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: Pyuria, urgency, and frequency are typical UTI symptoms, but elderly patients often present with atypical signs like confusion. Confusion is more prominent in this age group, so this is less specific and incorrect.
Choice B reason: Dysuria, frequency, and suprapubic pain are common UTI symptoms, but elderly patients may show confusion instead of classic signs. Confusion and frequency are more likely, so this is incorrect.
Choice C reason: In elderly patients (85 years), UTIs often cause confusion due to altered mental status, alongside frequency. Atypical symptoms like confusion are common, making this the correct manifestation for this age group.
Choice D reason: Hematuria and flank pain suggest complicated UTIs or kidney issues, not typical in elderly UTI presentation. Confusion and frequency are more expected, so this is incorrect.
Correct Answer is B
Explanation
Choice A reason: Latent phase follows seroconversion, not precedes infection. The correct sequence—exposure, infection, seroconversion, AIDS—reflects HIV progression. This option misorders the phases, making it incorrect for AIDS development.
Choice B reason: AIDS progresses through exposure (virus contact), infection (HIV enters body), seroconversion (antibody detection), and AIDS (advanced disease). This sequence accurately describes the disease’s history, making it correct.
Choice C reason: Symptomatic AIDS is not a distinct phase; AIDS itself is symptomatic. The standard progression includes exposure, infection, seroconversion, and AIDS, so “symptomatic AIDS” is incorrect.
Choice D reason: Window phase is part of seroconversion, not separate, and acute phase is early infection. The sequence—exposure, infection, seroconversion, AIDS—is clearer, so this is incorrect.
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