ATI LPN
Timby's Introductory Medical-Surgical Nursing Thirteenth, North American Edition
Chapter 63 : Caring for Clients With Orthopedic and Connective Tissue Disorders Questions
Question 1 of 5
The nurse is discussing the new medication that a client will be taking for treatment of rheumatoid arthritis. Which disease-modifying antirheumatic drug (DMARD) will the nurse educate the client about?
Correct Answer: A
Rationale: Methotrexate is a DMARD that reduces the amount of joint damage and slows the damage to other tissues as well. Celecoxib is a nonsteroidal anti-inflammatory drug (NSAI
D). Methylprednisolone is a steroid to reduce pain and inflammation and slow joint destruction. Mercaptopurine azathioprine is a cytotoxic drug.
Question 2 of 5
A client diagnosed with degenerative joint disease of the fingers reports now having bumps on the fingers that do not hurt. The nurse observes bony nodules on the distal interphalangeal joints. What type of 'bumps' does the nurse understand these are?
Correct Answer: D
Rationale: DJD affects the hands; the fingers frequently develop painless bony nodules on the dorsolateral surface of the interphalangeal joints. Heberden nodes are bony enlargement of the distal interphalangeal joints. Bouchard nodes are bony enlargement of the proximal interphalangeal joints. Rheumatoid nodules are associated with rheumatoid arthritis.
Tophi occur with gout and elevated uric acid levels.
Question 3 of 5
A client has been treated for migraine headaches for several months and comes to the clinic reporting no improvement. The nurse is talking with the client and hears an audible click when the client is moving the jaw. What does the nurse suspect may be happening?
Correct Answer: B
Rationale: The disorder can be confused with trigeminal neuralgia and migraine headaches. The client experiences clicking of the jaw when moving the joint, or the jaw can lock, which interferes with opening the mouth. Loose teeth will not cause a clicking of the jaw. The client does not have a dislocated jaw.
Question 4 of 5
A client has been diagnosed with temporomandibular disorder and has not been able to eat. What is an appropriate action for the nurse to take?
Correct Answer: C
Rationale: The nurse modifies the diet to include soft rather than coarse food, which is easier to chew. The nurse also provides nutritional liquid supplements and assists the client to acquire skills that control pain, such as using a bite guard during sleep. The client does not require pureed food or clear liquids. Pureed and clear liquids are not warranted because these are too extreme and may interfere with nutrition.
Question 5 of 5
A client is complaining of severe pain in the left great toe. What lab studies that the nurse reviews indicate that the client may have gout?
Correct Answer: B
Rationale: Gout is characterized by hyperuricemia (accumulation of uric acid in the blood) caused by alterations in uric acid production, excretion, or both. An elevated white blood count may indicate bleeding from somewhere in the body. Increased AST and ALT would indicate liver dysfunction.