GOUT nursing assessment findings, you will document this
finding as?*
1. During a home health visit you are helping a patient
with gout identify foods in their pantry they should
avoid eating. Select all the foods below the patient
should avoid:*
A. Sardines
B. Whole wheat bread
C. Sweetbreads
D. Crackers
E. Craft beer
F. Bananas
2. Gout is a type of arthritis that occurs due to the
accumulation of ____________ in the blood that causes
needle-like crystals to form around the joints.*
A. purines
B. creatinine
C. uric acid
D. amino acids
3. Identify which patient below is at MOST risk for
developing gout:*
A. A 56 year old male who reports consuming
foods low in purines.
B. A 45 year old male with a BMI of 40 who
reports taking hydrochlorothiazide and
aspirin.
C. A 39 year old female hospitalized with
bulimia that has a BMI of 24.
D. A 27 year old female with ulcerative colitis.
4. A patient is post-op from surgery. The patient has a
history of gout. While performing a head-to-toe
assessment, you assess the patient for signs and
symptoms of gout. As the nurse, you know that gout
tends to start at what site?*
A. Elbow
B. Big toe
C. Thumb or index finger
D. Knees
5. A 75 year old male is admitted for chronic renal
failure. You note that the patient has white/yellowish
nodules on the helix of the ear and fingers. The patient
reports they are not painful. As you document your
A. Nodosa
B. Keloid
C. Dermoid
D. Tophi
6. You're developing a nursing care plan for a patient
with gout present in the right foot. What specific nursing
interventions will you include in this patient's plan of
care? Select all that apply:*
A. Encourage fluid intake of 2-3 liter per
day.
B. Provide patient with foods high in purine
with each meal daily.
C. Place patient's right foot in a foot board
while patient is in bed.
D. Administer PRN dose of Aspirin for a pain
rating greater than 5 on 1-10 scale.
E. Apply alternating cold and warm
compresses to right foot as tolerated by the
patient daily.
7. A patient is ordered by the physician to take
Allopurinol (Zyloprim) for treatment of gout. You've
provided education to the patient about this medication.
Which statement by the patient requires you to re-
educate them about this medication?*
A. "This medication will help relieve the
inflammation and pain during an acute
attack."
B. "It is important I have regular eye exams
while taking this medication."
C. "I will not take large doses of vitamin C
supplements while taking this medication."
D. "Allopurinol decreases the production of
uric acid."
8. During the 1000 medication pass, your patient reports
to you that he is having muscle pain and tingling in his
fingers and toes. You note that the patient also has a
grayish color to his lips. You immediately notify the
doctor. In addition, you would hold which medication
that is scheduled to be administered at 1000?*
A. Ibuprofen
B. Prednisone
C. Colchicine
 D. Aspirin
9. It is important a patient with gout avoid medications
that can increase uric acid levels. Which medication
below is NOT known to increase uric acid levels?*
A. Aspirin
B. Niacin
C. Cyclosporine
D. Tylenol
10. You are providing a free clinic seminar to
participants about gout. Which statement by a
participant about the occurrence of gout is correct?*
A. "Gout attacks tend to awake the person
out of their sleep in the middle of the night."
B. "The pain felt with gout tends to be intense
during the first 30 minutes."
C. "It is best for a patient experiencing gout to
tightly bandage the affected extremity."
D. "Typically acute gout attacks are predictable
and tend to occur once or twice a week."
RHEUMATOID ARTHRITIS
1. During a routine health check-up visit a patient states,
"I've been experiencing severe pain and stiffness in my
joints lately." As the nurse, you will ask the patient what
questions to assess for other possible signs and
symptoms of rheumatoid arthritis? Select-all-that-
apply:*
A. "Does the pain and stiffness tend to be the
worst before bedtime?"
B. "Are you experiencing fatigue and fever
as well?"
C. "Is your pain and stiffness symmetrical
on the body?"
D. "Is your pain and stiffness aggravated by
extreme temperature changes?"
2. True or False: Rheumatoid arthritis tends to affect
women more than men and people who are over the age
of 60.*
A. True
B. False
3. Identify the correct sequence in how rheumatoid
arthritis develops:*
A. Development of pannus, synovitis,
ankylosis
B. Anklyosis, development of pannus,
synovitis
C. Synovitis, development of pannus,
anklyosis
D. Synovitis, anklyosis, development of
pannus
4. A patient with severe rheumatoid arthritis is
scheduled for a procedure called an arthrodesis. The
nursing student you are precepting asks what type of
procedure this is. Your response is:*
A. "It is a procedure where the affected
joint is removed and each end of the bones
found within that joint are fused together."
B. "It is a procedure that involves replacing the
joint with an artificial one."
C. "It is a procedure where the surgeon goes in
with a scope and cleans out the affected joint."
D. "It is a procedure where the synovium is
completely removed within the joint, which
helps decrease inflammation of the joint.
5. A 58 year old female is experiencing a flare-up with
rheumatoid arthritis. While assisting the patient with her
morning routine, the patient verbalizes a pain rating of
7 on 1-10 scale in the right and left wrist along with
severe stiffness. You note the wrist joints to be red,
warm, and swollen. What nonpharmalogical nursing
interventions can you provide to this patient to help
alleviate pain and stiffness? Select-all-that-apply:*
A. Exercise the affected joints
B. Assist the patient with a warm shower or
bath
C. Perform deep massage therapy to the wrist
joints
D. Assist the patient with applying wrist
splints
6. You are providing education to a patient, who was
recently diagnosed with rheumatoid arthritis, about
physical exercise. Which statement made by the patient
is correct?*
A. "It is best I try to incorporate a moderate
level of high impact exercises weekly into my
routine, such as running and aerobics."
B. "I will be sure to rest joints that are
experiencing a flare-up, but I will try to
maintain a weekly regime of range of motion
exercises along with walking and riding a
stationary bike."
C. "It is important I perform range of motion
exercises during joint flare-ups and incorporate
low-impact exercises into my daily routine."
D. "Physical exercise should be limited to only
range of motion exercises to prevent further
joint damage."
7. Disease-modifying antirheumatic drugs (DMARDS)
are used to treat rheumatoid arthritis. Select-all-the
drugs below that are DMARDS:*
A. Dexamethasone (Decadron)
B. Hydroxychloroquine (Plaquenil)
C. Teriparatide (Forteo)
D. Calcitonin
E. Leflunomide (Arava)
F. Methotrexate (Trexall)
8. A patient with rheumatoid arthritis is experiencing
sudden vision changes. Which medication found in the
patient's medication list can cause retinal damage?*
A. Hydroxychloroquine (Plaquenil)
B. Lefluomide (Arava)
C. Sulfasalazine (Azulfidine)
D. Methylprednisolone (Medrol)
9. You're providing care to a patient with severe
rheumatoid arthritis. While performing the head-to-toe
nursing assessment, you note the patient's overall skin
color to be pale and the patient looks exhausted. You
ask the patient how she is feeling, and she says "I'm so
tired. I can't even get out of this bed without getting
short of breath." Which finding on the patient's morning
lab work may confirm a complication that can be
experienced with rheumatoid arthritis?*
A. Potassium 3.2 mEq/L
B. Hemoglobin 7 g/dL
C. Sodium 135 mEq/L
D. WBC count 6,500
10. A physician suspects a patient may have rheumatoid
arthritis due to the patient's presenting symptoms. What
diagnostic testing can be ordered to help a physician
diagnose rheumatoid arthritis? Select all that apply:*
A. Rheumatoid factor
B. Uric acid level
C. Erythrocyte sedimentation
D. Dexa-Scan
E. X-ray imaging
OSTEOARTHRITIS
A. A 65 year old male with a BMI of 35.
B. A 59 year old female with a history of taking
long term doses of corticosteroids.
C. A 55 year old male with a history of
repeated right knee injuries.
D. A 60 year old female with high uric acid
levels.
3. During a head-to-toe assessment of a patient with
osteoarthritis, you note bony outgrowths on the distal
interphalangeal joints. You document these findings
as:*
A. Bouchard's Nodes
B. Heberden's Nodes
C. Neurofibromatosis
D. Dermatofibromas
4. A patient with osteoarthritis is describing their signs
and symptoms. Which signs and symptoms below are
NOT associated with osteoarthritis? Select-all-that-
apply:*
A. Morning stiffness greater than 30
minutes
B. Experiencing grating during joint
movement
C. Fever and Anemia
D. Symmetrical joint involvement
E. Pain and stiffness tends to be worst at the
end of the day
5. A patient with osteoarthritis has finished their first
physical therapy session. As the nurse you want to
evaluate the patient's understanding of the type of
exercises they should be performing regularly at home
as self-management. Select all the appropriate types of
exercise stated by the patient:*

1. Osteoarthritis develops due to the deterioration of the A. Jogging

synovium within the joint that can lead to complete
bone fusion.* B. Water aerobics

A. True C. Weight Lifting

B. False D. Tennis

2. Which patients below are at risk for developing E. Walking

osteoarthritis? Select-all-that-apply:*
6. A 63 year old patient has severe osteoarthritis in the 2. Select all the risk factors for developing
right knee. The patient is scheduled for a knee osteoarthritis:*
osteotomy. You are providing pre-op teaching about A. Malnutrition
this procedure to the patient. Which statement made by
B. Obesity
the patient is correct about this procedure?*
C. Manual labor jobs
A. "This procedure will realign the knee and D. Premature birth
help decrease the amount of weight
experienced on my right knee." E. Older age
F. Diabetes
B. "A knee osteotomy is also called a total knee
replacement." 3. ____________ affects the joints in a symmetrical
fashion.*
C. "A knee osteotomy is commonly performed A. Osteoarthritis
for patients who have osteoarthritis in both
B. Rheumatoid arthritis
knees."
4. Which patient below is presenting with signs and
D. "This procedure will realign the unaffected symptoms of rheumatoid arthritis? Select all that
knee and help alleviate the amount of weight apply:*
experienced on the right knee." A. A 35 year old patient who has severe
morning stiffness for 45 minutes.
7. A patient newly diagnosed with osteoarthritis asks
about the medication treatments for their condition. B. A 45 year old male with crepitus in the right
Which medication is NOT typically prescribed for knee.
OA?* C. A 30 year old female with warm, red, soft
joints on the hands and wrist.
A. NSAIDs
D. A 40 year old male whose x-ray imaging
results showed osteophytes formation and
B. Topical Creams decreased joint space in the left knee.
C. Oral corticosteroids 5. You're explaining to a group of outpatients about the
signs and symptoms that may present with
D. Acetaminophen (Tylenol) osteoarthritis. Select all the signs and symptoms that
may present with this condition:*
8. You receive your patient back from radiology. The A. Herberden's Node
patient had an x-ray of the hips and knees for the
B. Morning stiffness for less than 30 minutes
evaluation of possible osteoarthritis. What findings
would appear on the x-ray if osteoarthritis was present? C. Soft, tender, warm joints
Select-all-that-apply:*
D. Fever
A. Increased joint space E. Anemia
F. Hard and bony joints
B. Osteophytes
G. Crepitus
C. Sclerosis of the bone H. Bouchard's Node

D. Abnormal sites of hyaline cartilage 6. ________________ is a form of arthritis that is an

OSTEOARTHRITIS VS RHEUMATOID
ARTHRITIS
1. Your patient has arthritis that affects the weight-
bearing joints such as the hands, knees, hips, and spine.
This type of arthritis is most likely:*
A. Rheumatoid arthritis
B. Osteoarthritis
autoimmune condition that causes inflammation within
the joints, specifically the synovium.*
A. Rheumatoid arthritis
B. Osteoarthritis
7. Which statement is FALSE concerning rheumatoid
arthritis?*
A. Rheumatoid arthritis most commonly
affects the fingers and wrist.
 B. Rheumatoid arthritis is different from 2. The client has been diagnosed with OA for the last 7
osteoarthritis in that it doesn't affect other years and has tried multiple medical treatments and
systems of the body. alternative treatments but still has significant joint pain.
C. Rheumatoid arthritis can occur at any age Which psychosocial client problem would the nurse
(20-60 year old most commonly). identify?
D. Ankylosis can occur in severe cases of a. Severe pain
rheumatoid arthritis.
b. Body-image disturbance
8. You are assessing the diagnostic testing results for a
c. Knowledge deficit
patient that has rheumatoid arthritis. What result is NOT
an indicator of this disease?* d. Depression
A. Elevated erythrocyte sedimentation
3. Which member of the health care team should the
B. X-ray imaging showing osteophyte
formation nurse refer the client diagnosed with OA who is
complaining of not being able to get in and out of the
C. Positive c-reactive protein bathtub?
D. Positive rheumatoid factor
a. Physiatrist
9. During a head-to-toe assessment of a patient with b. Social worker
arthritis, you note bony outgrowths on the proximal
interphalangeal joint. These outgrowths are known as c. Physical therapist
__________ and occur in ______________.*
A. Heberden's Node, osteoarthritis d. Counselor

B. Bouchard's Node, rheumatoid arthritis 4. The occupational health nurse is teaching a class on
the risk factors for developing OA. Which is a
C. Heberden's Node, rheumatoid arthritis
modifiable risk for developing OA?
D. Bouchard's Node, osteoarthritis
a. Being overweight
10. A patient is newly diagnosed with osteoarthritis.
Which medication below is NOT ordered to treat this b. Increasing age
condition?* c. Previous joint damage
A. NSAIDs
d. Genetic susceptibility
B. Intra-articular corticosteroids
C. DMARDs 5. The client is diagnosed with osteoarthritis. Which
sign/symptom would the nurse expect the client to
D. Glucosamine
exhibit?
MIXED
a. Severe bone deformity
1. The client diagnosed with OA is a resident in a long
term care facility. The resident is refusing to bathe b. Joint stiffness
because she is hurting. Which instruction should the
c. Waddling gait
nurse give the unlicensed nursing assistant?
d. Swan neck fingers
a. Allow the client to stay in bed until the pain
becomes bearable 6. Which client goal would be most appropriate for a
client diagnosed with OA?
b. Tell the assistant to give the client a bed bath
this morning a. Perform passive range-of-motion exercises
c. Try to encourage the client to get up and b. Maintain optimal functional ability
go to the shower
c. Client will walk three miles a day
d. Notify the family that the client is refusing to
be bathed d. Client will join a health club

c. Try to encourage the client to get up and go 7. The client is complaining of joint stiffness, especially
to the shower in the morning. Which diagnostic tests would the nurse
expect the HCP to order to R/O OA?
a. Full body MRI scan
 b. Serum studies for synovial fluid amount
c. X-ray of the affected joints
d. Serum erythrocyte sedimentation rate (ESR)
8. The client diagnosed with OA is prescribed a NSAID.
Which instruction should the nurse teach the client?
a. Take the medication on an empty stomach
d. Assess the client for increasing joint
involvement
12. The nurse is assessing a client diagnosed with RA.
Which assessment findings warrant immediate
intervention?
a. The client complains of joint stiffness and the
knees feel warm to the touch

b. Make sure the client tapers the medication b. The client has experienced one kg weight
when discontinuing loss and is very tired

c. Apply the medication topically over the c. The client requires a heating pad applied to
affected joints the hips and back to sleep

d. Notify the HCP if vomiting blood
9. The HCP prescribes glucosamine and chondroitin for
a client diagnosed with OA. What is the scientific
rationale for prescribing this medication?
a. It will help decrease the inflammation in the
joints
d. The client is crying, has a flat facial affect,
and refuses to speak to the nurse
13. The client diagnosed with RA has developed swan-
neck fingers. Which referral would be the most
appropriate for the client?
a. Physical therapy

b. It improves tissue function and may b. Occupational therapy

decrease breakdown of cartilage
c. Psychiatric counselor
c. It is a potent medication that decreases the
d. Home health nurse
client's joint pain
14. Which client problem is priority for a client
d. It increases the production of synovial fluid
diagnosed with RA?
in the joint
a. Activity intolerance
10. The nurse is admitting the client with OA to the
medical floor. Which statement by the client indicates a b. Fluid and Electrolyte balance
complementary form of treatment for OA?
c. Alteration in comfort
a. "I take medication every two hours for my
d. Excessive nutritional intake
pain"
15. The nurse is caring for clients on a medical floor.
b. "I use a heating pad when I go to bed at night"
Which client should the nurse assess first?
c. "I wear a copper bracelet to help with my
a. The client diagnosed with RA who is
OA"
complaining of pain at a "3" on a 1-10 scale
d. "I always wear my ankle splints when I
b. The client diagnosed with Systemic Lupus
sleep"
Erythematosus who has a rash across the bridge
11. The client diagnosed with RA is receiving care of the nose
through a nurse practitioner clinic. Which preventive
c. The client diagnosed with advanced RA
care should the nurse include in the regularly scheduled
who is receiving antineoplastic drugs IV
clinic visits?
d. The client diagnosed with scleroderma who
a. Perform joint x-rays to determine progression
has hard, waxylike skin near the eyes
of the disease
16. Which intervention has the highest priority when
b. Send blood to the lab for an erythrocyte
caring for a client diagnosed with RA?
sedimentation rate (ESR)
a. Encourage the client to ventilate feelings
c. Recommend the flu and pneumonia
about the disease process
vaccines
 b. Discuss the effects of disease on the client's
career and other life roles
c. Instruct the client to perform most important
activities in the morning
d. Teach the client the proper use of hot and
cold therapy to provide pain relief
17. Which psychosocial problem would be priority for
a client diagnosed with RA?
a. Alteration in comfort
b. Ineffective coping
c. Anxiety
d. Altered body image
18. The client with RA has nontender movable nodules
in subcutaneous tissue over the elbows and shoulders.
Which statement is the best explanation for the nodules?
a. The nodules indicate a rapidly progressive
destruction of the affected tissue
b. The nodules are small amounts of synovial
fluid that have become crystallized
c. The nodules are lymph nodes that have
proliferated to try to fight the disease
d. The nodules present a favorable prognosis
and mean the client is better
19. The client diagnosed with RA who has been
prescribed Plaquenil, shows marked improvement.
Which instruction regarding the use of this medication
should the nurse teach?
a. Explain that the less medication loses its
efficacy after a few months
b. Continue to have regular eye exams while
taking the medication
c. Have yearly MRIs to follow the progress
d. Discuss that the drug is taken for 3 weeks and
then stopped for a week
20. The 20 year old female client diagnosed with
advanced unremitting RA is being admitted to receive a
regimen of immunosuppressive medications. Which
question should the nurse ask during the admission
process regarding the medications?
a. "Are you sexually active, and if so, are you
using birth control?"
b. "Have you discussed taking these drugs with
your parents?"
c. "Which arm do you prefer to have an IV in
for 4 days?"
d. "Have you signed an informed consent for
investigational drugs?"
21. The client with early-stage RA is being discharged
from the outpatient clinic. Which discharge instructions
should the nurse teach regarding the use of NSAIDs?
a. Take an over-the-counter medication for the
stomach
b. Drink a full glass of water with each pill
c. If a dose is missed, double the medication at
the next dosing time
d. Avoid taking the NSAID on an empty
stomach
22. The nurse is preparing to administer morning
medications. Which medication should the nurse
administer first?
a. The pain medication to a client diagnosed
with RA
b. The diuretic medication to a client diagnosed
with Lupus (SLE)
c. The steroid to a client diagnosed with
polymyositis
d. The appetite stimulant to a client diagnosed
with OA
23. The client recently diagnosed with RA is prescribed
aspirin, an NSAID medication. Which comment by the
client would warrant immediate intervention by the
nurse
a. "I always take the aspirin with food"
b. "If I have dark stools, I will call my HCP"
c. "Aspirin will not cure my arthritis"
d. "I am having some ringing in my ears"
Emergency department triage is an important nursing
function. A nurse working the evening shift is presented
with four patients at the same time. Which of the
following patients should be assigned the highest
priority?
A. A patient with low-grade fever. headache. and
myalgias for the past 72 hours.
B. A patient who is unable to bear weight on the
left foot. with swelling and bruising following
a running accident.
C. A patient with abdominal and chest pain
following a large. spicy meal.
 D. A child with a one-inch bleeding laceration on
the chin but otherwise well after falling while
jumping on his bed.
A patient is admitted to the hospital with a calcium level
of 6.0 mg/dL. Which of the following symptoms would
you NOT expect to see in this patient?
A. Numbness in hands and feet.
B. Muscle cramping.
C. Hypoactive bowel sounds.
D. Positive Chvostek’s sign.

A nurse is assigned to the pediatric rheumatology clinic

and is assessing a child who has just been diagnosed
with juvenile idiopathic arthritis. Which of the
following statements about the disease is most accurate?
A. The child has a poor chance of recovery without
joint deformity.
B. Most children progress to adult rheumatoid
arthritis.
C. Nonsteroidal anti-inflammatory drugs are
the first choice in treatment.
D. Physical activity should be minimized.