A 63-year-old White man presents with bowing deformity of his legs, gait abnormality, and tingling and weakness in his left leg. The nurse practitioner suspects Paget’s disease of bone (PDB). Which of the following most closely describes the pathophysiology of PDB?
PDB is a progressive disease that damages or destroys synovial joint structure and articular cartilage of the joints.
Excess osteoclastic activity is followed by compensatory osteoblastic activity, leading to the formation of bone that is less compact, mechanically weaker, and more susceptible to fracture.
PDB is an autoimmune disorder in which inflammation of the synovium leads to joint destruction and deformity.
PDB is caused by an imbalance of bone resorption and bone remodeling that leads to decreased skeletal mass.
The Correct Answer is B
Choice A reason: This describes osteoarthritis, not Paget’s disease. Osteoarthritis involves degeneration of joint cartilage and synovial structures, whereas Paget’s disease affects bone remodeling.
Choice B reason: Paget’s disease of bone is characterized by excessive osteoclastic bone resorption followed by disorganized osteoblastic bone formation. The newly formed bone is structurally abnormal—larger, less dense, and more vascular—making it prone to deformity and fracture. This explains the patient’s bowing and neurological symptoms due to nerve compression.
Choice C reason: This describes rheumatoid arthritis, an autoimmune condition affecting the synovium. Paget’s disease is not autoimmune and does not primarily involve joint inflammation.
Choice D reason: While PDB does involve abnormal bone remodeling, it does not lead to decreased skeletal mass. Instead, it results in structurally unsound bone that may be enlarged but weakened.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: H2 receptor antagonists such as ranitidine and famotidine are effective for mild GERD symptoms, but they are not considered first-line for moderate to severe GERD. PPIs are preferred due to their superior acid suppression and healing rates for erosive esophagitis.
Choice B reason: The American College of Gastroenterology recommends initiating PPI therapy once daily before the first meal of the day for GERD management. PPIs reduce gastric acid secretion by inhibiting the H+/K+ ATPase pump in parietal cells, providing effective symptom relief and mucosal healing.
Choice C reason: While some PPIs have undergone scrutiny for long-term safety concerns (e.g., risk of kidney disease, osteoporosis, and infections), they have not been widely recalled. Most remain approved and in use under proper clinical guidance.
Choice D reason: H2 receptor agonists do not exist; the correct term is H2 receptor antagonists. Moreover, they are less effective than PPIs for healing erosive GERD and maintaining remission, especially in severe cases.
Correct Answer is C
Explanation
Choice A reason: While a hematology consultation may be appropriate in severe or persistent cases, the immediate action required at an ANC of 1,100/μL is to interrupt clozapine therapy due to the risk of agranulocytosis. This value falls below the threshold for safe continuation.
Choice B reason: Continuing treatment at an ANC of 1,100/μL is contraindicated. Clozapine carries a risk of severe neutropenia, and guidelines recommend interruption of therapy when ANC drops below 1,500/μL, with more urgent action below 1,000/μL.
Choice C reason: Interrupting treatment is the correct action. An ANC of 1,100/μL indicates moderate neutropenia, and clozapine should be paused to prevent progression to agranulocytosis. Monitoring and potential re-initiation may follow depending on recovery.
Choice D reason: Suspending treatment implies a more permanent cessation. While this may be necessary if neutropenia worsens or recurs, the initial step at this ANC level is interruption, not full suspension.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.