statement by the client correlates with the diagnosis of RA? Select all that apply.
a) “look how many hand is deformed. My doctor calls it ‘hyperextension’”
b) “I’m having a hard time opening doors since it hurts so bad”
c) “every time I get something out of the freezer, my hands turn reddish purple in color”
d) “look, I didn’t button all my shirt buttons…it just hurts too much and look at the swelling in my hands”
e) “just look at my face. It looks like I have varicose veins on my cheeks”
A, B, D
Which of the following clients presenting to the emergency department would most likely be diagnosed with a pathologic stress fracture?
a) a competitive volleyball player diving to retrieve a volley and landing on his hip
b) a postmenopausal female who was diagnosed with breast cancer with metastasis to bone
c) a teenager who fell off a ladder and hit the concrete driveway, landing on is hip
d) a weight lifter who bench-presses 200 kg lost balance and fell to the side, landing on his hip
B
A child with a diagnosis of Legg-Calvé-Perthes disease will exhibit:
a) in toeing due to metatarsus adductus
b) congenital dislocation of the acetabulofemoral joint
c) defective synthesis of type 1 collagen
d) necrosis of the proximal femoral head
D
An elderly resident of an assisted-living facility has had his mobility and independence significantly impaired by the progression of his rheumatoid arthritis (RA). What is the primary pathophysiologic process that has contributed to this client’s decline in health?
a) cytokine release following mechanical joint injury
b) a mismatch between bone resorption and remodeling
c) immunologically mediated joint inflammation
d) excessive collagen production and deposition
C
A 77-year-old woman has been admitted to the geriatric medical unit of the hospital for the treatment of pneumonia. The nurse providing care for the client notes the presence of nasal calcitonin, vitamin D, and calcium chloride on the client’s medication administration record. The nurse should conclude that this client likely has a history of:
a) osteoarthritis
b) osteoporosis
c) rheumatoid arthritis
d) scleroderma
B
An adult female client visits with her healthcare provider about pain in her hand. She describes it as an audible grinding and cracking sound, especially in her thumb. “I had to buy an automatic jar opener…I just can’t grasp and open a jar…it just hurts too badly.” The health care provider suspects the client has a degenerative form of joint disease that is often evidenced by:
a) systemic lupus erythematosus
b) rheumatoid arthritis
c) osteoarthritis
d) ankylosing spondylitis
C
Which of the following clients are at risk for developing osteomalacia? Select all that apply.
a) a middle-aged adult with acute insufficiency caused by decreased cardiac output prior to having a coronary bypass graft surgery
b) a person who lives in a colder region of the northwest who doesn’t get out much during the winter months for fear of falling
c) a young 30 year old African American diagnosed with hypertension who is noncompliant related to taking medication and prescribed diet restrictions
d) an elderly female who “can’t stand to drink milk” and refuses calcium supplements since she has a history of kidney stones
e) a female client whose father had a genetic predisposition to primary hyperparathyroidism resulting in increased calcium resorption from the bone
B, D, E
A female client presents to the orthopedic clinic for evaluation. The primary care provider told her she has a “spur” on her joint. She asks, “Why did this happen? I guess I just didn’t exercise enough.” The nurse recognizes this to be a later structural change of osteoarthritis (OA), where the client no longer has a “shock absorber,” culminating in:
a) osteonecrosis and loss of synovial fluid
b) osteophyte formation and erosion of cartilage
c) formation of tophi in the synovial space
d) separation of the epiphyseal plate
B
When caring for a patient taking dantrolene, what adverse effects would the nurse monitor for? (Select all that apply.)
a) hepatitis
b) bradycardia
c) urinary retention
d) fatigue
e) rash
A, D, E
The nurse is teaching a class on muscular coordination and explains it is the movement of what electrolyte that contributes to the process of muscle contraction and relaxation?
a) hydrogen
b) chloride
c) magnesium
d) calcium
D
The nurse is caring for four patients. Which patient would have the highest risk for hepatotoxicity from dantrolene (Dantrium)?
a) a 65 year old woman who is on hormone replacement therapy
b) a 32 year old man who is taking an antipsychoticc drug
c) an 87 year old man who is taking cardiac glycoside
d) a 48 year old woman who is taking an antihypertensive agent
A
A nurse is caring for a patient with severe rheumatoid arthritis who takes anti-inflammatory agents on a regular basis. What medication should the nurse question if ordered by the physician to be taken in addition to the anti-inflammatory agent?
a) calcium channel blocker
b) beta-blocker
c) antibiotic
d) oral antidiabetic agent
B
When the nurse learns that the patient with rheumatic arthritis is complaining of stomatitis, the nurse should further assess the patient for the adverse effects of what medication?
a) salicylate therapy
b) gold-containing compounds
c) corticosteroids
d) antimalarials
B
