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 gathering objective data for a client at the clinic reporting arthritic pain in the hands. The nurse observes that the fingers are hyperextended at the proximal interphalangeal joint with fixed flexion of the distal interphalangeal joint. What does the nurse recognize this deformity as?
Correct Answer: A
Rationale: A swan neck deformity is a hyperextension of the proximal interphalangeal joint with fixed flexion of the distal interphalangeal joint. A Boutonniere deformity is a persistent flexion of the proximal interphalangeal joint with hyperextension of the distal interphalangeal joint. Ulnar deviation is when the fingers are deviating laterally toward the ulna. A rheumatoid nodule is a subcutaneous nodule.
Question 2 of 5
The nurse is preparing a client for a surgical procedure that will allow visualization of the extent of joint damage of the knee for a client with rheumatoid arthritis and also obtain a sample of synovial fluid. What procedure will the nurse prepare the client for?
Correct Answer: D
Rationale: Arthroscopic examination may be carried out to visualize the extent of joint damage as well as to obtain a sample of synovial fluid. An open reduction would be used for the treatment of a fracture. Needle aspiration will not allow visualization of the joint damage but will allow obtaining the sample of synovial fluid. Arthroplasty is the restructure of the joint surface after diagnosis is made.
Question 3 of 5
A client is receiving treatment for rheumatoid arthritis but reports being allergic to eggs. What medication would the client be unable to receive?
Correct Answer: B
Rationale: Clients allergic to eggs should not receive Synvisc injections because they will also be allergic to this. The other medications can be taken with an egg allergy.
Question 4 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 5 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.