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 D
Explanation
Choice A reason: Retching is the involuntary attempt to vomit, involving abdominal muscle contractions without expelling stomach contents. The patient is actively expelling contents, which defines vomiting, not just the effort of retching, making this an incorrect term for documentation.
Choice B reason: Expectorate refers to coughing up and spitting out mucus or sputum from the respiratory tract. The patient is expelling stomach contents, not respiratory secretions, making expectorate an incorrect term for this gastrointestinal event.
Choice C reason: Regurgitation is the passive return of undigested food or liquid from the stomach or esophagus, often without force. The forceful expulsion of stomach contents described indicates vomiting, not regurgitation, making this an incorrect documentation term.
Choice D reason: Vomiting is the forceful expulsion of stomach contents through the mouth, driven by coordinated abdominal and diaphragmatic contractions. The patient’s active expulsion into a basin matches this definition, making vomiting the correct term for documentation.
Correct Answer is C
Explanation
Choice A reason: Extending red blood cell lifespan is not a goal in polycythemia vera, where excessive red cell production increases blood viscosity. Treatment aims to reduce cell mass, not prolong cell life, as this would worsen hyperviscosity, making this an incorrect goal.
Choice B reason: Reducing the mean size of red blood cells is irrelevant, as polycythemia vera involves increased red cell count, not size. Treatment focuses on lowering hematocrit to decrease viscosity, not altering cell dimensions, making this an incorrect treatment goal.
Choice C reason: Reducing blood viscosity is the primary goal in polycythemia vera, achieved through phlebotomy or myelosuppressive therapy to lower red cell mass. This alleviates symptoms like itching and prevents thrombotic complications, directly addressing the disease’s pathophysiology, making this correct.
Choice D reason: Controlling hypertension is a secondary concern in polycythemia vera, often resulting from increased blood volume. While managed, the primary goal is reducing blood viscosity to prevent complications, as hypertension is a symptom, not the root cause, making this incorrect.
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