Choice A rationale:

Swollen and painful knees are common symptoms of rheumatoid arthritis (RA); however, they are not the most characteristic presentation.

The hallmark of RA is joint stiffness, especially in the morning.

Choice B rationale:

Morning stiffness lasting for about 30 minutes or longer is a classic and characteristic symptom of rheumatoid arthritis.

It results from inflammation in the synovial joints, making this the correct choice.

Choice C rationale:

Having a high-grade fever is not a typical presentation of rheumatoid arthritis.

Fever may indicate an infection or another underlying condition but is not specific to RA.

Choice D rationale:

Dry and itchy skin is not a common symptom of rheumatoid arthritis.

It is more likely related to dermatological or allergic conditions.

Choice A rationale:

Surgery for joint replacement is considered in cases of severe joint damage, but it is not the primary treatment method for rheumatoid arthritis (RA).

Therefore, this is an incorrect choice.

Choice B rationale:

Rest and physical therapy are essential components of the treatment plan for RA.

Rest helps reduce joint inflammation, and physical therapy can improve joint function and reduce pain.

This is the correct choice.

Choice C rationale:

Antibiotics are not used to treat rheumatoid arthritis.

RA is an autoimmune disease, and disease-modifying antirheumatic drugs (DMARDs) are the standard medications used to manage it.

Choice D rationale:

Corticosteroids are used in the treatment of RA, but they are not typically considered the first-line therapy.

DMARDs are usually initiated first, and corticosteroids may be added if needed for symptom control.

Choice A rationale:

Applying heat to affected joints can help alleviate pain and stiffness in rheumatoid arthritis.

Heat therapy promotes muscle relaxation and increased blood flow to the joints, improving comfort.

Choice B rationale:

Engaging in high-impact aerobic exercises can be detrimental to individuals with rheumatoid arthritis.

High-impact activities can exacerbate joint pain and inflammation.

Therefore, this is not an appropriate intervention.

Choice C rationale:

Taking disease-modifying antirheumatic drugs (DMARDs) as prescribed is a crucial part of managing rheumatoid arthritis.

These medications can slow disease progression and reduce symptoms.

Choice D rationale:

Limiting physical activity to prevent joint damage is not recommended for individuals with rheumatoid arthritis.

While it's essential to avoid overexertion and high-impact activities, maintaining regular, low-impact exercise is beneficial for joint health.

Choice E rationale:

Performing regular joint-strengthening exercises can help improve joint stability and reduce pain in rheumatoid arthritis.

Strengthening exercises can be an essential part of a comprehensive self-management strategy.

Choice A rationale:

Encouraging the client to avoid using affected joints as much as possible can lead to muscle atrophy and joint stiffness.

It is essential to promote movement and function in individuals with rheumatoid arthritis to prevent further complications.

Choice B rationale:

Teaching the client self-administration of corticosteroid injections can provide pain relief and reduce inflammation in affected joints.

This is a valuable intervention for managing rheumatoid arthritis symptoms.

Choice C rationale:

Providing emotional support and counseling to address body image concerns is essential for the overall well-being of the client.

However, it does not directly address joint deformities, which are the primary concern in this scenario.

Choice D rationale:

Instructing the client to apply ice packs to inflamed joints daily may provide temporary relief of symptoms but does not address joint deformities.

Ice should be used cautiously in RA, as extreme cold can worsen joint stiffness.

Choice A rationale:

Monitoring blood pressure and heart rate is essential for overall health assessment, but it is not specific to rheumatoid arthritis.

Joint deformities and signs of inflammation are more directly related to RA complications.

Choice B rationale:

Gastrointestinal symptoms can occur in some individuals with rheumatoid arthritis, especially if they are taking certain medications like nonsteroidal anti-inflammatory drugs (NSAIDs).

However, joint deformities and inflammation are more critical to monitor for potential complications.

Choice C rationale:

Neurological function is not typically a primary concern in rheumatoid arthritis.

Joint involvement and inflammation are more common complications that require monitoring.

Choice D rationale:

Joint deformities and signs of inflammation are crucial aspects of the assessment in rheumatoid arthritis.

These complications can lead to significant disability and decreased quality of life in individuals with RA.

Monitoring and early intervention are essential.

Questions

Choice A rationale:

Teaching the patient that they don't need to take medications if they feel fine is incorrect.

Rheumatoid Arthritis (RA) is a chronic autoimmune disease that requires continuous management.

Even when patients feel fine, they should adhere to their prescribed medications and treatment regimens to prevent disease progression and manage symptoms.

Choice B rationale:

Encouraging the patient to adhere to prescribed medications and treatment regimens is the correct answer.

The nurse's role in educating a patient with RA is to emphasize the importance of compliance with medication and treatment plans.

RA is a progressive disease, and timely intervention is crucial in preventing joint damage and deformities.

Medications such as disease-modifying antirheumatic drugs (DMARDs) can help control inflammation and slow down the progression of the disease.

Choice C rationale:

Advising the patient to avoid exercise to prevent joint stress is incorrect.

Exercise is an essential component of RA management.

It helps maintain joint mobility, strengthen muscles around the joints, and improve overall function.

The nurse should encourage the patient to engage in appropriate and recommended exercises as part of their treatment plan.

Choice D rationale:

Recommending the patient rely solely on emotional support to cope with the disease is incorrect.

While emotional support is valuable in managing chronic conditions like RA, it is not a substitute for medical treatment and adherence to prescribed medications.

Patients should have a comprehensive treatment plan that includes medical management, physical therapy, and emotional support.

Choice A rationale:

Advising the patient to avoid using assistive devices to maintain independence is incorrect.

Assistive devices can be helpful in reducing joint stress and preserving independence for individuals with RA.

Encouraging their use when necessary is part of joint protection strategies.

Choice B rationale:

Telling the patient that they don't need to modify any activities and continue as usual is not appropriate.

Patients with RA may need to make modifications to their daily activities to protect their joints and manage their condition effectively.

Encouraging appropriate modifications is essential.

Choice C rationale:

Recommending the patient practice joint protection techniques and use assistive devices when necessary is the correct answer.

Joint protection techniques, such as using proper body mechanics and avoiding activities that strain the joints, can help minimize further damage.

Assistive devices like splints or braces can also aid in joint protection.

Choice D rationale:

Suggesting the patient engage in vigorous exercise to strengthen their joints is not appropriate advice.

While exercise is beneficial, it should be tailored to the patient's specific needs and limitations.

Vigorous exercise without proper guidance can exacerbate joint inflammation in RA.

Choice A rationale:

Mentioning that Rheumatoid nodules may develop under the skin is correct.

Rheumatoid nodules are a known complication of Rheumatoid Arthritis.

These firm lumps can form under the skin, often around joints.

Choice B rationale:

Stating that there is no increased risk of infections due to medications is incorrect.

Some medications used to treat RA, such as corticosteroids or biologics, can suppress the immune system, increasing the risk of infections.

Patients should be educated about infection prevention and when to seek medical attention.

Choice C rationale:

Indicating that systemic complications cannot affect organs is incorrect.

Rheumatoid Arthritis is a systemic autoimmune disease, and it can affect various organs and systems in the body.

This may include inflammation of the lungs (interstitial lung disease), eyes (uveitis), or blood vessels (vasculitis).

Choice D rationale:

Mentioning that there is no increased risk of cardiovascular diseases is incorrect.

RA is associated with an increased risk of cardiovascular diseases such as heart attacks and strokes.

Chronic inflammation and other factors contribute to this elevated risk.

Patients with RA should be educated about cardiovascular risk factors and lifestyle modifications to mitigate these risks.

Choice A rationale:

Advising the client to avoid maintaining a healthy weight is incorrect.

Maintaining a healthy weight is important in reducing the risk of developing Rheumatoid Arthritis.

Excess weight can place additional stress on the joints, increasing the risk of joint damage.

Choice B rationale:

Recommending that the client engage in regular exercise and maintain a balanced diet is the correct answer.

Lifestyle modifications such as regular exercise and a balanced diet can help reduce the risk of developing Rheumatoid Arthritis.

Exercise helps maintain joint health and overall well-being, while a balanced diet can support overall immune function and reduce inflammation.

Choice C rationale:

Suggesting that the client increase exposure to environmental toxins and infections is not appropriate.

Environmental toxins and infections are not known risk factors for developing Rheumatoid Arthritis.

In fact, exposure to toxins and infections may exacerbate the condition in those who already have RA.

Choice D rationale:

Advising the client to ignore any chronic inflammatory conditions is not appropriate.

Chronic inflammatory conditions may be risk factors for developing RA, and they should be managed appropriately.

Identifying and addressing any chronic inflammatory conditions can contribute to overall health and potentially reduce the risk of RA.

Questions

Choice A rationale:

Administering analgesics for pain relief is an appropriate nursing intervention for managing RA.

Pain relief is an essential aspect of care for clients with RA to improve their quality of life and promote comfort.

Choice B rationale:

Teaching the client relaxation techniques is an appropriate nursing intervention.

Stress reduction can help manage RA symptoms, as stress can exacerbate inflammation and pain in RA patients.

Choice C rationale:

Encouraging smoking as a stress-relief method is not an appropriate nursing intervention.

Smoking is a known risk factor for RA and can worsen the condition.

It should be discouraged, especially in RA patients.

Choice D rationale:

Providing joint protection techniques is an important nursing intervention for managing RA.

Teaching clients how to protect their joints from further damage and manage activities of daily living can improve their overall functioning.

Choice E rationale:

Recommending high-impact aerobic exercise is not an appropriate nursing intervention for managing RA.

High-impact exercises can exacerbate joint pain and inflammation in RA patients.

Low-impact exercises, on the other hand, are often recommended.

Choice A rationale:

This statement is incorrect.

RA can lead to complications, even if treated promptly.

Prompt and effective treatment can help manage the disease and reduce the risk of complications, but it does not guarantee the absence of complications.

Choice B rationale:

This statement is correct.

Complications of RA may include cardiovascular problems (due to inflammation) and joint deformities.

RA can affect multiple body systems, not just the joints.

Choice C rationale:

This statement is incorrect.

RA can involve other body systems, and its complications can extend beyond joint-related issues.

Choice D rationale:

This statement is incorrect.

RA complications are not primarily the result of excessive physical activity.

While joint protection is important, complications can occur even with appropriate activity levels.

Choice A rationale:

This statement is incorrect.

Avoiding all physical activity is not recommended for RA prevention.

In fact, regular and appropriate physical activity can help maintain joint function and reduce the risk of developing RA.

Choice B rationale:

This statement is correct.

Maintaining a healthy weight is a recommendation for reducing the risk of RA.

Obesity is a known risk factor for the development of RA.

Choice C rationale:

This statement is incorrect.

Smoking has been associated with an increased risk of RA, so it is not advisable to suggest that smoking has no impact on RA prevention.

Choice D rationale:

This statement is incorrect.

Genetics alone do not determine the prevention of RA.

While genetics may play a role in susceptibility, lifestyle factors and environmental exposures also contribute to the risk of developing the disease.

Choice A rationale:

Administering antibiotics regularly is not a standard intervention for managing Rheumatoid Arthritis.

RA is an autoimmune disease, and antibiotics are not typically used as a primary treatment.

Choice B rationale:

Encouraging regular exercise and physical therapy is an appropriate intervention.

Exercise can help improve joint function and reduce stiffness, while physical therapy can provide targeted rehabilitation exercises and techniques to manage RA symptoms.

Choice C rationale:

Advising the patient to avoid joint protection techniques is not appropriate.

Joint protection techniques are essential in managing RA and reducing the risk of joint damage.

Choice D rationale:

Providing emotional support and counseling is a valuable part of managing RA.

Living with a chronic condition can be emotionally challenging, and patients benefit from emotional support and coping strategies.

Choice E rationale:

Collaborating with the healthcare team to develop an individualized care plan is essential in managing RA effectively.

Each patient's condition is unique, and a personalized care plan ensures that their specific needs are addressed.

Choice A rationale:

This statement is incorrect.

RA does not occur when the immune system attacks the bones; it primarily affects the synovial joints.

Choice B rationale:

This statement is incorrect.

While inflammation is a hallmark of RA, it is not caused by a viral infection.

Choice C rationale:

This statement is correct.

Chronic inflammation in RA damages the synovial membrane, leading to joint destruction and deformities, which are characteristic of the disease.

Choice D rationale:

This statement is incorrect.

RA is not characterized by a thickening of the cartilage in the joints.

Instead, it primarily affects the synovium and can lead to cartilage damage over time.