Which of the following are common signs and symptoms that can be present when your patient has Rheumatoid Arthritis? (Select all that apply)

Malar rash

Morning stiffness

Swan neck deformities

Bilateral joint deformities

Joint pain at rest

Answer and Explanation

Correct Answer : B,C,D

A.   This is primarily associated with Systemic Lupus Erythematosus (SLE), not Rheumatoid Arthritis. While some RA patients may have skin changes, a malar rash is not a typical manifestation of RA.
B.   Morning stiffness is a hallmark symptom of Rheumatoid Arthritis. Patients often experience stiffness in their joints after periods of inactivity, particularly in the morning, which typically lasts for at least 30 minutes and can improve with movement.
C.   Swan neck deformities are specific joint deformities seen in RA, where there is hyperextension of the proximal interphalangeal joints and flexion of the distal interphalangeal joints. This is a common feature in advanced cases of RA.
D.   : RA typically presents with symmetrical joint involvement. This means that if one side is affected, the opposite side is likely to be similarly affected, leading to bilateral joint deformities.
E.   While joint pain can occur at rest, RA is more characterized by pain and stiffness during periods of inactivity and improvement with movement. However, as the disease progresses, patients may experience pain even at rest.

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Correct Answer is ["B","C","D","F"]

Explanation

A. Aging can lead to changes in immune function, including alterations in white blood cell counts. While absolute counts may not be drastically lower, the immune response may be less effective. This is important information as it helps the patient understand their altered immune status and potential infection risks.
B. Older adults may have a diminished immune response, which can lead to false-negative results in tuberculosis skin tests (e.g., PPD test). This is crucial information, as it can affect diagnosis and treatment decisions, highlighting the need for alternative screening methods.
C. Vaccinations are critical for older adults to help prevent infections. Influenza, pneumococcal, and shingles vaccines can significantly reduce the risk of these infections, which are more severe in the elderly. This is an essential component of their health maintenance.
D. Older adults are at increased risk for respiratory tract infections (like pneumonia) and genitourinary infections (like urinary tract infections) due to factors such as comorbidities and changes in immune function. Educating clients about these risks helps them recognize symptoms and seek timely care.
E. Older adults often require booster vaccinations to maintain immunity, as their immune response may diminish over time. This misinformation could lead to increased susceptibility to vaccine-preventable diseases.
F. It is common for elderly individuals to present with atypical signs of infection, including the absence of fever even in severe cases. This is important for both the patient and caregivers to understand, as it may lead to delayed recognition and treatment of infections.

A. Can cause sodium and fluid retention. B. Long-term effects include fat redistribution. C. Might make the client feel jittery or nervous. D. Never stop prednisone abruptly.

Correct Answer is D

Explanation

A. Prednisone can lead to sodium and fluid retention, which can result in hypertension and edema. While this is an important consideration, it is not the most critical point to emphasize initially. Managing weight and blood pressure is essential, but there are more immediate concerns with the medication's use.
B. Long-term use of prednisone can result in changes such as fat redistribution, leading to a "moon face," buffalo hump, and increased abdominal fat. This is significant for understanding the side effects of prolonged therapy, but it is not the most urgent information for the client to know.
C. Prednisone can cause side effects such as mood changes, anxiety, or jitteriness, especially when initiating treatment or adjusting dosages. While this is relevant, the potential for emotional or psychological effects is secondary to the critical management of the medication.
D. This is the most critical point to emphasize. Prednisone is a corticosteroid that can suppress the body's natural adrenal function. Abrupt discontinuation can lead to adrenal crisis, which can be life- threatening.

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Which of the following are common signs and symptoms that can be present when your patient has Rheumatoid Arthritis? (Select all that apply)

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Explanation

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