A 65-year-old patient presents to the clinic with complaints of joint pain in the knees and hands. The patient states, "The pain gets worse when I walk or use my hands for too long, but it feels better when I rest." The nurse recognizes that the patient's symptoms are most consistent with which condition?

Systemic lupus erythematosus (SLE)

Osteoarthritis (OA)

Rheumatoid arthritis (RA)

Gouty arthritis

Answer and Explanation

The Correct Answer is B

A. Systemic lupus erythematosus (SLE): SLE can cause joint pain, but it is usually accompanied by systemic symptoms such as a butterfly rash, fatigue, and organ involvement.

B. Osteoarthritis (OA): Osteoarthritis pain typically worsens with activity and improves with rest. It commonly affects weight-bearing joints like the knees and hands.

C. Rheumatoid arthritis (RA): RA pain is usually worse in the morning and improves with movement. It also presents with joint swelling and systemic inflammation.

D. Gouty arthritis: Gout typically presents with acute, severe pain and redness, commonly affecting the big toe, rather than chronic worsening pain with activity.

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Naxlex Comprehensive Predictor Exams

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Free Nursing Study Resources

Correct Answer is B

Explanation

A. Apply an antibiotic ointment and reassess in two weeks. SCC is a form of skin cancer and requires biopsy for diagnosis. Simply applying an antibiotic and waiting could delay necessary treatment.

B. Refer the patient to a dermatologist for a biopsy. The priority action for a suspicious lesion that does not heal is to refer the patient for biopsy and further evaluation, as early detection and treatment of SCC are crucial.

C. Reassure the patient that the lesion is benign and monitor for changes. SCC can be aggressive if untreated, and assuming benignity without biopsy could result in delayed diagnosis and worsening prognosis.

D. Educate the patient on proper wound care and sun protection. While wound care and sun protection are important, the priority is obtaining a definitive diagnosis through biopsy.

A. Increased oral temperature from 36.6° C (97.8° F) to 37° C (98.6° F). B. Increased heart rate from 68 to 72/min. C. Increased respiratory rate from 18 to 44/min. D. Increased blood pressure from 112/68 to 120/72 mm Hg

Correct Answer is C

Explanation

A. Increased oral temperature from 36.6° C (97.8° F) to 37° C (98.6° F). A slight temperature increase is expected post-injury due to normal inflammatory response and does not indicate a serious complication.

B. Increased heart rate from 68 to 72/min. This small increase in heart rate is not clinically significant and does not indicate a serious complication.

C. Increased respiratory rate from 18 to 44/min. A sudden increase in respiratory rate could indicate a fat embolism, a life-threatening complication associated with long bone fractures. Fat emboli can travel to the lungs, causing respiratory distress. Immediate intervention is required.

D. Increased blood pressure from 112/68 to 120/72 mm Hg. This small increase in blood pressure is not alarming and does not indicate a serious complication.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

A nurse is assessing a client who has a fracture of the femur. The nurse obtains vital signs on admission and again in 2 hours. Which of the following changes in assessment should indicate to the nurse that the client could be developing a serious complication?

Correct Answer is C

Explanation

A nurse is providing discharge instructions to the parent of a child diagnosed with impetigo. Which of the following statements by the parent indicates a correct understanding of the treatment plan?

A patient is diagnosed with gout and asks the nurse how to prevent future flare-ups. Which statement by the patient indicates a correct understanding of dietary modifications for gout management?

The nurse is educating a patient with osteoporosis about fall prevention strategies at home and in the hospital. Which statement by the patient indicates a correct understanding of the teaching?

A nurse is preparing to transport a patient with active tuberculosis (TB) to another department for a diagnostic procedure. Which of the following infection control precautions should the nurse implement?

A nurse is assessing a patient who has sustained a burn injury. The affected area is dry, white, and charred, with no pain present. Based on the classification of burns, the nurse understands this burn is:

A nurse is providing medication education to a patient newly prescribed ethambutol for tuberculosis (TB) treatment. The nurse should instruct the patient to report which of the following side effects immediately?

A nurse is caring for a client who is scheduled for an arthroplasty. The nurse asks client to state if he understands the procedure that is being performed. Which of the following statements by the client indicates an understanding of the procedure?