A client presents in the emergency department with joint pain. Which condition would be least likely to cause this symptom?

Osteoporosis

Systemic lupus erythematosus

Osteoarthritis

Rheumatoid arthritis

Answer and Explanation

The Correct Answer is A

Choice A reason: Osteoporosis causes bone density loss, leading to fractures, not primary joint pain. Pain occurs secondary to fractures, not joint inflammation or degeneration. This condition is the least likely to cause joint pain directly, as its pathology focuses on bone fragility rather than synovial or cartilage issues.

Choice B reason: Systemic lupus erythematosus (SLE) causes joint pain due to autoimmune-mediated synovitis, affecting multiple joints symmetrically. Inflammatory cytokines drive pain and swelling, making SLE a common cause of joint pain, unlike osteoporosis, which primarily affects bone structure without direct joint involvement.

Choice C reason: Osteoarthritis causes joint pain due to cartilage degeneration and bone-on-bone friction, particularly in weight-bearing joints like knees. Mechanical stress and inflammation contribute to chronic pain, making osteoarthritis a frequent cause of joint pain, unlike osteoporosis, which lacks primary joint pathology.

Choice D reason: Rheumatoid arthritis causes significant joint pain through autoimmune synovial inflammation, leading to swelling, stiffness, and cartilage damage. This systemic condition affects multiple joints, making it a primary cause of joint pain, unlike osteoporosis, which is associated with bone loss, not joint inflammation.

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Correct Answer is D

Explanation

Choice A reason: PPIs are used for short-term treatment of ulcers and gastroesophageal reflux disease (GERD), typically 4-8 weeks, not long-term, due to risks like nutrient deficiencies or infections. Long-term use is reserved for specific conditions like Barrett’s esophagus, making this statement inaccurate for general use.

Choice B reason: While PPIs are available orally and intravenously, this is not the primary focus of patient education. Their efficacy in suppressing acid production is more critical than administration routes. This statement is less relevant, as it does not address therapeutic use or safety considerations.

Choice C reason: PPIs cause adverse effects in older adults, including increased risks of fractures, Clostridium difficile infection, and vitamin B12 deficiency due to prolonged acid suppression. This statement is inaccurate, as older clients are particularly susceptible to these risks, requiring careful monitoring during PPI therapy.

Choice D reason: PPI treatment emphasizes the lowest effective dose for the shortest duration to minimize risks like infections, fractures, or nutrient malabsorption. This approach balances acid suppression with safety, especially for ulcers or GERD, making this statement accurate and critical for patient education on safe use.

A. Nausea B. Joint swelling C. Generalized aching and stiffness D. Presence of rheumatoid nodules

Correct Answer is A

Explanation

Choice A reason: Methotrexate, a DMARD, inhibits folate metabolism, suppressing immune activity in rheumatoid arthritis. A common side effect is nausea, resulting from gastrointestinal mucosal irritation due to folate antagonism. This affects rapidly dividing cells in the gut, making nausea a recognized complication requiring monitoring or antiemetic support.

Choice B reason: Joint swelling is a symptom of active rheumatoid arthritis, not a complication of methotrexate. Methotrexate reduces joint inflammation by inhibiting immune responses. Persistent swelling suggests inadequate disease control, not a drug side effect, making this finding unrelated to methotrexate complications.

Choice C reason: Generalized aching and stiffness are symptoms of rheumatoid arthritis itself, not methotrexate complications. Methotrexate aims to alleviate these by reducing synovial inflammation. If these persist, it indicates disease activity, not a drug side effect, making this finding incorrect for a methotrexate complication.

Choice D reason: Rheumatoid nodules are a feature of rheumatoid arthritis, not a side effect of methotrexate. These subcutaneous nodules result from chronic inflammation, not drug toxicity. Methotrexate may reduce nodule formation by controlling disease activity, making this finding unrelated to medication complications.

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A client presents in the emergency department with joint pain. Which condition would be least likely to cause this symptom?

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Naxlex Comprehensive Predictor Exams

Which statement about proton pump inhibitors (PPIs) should be included in a client education workshop?

Correct Answer is D

Explanation

The nurse is caring for a client who reports taking methotrexate, a disease-modifying anti-rheumatic drug (DMARD) for rheumatoid arthritis. What finding, if experienced by the client, would the nurse suspect is a complication of the medication?

Correct Answer is A

Explanation

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