easy
A 62-year-old reports, “My hands are stiff every morning for about 2 hours, and my fingers look crooked.” What condition is MOST likely?
A. Osteoarthritis
B. Rheumatoid arthritis
C. Gout
D. Carpal tunnel syndrome
RA
Prolonged morning stiffness and deformity of small joints are classic RA features; OA stiffness is shorter and often after use
A patient says, “My lower back pain gets worse at night and sometimes wakes me up. Pain meds barely help.” What is the nurse’s PRIORITY action?
A. Teach proper lifting technique
B. Ask about any unexplained weight loss or fevers
C. Encourage bed rest for 3 days
D. Suggest a firmer mattress
Ask abt unexpalined weight loss
Night pain unrelieved by rest or meds may indicate malignancy or serious pathology; further screening for “red flag” symptoms is priority
Which additional symptoms might the nurse expect in a patient with active rheumatoid arthritis? (Select all that apply.)
A. Fatigue
B. Low-grade fever
C. Weight loss
D. Jaundice
E. Photosensitivity rash only
A, B, C
RA is systemic → fatigue, low fever, weight loss. Jaundice and photosensitivity more suggest liver/SLE issues
A patient with severe knee osteoarthritis says, “I can no longer climb stairs and I stopped going to church.” What is the priority nursing focus?
A. Discuss total knee replacement only
B. Evaluate impact on ADLs/IADLs and fall risk
C. Encourage the patient to “push through” the pain
D. Reassure that reduced activity is expected with age
B
Assess functional limitations and safety first, then plan interventions.
If your pt has pain with movement that would most likely be a ...
fracuture or metastasic diease
A patient with chronic knee pain from OA wants to stay active. Which nurse teaching is BEST?
A. “Avoid all exercise to protect the joint.”
B. “Use low-impact activities like swimming or walking.”
C. “High-impact jogging will strengthen the joint fastest.”
D. “Take narcotics before you exercise every day.
B
Low-impact exercise maintains mobility and reduces pain.
you observe a patient using a wide base of support, swaying, and taking unsteady steps. What is the BEST nursing action?
A. Document a normal gait pattern.
B. Ask the patient to walk faster to “get used to it.”
C. Stay close, provide a gait belt, and implement fall precautions.
D. Tell the patient to walk without shoes.
C
Ataxic gait = high fall risk; safety first with assistance and precautions.
Which patients are at highest risk for osteoporosis? (Select all that apply.)
A. 70-year-old woman, BMI 18, sedentary, smokes
B. 45-year-old man who lifts weights daily
C. 60-year-old woman on long-term prednisone
D. 30-year-old woman with high calcium intake
E. 80-year-old man with history of hip fractur
A, C, E
Age, low BMI, steroids, smoking, and prior fracture increase osteoporosis risk.
Which interventions are essential to reduce fall risk in a patient with advanced osteoporosis? (Select all that apply.)
A. Keep frequently used items within reach.
B. Use non-skid footwear.
C. Keep bed in high position for easy exit.
D. Remove loose rugs in the home.
E. Encourage rushing to the bathroom to avoid incontinence.
A, B, D
A, B, D support safe mobility. High bed and rushing increase risk.
While screening a teen, you notice one shoulder higher than the other and a lateral curvature of the spine when the patient bends forward. What condition is this?
A. Kyphosis
B. Lordosis
C. Scoliosis
D. Ankylosing spondylitis
C
Lateral curvature with asymmetry indicates scoliosis.
If your elderly pt has gradually gotten absoloute loss in muscle mass, how would you interpret this info?
It is due to atrophy, leading to weakness and slower movement. seen in elders who are sedentary
A 19-year-old reports severe leg pain after a soccer injury. Leg appears deformed and he refuses to move it. What is the nurse’s PRIORITY?
A. Encourage him to “try to walk it off.”
B. Immobilize the leg and assess distal pulses.
C. Apply heat to reduce pain.
D. Ask him to rate pain and give oral ibuprofen only
B
Suspected fracture → immobilize and check circulation to prevent neurovascular compromise.
An older adult fell and now has an externally rotated, shortened right leg and severe hip pain. What is the best nursing action?
A. Encourage the client to walk to prevent stiffness.
B. Place pillows between the knees and logroll gently; notify provider.
C. Apply heat and reassess in 1 hour.
D. Ask the client to stretch the leg.
B
Classic hip fracture signs; immobilize leg in proper alignment and contact provider.
Which statement by a 22-year-old woman shows good understanding about building peak bone mass?
A. “It doesn’t matter if I drink milk now; bones only thin after menopause.”
B. “Weight-bearing exercise now can help prevent fractures later in life.”
C. “If I take calcium now, I won’t ever need vitamin D.”
D. “Smoking won’t affect my bones until I’m older.
B
Early weight-bearing activity helps maximize peak bone mass; lifestyle matters now.
Name some findings in older clients
Bone remolding is slow
postural changes, decreased height
loss of subcu fat
slower mobility and gait
Which assessment findings are MOST consistent with osteoarthritis? (Select all that apply.)
A. Pain that worsens at the end of the day
B. Heberden’s nodes on distal finger joints
C. Symmetric joint involvement in both hands
D. Prolonged morning stiffness >1 hour
E. Pain relieved by rest
A, B, E
OA: bony nodes, pain with use, relief with rest. RA: symmetric joints and long morning stiffness.
Which finding in an older adult is MOST concerning and NOT just age-related?
A. Decreased height by 1 inch
B. Kyphosis in upper back
C. Sudden onset of hip pain after minimal trauma
D. Slightly reduced ROM in shoulders
C
Minimal-trauma hip pain may signal fracture or severe osteoporosis → urgent.
A basketball player twisted his ankle 1 hour ago. It is swollen and painful. What is the BEST immediate nursing instruction?
A. Apply moist heat
B. Elevate the ankle and apply ice
C. Walk on it to prevent stiffness
D. Massage the joint
B
Use RICE (Rest, Ice, Compression, Elevation) in first 24–48 hours.
For a patient with acute gout, which nursing instruction is MOST appropriate?
A. “Increase organ meats in your diet.”
B. “Drink plenty of fluids and avoid alcohol.”
C. “Stay completely immobile to prevent joint damage.”
D. “Wear tight shoes for support.”
B
Hydration and avoiding alcohol/purines help prevent uric acid crystal formation.
If peak bone mass is acheived by 30s, what is pt education to give?
Take calcium supplements, vita d and weight bearing exercies
A man reports sudden, severe pain, redness, and swelling in his right big toe after a big steak and beer dinner. What condition is most likely?
A. Osteoarthritis
B. Rheumatoid arthritis
C. Gouty arthritis
D. Septic arthritis
C
Acute onset, big toe, purine-rich meal → classic gout presentation.
A patient with a cast on the forearm reports increasing pain unrelieved by opioids and numb fingers. What is the best nursing action?
A. Elevate the arm above heart level
B. Loosen the cast and notify provider immediately
C. Apply ice and recheck in 2 hours
D. Encourage active ROM exercises
B
Classic signs of compartment syndrome = neurovascular emergency; relieve pressure and call provide
A patient with suspected lumbar disk herniation reports pain radiating down the leg and positive straight leg raise test. What is a PRIORITY assessment?
A. Check for facial symmetry
B. Assess bowel and bladder function
C. Inspect scalp for lesions
D. Assess pupillary reaction
B
Lumbar nerve compression can impair bowel/bladder control → red flag requiring urgent evaluatio
Following cast placement for a tibial fracture, which finding requires immediate action?
A. Warm toes and cap refill <2 seconds
B. Mild pain relieved by prescribed analgesic
C. Inability to move toes with absent pedal pulses
D. Slight swelling around cast edge
C
Absent pulses and loss of movement indicate compromised circulation → emergency.
What is low bone mineral density a predictor of?
hib/vertebral fractures