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 A
Explanation
Choice A reason: Atherosclerosis erodes the vessel wall by forming plaques that weaken arterial layers, promoting aneurysm formation. This degenerative process destabilizes the wall, making it the correct effect in aneurysm development.
Choice B reason: Ischemia of the intima is not a primary atherosclerosis effect; plaques cause wall damage, not just intimal ischemia. Vessel wall erosion is more accurate for aneurysm formation, so this is incorrect.
Choice C reason: Atherosclerosis narrows vessels but doesn’t primarily obstruct them in aneurysm formation. Wall erosion and weakening lead to dilation, not blockage, so this is incorrect for aneurysm development.
Choice D reason: Atherosclerosis reduces nitric oxide, impairing vasodilation, but this isn’t directly linked to aneurysms. Vessel wall erosion by plaques is the key mechanism, so this is incorrect for the effect.
Correct Answer is C
Explanation
Choice A reason: Wheezing is associated with lung conditions or left heart failure, not right-sided heart failure. Peripheral edema results from venous congestion in right heart failure, so this is incorrect.
Choice B reason: Vasospasms are linked to vascular conditions, not right-sided heart failure. Peripheral edema is a hallmark due to fluid backup, so this is incorrect for the manifestation.
Choice C reason: Peripheral edema, swelling in legs or ankles, is a primary manifestation of right-sided heart failure, caused by venous congestion from impaired right heart pumping. This is the correct choice.
Choice D reason: Tingling in extremities is neurological or vascular, not typical of right-sided heart failure. Peripheral edema is more characteristic, so this is incorrect for the manifestation.
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