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WorksheetsP& R QUIZ #1
Total questions: 68
Worksheet time: 49mins
What is valve stenosis?
narrowing of the valves
hardening of the valves
leakage of the valves
tearing of the valves
What is a corticosteroid?
a class of drug that relieves cyanosis
a class of drug that decreases inflammation
a class of drug that prevents sore throats
a class of drug that fights viruses
What ages are children at greater risk for developing RF if they frequently have strep throat?
0-10
0-5
5-10
5-15
What causes RF and RHD?
Influenza A
Untreated Rhinovirus infections
Untreated strep throat infections
Rheumatoid arthritis
What is a rheumatic fever symptom?
nausea
painful tender joints.
high blood pressure
dry, flaky skin
Joint pain associated with rheumatic fever would:
be worse in the morning
occur simultaneously with a sore throat
be worse later in the day
occur 10 - 14 days after an untreated sore throat
Positive indicators for rheumatic heart disease would include:
all of the above
abnormal electrocardiogram
x-ray showing an enlarged heart
lung congestion
This valve is the most commonly affected by rheumatic heart disease...
Tricuspid
Mitral
Pulmonic
Aortic
Rheumatic Heart Disease is the most common cause of chronic valve disease.
TRUE
FALSE
Your 8 year patient has been admitted for rheumatic fever. You know that salicylates are for:
valve stenosis
Subcutaneous nodules
Chorea symptoms
Polyarthritis
Which of the following is NOT a sign of rheumatic fever?
Pericardial rub
Pulsus paradoxus
Erythema marginatum
Migratory polyarthritis
What instructions should be provided for a patient with a hx of rheumatic fever for dental work?
Administration of aspirin
Take prophylactic antibiotics
Avoid any kind of activities
Administration of steroids
Lupus is a(n)...
mental disorder
autoimmune disorder
cancer
bone disease
Sun exposure is a common cause of SLE exacerbation.
TRUE
FALSE
A rash is the most common symptom of lupus.
TRUE
FALSE
The real cause of lupus is unknown.
TRUE
FALSE
Does Lupus have a cure?
YES
NO
Lupus mosty strikes
Teens
Kids
Women
Men
Lupus affects?
Skin & hair
All systems
Liver & Kidney functions
Heart & blood vessels
Which mnemonic is used to remember the diagnostic criteria for SLE?
JONES
CREST
FOMO
SOAP BRAIN MD
Which patient statement about SLE is true?
"SLE will not affect my lungs or breathing."
"I will need to wear gloves when it is really cold outside."
"Long-term therapy with steroids will cure my disease."
"I should use a sunscreen with an SPF of at least 15."
Blood work for SLE patients includes (SATA):
ESR
ANA
CBC
Rheumatoid factor
Which of the following clinical findings supports the diagnosis of SLE?
Increased hair growth
Malar rash
Weight gain
Petechiae on thighs
Which priority instructions should be given to the patient diagnosed with SLE?
Increase oral intake daily
Slurred speech may occur with disease progression
Desensitization programs to triggers are recommended
Utilize sun protection when outdoors
Teaching that the nurse will plan for the patient with SLE includes:
The use of non pharmacologic pain interventions
The necessity of genetic counseling before planning a family
Increasing dietary protein and carbohydrate intake
Avoid live vaccines while on immunosuppressants
A nurse caring for a client with SLE would expect which medication to be prescribed?
Antidiarrheal
Antibiotic
Opioid analgesic
Corticosteroid
Which of the following assessment findings is common for a client with SLE?
Butterfly rash.
Renal calculi.
Subcutaneous nodules.
Joint deformity.
Lupus and scleroderma result from
a previous traumatic event.
an undiagnosed mental condition.
an overactive immune system.
a previous encounter with a viral antigen.
What causes of scleroderma?
Muscle tissue atrophies
Joint bones become deformed
Capillaries in the limbs narrow
Connective tissue in the skin hardens
Scleroderma treatments include: SATA
Skin Care
Dental care
Stress reduction
Managing GI symptoms
SSc can cause dysphagia.
True
False
A patient presents with the following symptoms. Which diagnosis does the nurse anticipate?
Systemic Lupus Erythematosus
Diffuse Cutaneous SSc
Limited Cutaneous SSc
Sjogren's Syndrome
This is diffuse cutaneous Systemic Sclerosis.
True
False
A patient who has Raynaud's and Dysphagia could have Scleroderma.
True
False
A client is diagnosed with scleroderma. Which intervention should the nurse anticipate to be prescribed?
Maintain bed rest as much as possible.
Administer corticosteroids prescribed for inflammation.
Keep the room temperature warm during the day and cool at night.
Advise the client to remain supine for 1 to 2 hours after meals
Scleroderma can cause facial disfigurement and alteration of body image & self-identity
True
False
This condition causes poor circulation to fingers and toes and is commonly seen in scleroderma
Chorea Sydenham
Carpel Tunnel Syndrome
Raynaud's Phenomenon
Diabetes
A client with rheumatoid arthritis (RA) is on the postoperative nursing unit after having elective surgery. The client reports that one arm feels like pins and needles and that the neck is very painful since returning from
surgery. What action by the nurse is best?
Assist the client to change positions.
Document the findings in the clients chart.
Encourage range of motion of the neck.
Notify the provider immediately.
The nurse working in the rheumatology clinic is seeing clients with rheumatoid arthritis (RA). What assessment would be most important for the client whose chart contains the diagnosis of Sjogren's syndrome?
Abdominal assessment
Oxygen saturation
Renal function studies
Visual acuity
A nurse works in the rheumatology clinic and sees clients with rheumatoid arthritis (RA). Which client should the nurse see first?
Client who reports jaw pain when eating
Client with a red, hot, swollen right wrist
Client who has a puffy-looking area behind the knee
Client with a worse joint deformity since the last visit
The nurse is working with a client who has rheumatoid arthritis (RA). The nurse has identified the priority problem of poor body image for the client. What finding by the nurse indicates goals for this client problem are being met?
Attends meetings of a book club
Has a positive outlook on life
Takes medication as directed
Uses assistive devices to protect joints
A client is started on etanercept (Enbrel). What teaching by the nurse is most appropriate?
Giving subcutaneous injections
Having a chest x-ray once a year
Taking the medication with food
Using heat on the injection site
The nurse in the rheumatology clinic is assessing clients with rheumatoid arthritis (RA). Which client should the nurse see first?
Client taking celecoxib (Celebrex) and ranitidine (Zantac)
Client taking etanercept (Enbrel) with a red injection site
Client with a blood glucose of 190 mg/dL who is taking steroids
Client with a fever and cough who is taking tofacitinib (Xeljanz)
A client with rheumatoid arthritis (RA) has an acutely swollen, red, and painful joint. What nonpharmacologic treatment does the nurse apply?
Heating pad
Ice packs
Splints
Wax dip
The nurse on an inpatient rheumatology unit receives a hand-off report on a client with an acute exacerbation of systemic lupus erythematosus (SLE). Which reported laboratory value requires the nurse to assess the client further?
Creatinine: 3.9 mg/dL
Platelet count: 210,000/mm3
Red blood cell count: 5.2/mm3
White blood cell count: 4400/mm3
A client who has had systemic lupus erythematosus (SLE) for many years is in the clinic reporting hip pain with ambulation. Which action by the nurse is best?
Assess medication records for steroid use.
Facilitate a consultation with physical therapy.
Measure the range of motion in both hips.
Notify the health care provider immediately.
A nurse is caring for a client with systemic sclerosis. The client's facial skin is very taut, limiting the client's ability to open the mouth. After consulting with a registered dietitian for appropriate nutrition, what other consultation should the nurse
Dentist
Massage therapist
Occupational therapy
Physical therapy
A client recently diagnosed with systemic lupus erythematosus (SLE) is in the clinic for a follow-up visit. The nurse evaluates that the client practices good self-care when the client makes which statement?
"I always wear long sleeves, pants, and a hat when outdoors."
"I try not to use cosmetics that contain any type of sunblock."
"Since I tend to sweat a lot, I use a lot of baby powder."
"Since I can't be exposed to the sun, I have been using a tanning bed."
A client has newly diagnosed systemic lupus erythematosus (SLE). What instruction by the nurse is most important?
"Be sure you get enough sleep at night."
"Eat plenty of high-protein, high-iron foods."
"Notify your provider at once if you get a fever."
"Weigh yourself every day on the same scale."
A client comes to the family medicine clinic and reports joint pain and stiffness. The nurse is asked to assess the client for Heberden's nodules. What assessment technique is correct?
Inspect the client's distal finger joints.
Palpate the client's abdomen for tenderness.
Palpate the client's upper body lymph nodes.
Perform range of motion on the client's wrists.
The nursing student studying rheumatoid arthritis (RA) learns which facts about the disease? (Select all that apply.)
It affects single joints only.
Antibodies lead to inflammation.
It consists of an autoimmune process.
Morning stiffness is rare.
Permanent damage is inevitable.
A nurse is teaching a female client with rheumatoid arthritis (RA) about taking methotrexate (MTX) (Rheumatrex) for disease control. What information does the nurse include? (Select all that apply.)
a. "Avoid acetaminophen in over-the-counter medications."
b. "It may take several weeks to become effective on pain."
c. "Pregnancy and breast-feeding are not affected by MTX."
d. "Stay away from large crowds and people who are ill."
e. "You may find that folic acid, a B vitamin, reduces side effects."
(a)
The nurse working in the rheumatology clinic assesses clients with rheumatoid arthritis (RA) for late manifestations. Which signs/symptoms are considered late manifestations of RA? (Select all that apply.)
Anorexia
Felty's syndrome
Joint deformity
Low-grade fever
Weight loss
The nurse is caring for a client with systemic sclerosis (SSc). What comfort measures can the nurse delegate to the unlicensed assistive personnel (UAP)? (Select all that apply.)
Collaborate with a registered dietitian for appropriate foods.
Inspect the skin and note any areas of ulceration.
Keep the room at a comfortably warm temperature.
Place a foot cradle at the end of the bed to lift sheets.
Remind the client to elevate the head of the bed after eating.
A client has rheumatoid arthritis (RA) and the visiting nurse is conducting a home assessment. What options can the nurse suggest for the client to maintain independence in activities of daily living (ADLs)? (Select all that apply.)
Grab bars to reach high items
Long-handled bath scrub brush
Soft rocker-recliner chair
Toothbrush with built-up handle
Wheelchair cushion for comfort
What is it called when one joint slips past another (partially dislocates)?
swan neck
ulnar drift
subluxation
gel phenomenon
what disorder, associated with RA, is this?
(a)
what disorder, associated with RA, is this?
(a)
Which extra articular manifestation of RA can cause pulmonary effects?
Gel Phenomenon
Uveitis
Rheumatoid nodules
Felty Syndrome
Patient has dry mouth, itching eyes, & decreased tear production. what disorder is this?
Gel Phenomenon
Sjogren's Syndrome
Periungual Lesions
Felty Syndrome
What are some interventions for a patient with Sjogrens syndrome?
give the patient sweet drinks
provide silicone-based lubricants
provide artificial saliva
assist patient in oral care every shift
This treatment physically removes the antibodies from the blood.
transfusion
plasmapheresis
hemodialysis
photosynthesis
Patient is suspected to have RA. What test is most specific for diagnosis of RA?
Erythrocyte
Sedimentation Rate (ESR)
Complete Blood Count (CBC)
Anti-cyclic citrullinated protein antibody (anti-CCP)
Rheumatoid Factor (RF)
which two lab tests show active inflammation?
CBC and C-Reactive Protein
C-Reactive protein and antinuclear antibody
Synovial Fluid Analysis and Rheumatoid Factor
Erythrocyte Sedimentation Rate and C-Reactive Protein
In arthrocentesis, the synovial fluid is analyzed for all, except:
Cloudiness
WBC
Rheumatoid Factor
Viscosity
Which drug is given via IV infusions ?
Humira
Remicade
Zantac
Enbrel
what does DMARDs stand for?
Disease Modifying Anti-Relapse Drugs
Disease Modifying Anti-Rheumatic Drugs
Disease Modifying Anti-Reprogram
Drugs
Disease Molecular Anti-Rheumatic Drugs
Which is NOT a nursing consideration in treating the patient with RA?
Promote Growth & Development
Managing Fatigue
Promoting Mobility
Enhancing Body Image
