A client presents to the health care clinic with a 3-day history of fever, chills, neck pain and stiffness, and headache. The nurse observes an elevated temperature of 102.5°F and pain with rotation of the head side to the side and decreased ability to flex the head forward. The nurse recognizes these findings as most likely the onset of what infectious process?

Bursitis

Meningitis

Spondylitis

Arthritis

Answer and Explanation

The Correct Answer is B

A.   Bursitis is the inflammation of the bursa, a small fluid-filled sac that reduces friction between bones and soft tissues. It typically causes localized pain and tenderness in the area of the bursa, often in the shoulders, elbows, or hips.

B.   Meningitis is an infection or inflammation of the protective membranes covering the brain and spinal cord (the meninges). It often presents with symptoms such as fever, headache, neck stiffness, and photophobia. The neck stiffness, particularly difficulty flexing the head forward (nuchal rigidity), is a classic sign.
C.   Spondylitis refers to inflammation of the spine. It can present with chronic back pain and stiffness but is typically associated with long-term symptoms rather than acute systemic symptoms like fever and chills. Conditions such as ankylosing spondylitis can cause chronic back pain and stiffness but are less likely to present with acute fever and headache.
D.   Arthritis is inflammation of the joints and can cause pain, swelling, and stiffness in the affected joints. While arthritis can affect the neck (cervical spine arthritis), it typically does not present with systemic symptoms such as fever and chills unless there is an associated infection or inflammatory process.

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Correct Answer is B

Explanation

A. Coma is a state of profound unconsciousness where the patient cannot be awakened and does not respond to any stimuli, including verbal commands or physical stimuli.

B. Lethargy is characterized by a state of drowsiness or fatigue where the patient may fall asleep easily but can be roused to respond appropriately when stimulated. The patient shows decreased alertness but is still capable of engaging with stimuli.
C. Obtunded refers to a state where the patient has reduced alertness and responsiveness. They may respond slowly and require increased stimulation to achieve a response. They are less aware of their environment and have dulled senses.
D. Stupor is a state of near-unconsciousness where the patient can only be awakened by vigorous or painful stimuli. They may not respond to verbal commands but may show some response to more intense stimuli.

A. Lateral epicondylitis B. Rheumatoid Arthritis C. Gout D. Medial epicondylitis

Correct Answer is A

Explanation

A. Lateral epicondylitis, commonly known as "tennis elbow," is an overuse injury characterized by pain and tenderness on the outer part of the elbow (lateral epicondyle). It results from repeated stress and

strain on the forearm muscles and tendons, often due to activities involving repetitive arm motions such as tennis. The pain typically worsens with activities involving gripping, extending, or lifting.
B. Rheumatoid arthritis (RA) is a chronic inflammatory disease that typically affects joints symmetrically, causing pain, swelling, and stiffness. It usually involves joints like the hands, wrists, and knees rather than the elbows alone. RA symptoms are generally more diffuse and persistent, rather than specifically linked to recent physical activity and localized pain associated with movement.
C. Gout is a form of arthritis caused by the accumulation of uric acid crystals in the joints. It often presents with sudden, severe pain, redness, and swelling, typically affecting the big toe but can also affect other joints. Gout attacks usually occur at night and are often very acute and localized. It is less likely to be associated with the type of pain described (pain during extension and flexion) and recent physical activity.
D. Medial epicondylitis, also known as "golfer’s elbow," is similar to lateral epicondylitis but affects the inner part of the elbow (medial epicondyle). It is more commonly associated with activities that involve gripping and wrist flexion rather than the generalized extension and flexion pain described.

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Naxlex Comprehensive Predictor Exams

A client opens the eyes and answers questions however falls back asleep within seconds. How should the nurse document this assessment finding?

Correct Answer is B

Explanation

A 75-year-old male patient who recently started playing Tennis at the local adult care center is complaining of elbow pain associated with extension and flexion range of movement. The nurse knows the likely cause of this patient discomfort is due to:

Correct Answer is A

Explanation

In the Neuro ICU, a comatose patient has this posture in bed: Upper arms are flexed tight to the sides with elbows, wrists, and fingers flexed. The legs are extended and internally rotated. The nurse interprets this posture as:

Which are the 3 areas included in the Glasgow Coma Scale to assess levels of consciousness? Select all that Apply.

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