Orthopaedic Nurses Certification Board (ONCB) Metabolic/Inflammatory/Tumors Practice Exam

What condition should a nurse suspect in a patient with intermittent vasospasms of fingertips?

1. Reactive arthritis

2. Systemic lupus erythematosus

3. Polymyalgia rheumatica

4. Systemic sclerosis

The correct answer is: Systemic sclerosis

The presence of intermittent vasospasms in the fingertips is most commonly associated with systemic sclerosis, also known as scleroderma. This condition is characterized by the hardening and tightening of the skin and connective tissues, where vascular abnormalities play a significant role. Patients often experience episodes of Raynaud's phenomenon, which is characterized by color changes in the fingers and toes during cold exposure or stress due to vasoconstriction. In systemic sclerosis, the microvascular changes can lead to inadequate blood flow to the extremities, resulting in the vasospasms observed in the fingertips. This response is very specific and is a hallmark symptom of the disease, linking the vascular dysfunction directly to the pathology of systemic sclerosis. This understanding is critical for nurses to recognize the underlying disorder and provide appropriate care and referral for further evaluation and management.