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: Vasodilation increases blood flow, causing redness and heat, but doesn’t directly cause fluid leakage. Increased capillary permeability allows fluid to escape into tissues, causing edema, so this is incorrect for the primary cause of inflammatory edema.
Choice B reason: Increased capillary permeability, triggered by inflammatory mediators, allows plasma to leak into tissues, causing edema. This is the primary mechanism during inflammation, making it the correct choice for the cause of edema in the process.
Choice C reason: Neutrophil emigration fights infection but doesn’t directly cause fluid accumulation. Capillary permeability changes lead to edema, so this is incorrect for the cause of swelling in inflammation.
Choice D reason: Endothelial cell contraction contributes to permeability but is a secondary mechanism. Increased capillary permeability is the overarching process causing fluid leakage and edema, so this is less precise and incorrect.
Correct Answer is D
Explanation
Choice A reason: GABA is a major inhibitory neurotransmitter, regulating neural activity. Unlike dobutamine, a synthetic drug, GABA naturally transmits signals across synapses, so this is incorrect as the non-neurotransmitter.
Choice B reason: Norepinephrine and epinephrine are catecholamine neurotransmitters, critical for autonomic and central nervous system signaling. Dobutamine is not a neurotransmitter, so this is incorrect.
Choice C reason: Dopamine is a neurotransmitter involved in reward, movement, and mood. Dobutamine, a cardiac medication, does not function as a neurotransmitter, so this is incorrect.
Choice D reason: Dobutamine is a synthetic beta-agonist for heart failure, not a neurotransmitter. GABA, norepinephrine, epinephrine, and dopamine transmit neural signals, making dobutamine the correct exception.
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