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 C
Explanation
Choice A reason: Appendicitis typically causes diarrhea or reduced bowel movements, not constipation with gastric distention. Hyperthermia and tachycardia are common due to inflammation, so this is incorrect for appendicitis manifestations.
Choice B reason: Appendicitis is associated with leukocytosis, not leukopenia, reflecting infection. Constipation is less common than diarrhea or pain, so hyperthermia and tachycardia better match, making this incorrect.
Choice C reason: Appendicitis causes hyperthermia (fever) from infection and tachycardia from pain and inflammation. These are classic manifestations, aligning with the body’s response to appendiceal inflammation, making this the correct choice.
Choice D reason: Hypothermia and bradycardia are not typical in appendicitis; fever and increased heart rate occur due to infection. Hyperthermia and tachycardia are expected, so this is incorrect for appendicitis symptoms.
Correct Answer is B
Explanation
Choice A reason: Thrombocytopenia is a low platelet count (<150,000/mm³), not >100,000/mm³, which may still be normal or low-normal. A count <150,000 defines the condition, so this is incorrect.
Choice B reason: Thrombocytopenia is defined as a platelet count less than 150,000/mm³, increasing bleeding risk. This accurately describes the condition, making it the correct choice for the definition.
Choice C reason: Thrombocytopenia causes bleeding, not increased clotting, due to low platelets. Clotting issues arise from high platelets, so this is incorrect for thrombocytopenia’s effects.
Choice D reason: Thrombocytopenia results from decreased platelet production or increased destruction, not increased production. Low platelet count defines it, so this is incorrect for the cause.
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