A 57-year-old man presents with a chief complaint of pain in his right hip that worsens with activity and improves with rest. The NP suspects osteoarthritis. Upon assessment, the NP would expect to find all of the following EXCEPT which one?
Stiffness
Limited mobility
Joint swelling
Bruising
The Correct Answer is D
Choice A reason: Stiffness, especially after periods of inactivity or in the morning, is a hallmark symptom of osteoarthritis. It typically improves with gentle movement.
Choice B reason: Limited mobility is common in osteoarthritis due to joint degeneration, pain, and structural changes such as osteophyte formation and cartilage loss.
Choice C reason: Joint swelling may occur due to synovial inflammation or effusion, although it is typically mild compared to inflammatory arthritides like rheumatoid arthritis.
Choice D reason: Bruising is not a feature of osteoarthritis. It suggests trauma or a bleeding disorder and is not associated with the degenerative changes seen in OA.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: This describes the pathophysiology of gastroesophageal reflux disease (GERD), not ulcerative colitis. UC affects the colon, not the esophagus.
Choice B reason: This explanation pertains to peptic ulcer disease, where H. pylori and NSAIDs disrupt gastric mucosal defenses. It does not apply to UC, which is an inflammatory bowel disease.
Choice C reason: These factors may influence general gastrointestinal health or contribute to irritable bowel syndrome (IBS), but they do not explain the autoimmune and inflammatory nature of UC.
Choice D reason: Ulcerative colitis is characterized by chronic inflammation of the colon due to defects in the epithelial barrier, dysregulated immune responses, abnormal leukocyte trafficking, and altered gut microbiota. These mechanisms lead to mucosal ulceration, bleeding, and systemic symptoms.
Correct Answer is D
Explanation
Choice A reason: Dual blockade with ACE inhibitors and ARBs has been studied but is not recommended due to increased risk of adverse effects such as hyperkalemia, hypotension, and acute kidney injury. It does not provide additional renal protection and may worsen outcomes.
Choice B reason: Thiazide diuretics are useful for blood pressure control, especially in volume overload, but they do not specifically address albuminuria. They are not the preferred agents for reducing proteinuria.
Choice C reason: Even though blood pressure is controlled, progressive albuminuria indicates ongoing renal damage. Doing nothing overlooks the need for targeted intervention to reduce proteinuria and preserve kidney function.
Choice D reason: Calcium channel blockers, particularly non-dihydropyridine types like verapamil or diltiazem, have shown benefit in reducing proteinuria. They can be added to ACE inhibitors to enhance renal protection without the risks associated with dual renin-angiotensin system blockade.
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