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

Answer and Explanation

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.

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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.

A. Number of mast cells is insufficient B. Circulatory impairment C. Underlying chronic illness(es) D. Complement and chemotaxis are deficient

Correct Answer is C

Explanation

Choice A reason: Insufficient mast cell numbers are not a primary cause of impaired healing in older adults. Mast cells contribute to inflammation, but chronic diseases like diabetes disrupt multiple healing pathways more significantly, making this incorrect.

Choice B reason: Circulatory impairment, such as atherosclerosis, can delay healing by limiting oxygen and nutrient delivery. However, it’s often a consequence of chronic illnesses like diabetes, which broadly affect healing, making this less primary than chronic conditions.

Choice C reason: Underlying chronic illnesses, like diabetes or cardiovascular disease, impair inflammation and wound healing in older adults by disrupting immune function, collagen deposition, and perfusion. These prevalent conditions directly impact healing, making this the correct cause.

Choice D reason: Complement and chemotaxis deficiencies occur in specific immunodeficiencies, not commonly in aging. Chronic illnesses like diabetes more consistently impair healing through systemic effects, making this a less likely primary cause.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient with appendicitis is likely to experience which clinical manifestations?

Correct Answer is C

Explanation

Some older adults have impaired inflammation and wound healing because of which problem?

Correct Answer is C

Explanation

How do we measure inflammation? (Select all that apply)

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