A 95-year-old female presents to the emergency department with painful joints. Upon examination, you notice bumps and lumps all over her hands. What are these likely to be?
Gout tophi
Rheumatoid nodules
Osteoarthritis nodes
Carpal tunnel syndrome
The Correct Answer is C
Choice A reason: Gout tophi are urate crystal deposits, typically on joints like the big toe, not widespread on hands. Osteoarthritis nodes (Heberden’s/Bouchard’s) are more common in elderly hands, so this is incorrect.
Choice B reason: Rheumatoid nodules occur in rheumatoid arthritis, usually near elbows, not diffusely on hands. Osteoarthritis nodes are bony growths on finger joints, more likely in this patient, so this is incorrect.
Choice C reason: Osteoarthritis nodes (Heberden’s and Bouchard’s) are bony lumps on finger joints, common in elderly women with joint pain. This matches the hand findings, making it the correct diagnosis.
Choice D reason: Carpal tunnel syndrome causes wrist pain and numbness, not joint lumps. Osteoarthritis nodes explain the hand bumps in this elderly patient, so this is incorrect.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Weight loss occurs in both DKA and HHNS due to prolonged hyperglycemia and fluid loss. Kussmaul respirations are specific to DKA’s acidosis, so this is incorrect for DKA-only.
Choice B reason: Kussmaul respirations, rapid and deep breathing, are unique to DKA, compensating for metabolic acidosis from ketones. HHNS lacks significant acidosis, making this the correct DKA-specific manifestation.
Choice C reason: Increased serum glucose is common to both DKA and HHNS, as both involve severe hyperglycemia. Kussmaul respirations are DKA-specific, so this is incorrect.
Choice D reason: Fluid loss occurs in both DKA and HHNS due to osmotic diuresis. Kussmaul respirations are exclusive to DKA’s acidotic state, so this is incorrect.
Correct Answer is A
Explanation
Choice A reason: T cells, including cytotoxic and helper T cells, drive cell-mediated immunity by directly attacking infected cells and coordinating immune responses. They target intracellular pathogens and tumors, forming the core of cellular immunity, making this the correct choice.
Choice B reason: B cells mediate humoral immunity, producing antibodies against extracellular pathogens. While critical for immune defense, they do not directly drive cell-mediated responses, which rely on T-cell activity, making this incorrect for cell-mediated immunity.
Choice C reason: “None of the above” is incorrect, as T cells play a central role in cell-mediated immunity. Their functions, like cytotoxicity and cytokine production, are essential for this immune response, making this an invalid choice.
Choice D reason: “All of the above” is incorrect, as only T cells, not B cells, are primarily responsible for cell-mediated immunity. B cells support humoral immunity, not the cellular response driven by T cells, making this an incorrect choice.
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