Rheumatoid Arthritis

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Sample questions from Rheumatoid Arthritis

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.In an outpatient rheumatology clinic, a 46-year-old client with rheumatoid arthritis reports morning stiffness lasting 90 minutes and difficulty opening jars. The client takes methotrexate weekly and has no acute joint redness or fever. Which intervention is most appropriate to improve hand function?

   • A.Apply an ice pack to both hands for 30 minutes each morning
   • B.Encourage gentle range-of-motion exercises after a warm shower
   • C.Advise the client to stop methotrexate on days with stiffness
   • D.Recommend complete rest of the hands until stiffness resolves

   Rationale: Gentle movement after warmth can reduce stiffness and help maintain range of motion. Complete rest promotes stiffness, prolonged ice is less helpful for chronic morning stiffness, and methotrexate should not be stopped without prescriber direction. A balance of activity and rest supports function in rheumatoid arthritis.

2. 2.Refer to the client's chart. A nurse is reviewing the plan of care for a client admitted for worsening rheumatoid arthritis symptoms. Which actions should the nurse implement? Select all that apply.

   • A.Schedule demanding activities when the client reports the best energy
   • B.Offer adaptive devices for dressing and meal preparation
   • C.Encourage prolonged bed rest to prevent further joint damage
   • D.Assess joint pain and function before and after interventions
   • E.Apply a heating pad directly to swollen joints for several hours

   Rationale: Planning activity during periods of greatest energy and reassessing pain and function individualizes care using the charted fatigue and joint limitations. Adaptive devices promote independence when hand function is impaired. Prolonged bed rest worsens stiffness and deconditioning, while prolonged direct heat risks burns and is inappropriate for acutely inflamed joints.

3. 3.During a home health visit, a 71-year-old client with rheumatoid arthritis says, "My hands are too stiff to manage my pill bottles." The client is alert and lives alone. Which action best promotes safe medication use?

   • A.Arrange easy-open containers or a medication organizer after reviewing safety needs
   • B.Recommend transferring all medications into unmarked containers
   • C.Suggest skipping doses on mornings when the hands are stiff
   • D.Tell the client to ask a neighbor to open each bottle daily

   Rationale: Easy-open packaging or an appropriate organizer can support adherence while maintaining medication identification and safety. Reliance on a neighbor may be impractical, unmarked containers create medication errors, and skipped doses can worsen disease control. The nurse should also assess cognition and ability to manage the chosen system.

4. 4.At change of shift on a medical unit, a 58-year-old client with rheumatoid arthritis is due for methotrexate, but the medication record lists a daily dose while the client says it is taken weekly. What should the nurse do first?

   • A.Ask the client to choose whether to take the medication
   • B.Administer the listed dose and monitor for nausea
   • C.Hold the dose and clarify the prescription with the prescriber and pharmacist
   • D.Change the record to weekly without contacting the prescriber

   Answer and rationale are in the full material.

5. 5.Refer to the client's chart. An adult client with rheumatoid arthritis is being evaluated for discharge after treatment of a flare. Which finding best supports that the current plan is effective?

   • A.The client reports unchanged pain and cannot tolerate prescribed exercises
   • B.The client has stopped eating because opening containers is difficult
   • C.The client has increasing joint swelling despite medication administration
   • D.The client can transfer from bed to chair with less assistance than at admission

   Answer and rationale are in the full material.