A nurse in a provider's office is assessing a client.
The nurse should identify that which of the following findings are manifestations of pulmonary tuberculosis? (Select all that apply.)
Flushed cheeks.
Night sweats.
Weight gain.
Low-grade fever.
Blood in the sputum.
Correct Answer : B,D,E
Choice A rationale
Flushed cheeks are typically associated with conditions causing vasodilation or fever, such as infections or inflammatory responses. While a fever can occur in tuberculosis, flushed cheeks are not a primary or specific manifestation of pulmonary tuberculosis. The pallor often seen in chronic illnesses like TB is due to anemia.
Choice B rationale
Night sweats in pulmonary tuberculosis result from the body's febrile response to the chronic infection. The hypothalamus attempts to regulate body temperature, leading to peripheral vasodilation and diaphoresis, particularly during the nighttime hours when metabolic rates can shift. This is a common systemic symptom.
Choice C rationale
Weight gain is not a manifestation of pulmonary tuberculosis. Instead, clients with active tuberculosis often experience significant weight loss, known as "consumption," due to the chronic inflammatory state, increased metabolic demands, and anorexia caused by the infection and systemic cytokine release.
Choice D rationale
A low-grade fever is a common systemic manifestation of pulmonary tuberculosis. This persistent elevation in body temperature, often occurring in the afternoon or evening, is a result of the inflammatory response triggered by the Mycobacterium tuberculosis infection and the release of pyrogens.
Choice E rationale
Blood in the sputum, or hemoptysis, is a significant manifestation of pulmonary tuberculosis. It results from the erosion of blood vessels within the lung parenchyma by the granulomatous inflammation and cavitation characteristic of the disease, leading to bleeding into the airways.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Rheumatoid arthritis is a chronic autoimmune inflammatory disease that commonly affects the small joints of the hands and feet bilaterally and symmetrically. Characteristic late-stage findings include ulnar deviation of the fingers, swan-neck deformities (hyperextension of the PIP joint and flexion of the DIP joint), and boutonnière deformities (flexion of the PIP joint and hyperextension of the DIP joint) due to chronic synovial inflammation.
Choice B rationale
Osteoarthritis is a degenerative joint disease characterized by cartilage breakdown, primarily affecting weight-bearing joints but also the hands. Hand findings include Heberden's nodes (DIP joints) and Bouchard's nodes (PIP joints), which are bony enlargements. Unlike rheumatoid arthritis, osteoarthritis is typically asymmetrical and lacks significant inflammation.
Choice C rationale
Gout is a form of inflammatory arthritis caused by uric acid crystal deposition in joints. While it can affect the hands, it most commonly presents as acute, severe pain, swelling, and redness in a single joint, often the great toe. Chronic gout can lead to tophi, which are visible urate deposits, but not the specific deformities seen in rheumatoid arthritis.
Choice D rationale
Paget's disease of bone is a chronic disorder characterized by abnormal bone remodeling, leading to enlarged and misshapen bones. It primarily affects the skull, spine, pelvis, and long bones of the extremities. Hand involvement is uncommon and does not typically result in the characteristic joint deformities seen in the scenario.
Correct Answer is ["A","C","D"]
Explanation
Choice A rationale
A seizure lasting greater than 5 minutes is a critical diagnostic criterion for status epilepticus. This prolonged duration signifies a failure of the normal inhibitory mechanisms that typically terminate seizure activity, necessitating urgent medical intervention to prevent potential neurological damage from sustained neuronal hyperexcitation.
Choice B rationale
Status epilepticus is not limited to only clonic type seizures. It can manifest as any type of seizure, including tonic, myoclonic, or absence seizures, occurring continuously or in rapid succession without full recovery of consciousness between episodes. This broad presentation highlights the diverse pathophysiology of uncontrolled neural discharge.
Choice C rationale
Sustained seizure activity in status epilepticus significantly increases metabolic demand and can lead to neuronal excitotoxicity and hypoxia. Prolonged oxygen deprivation and glucose depletion in brain tissue can result in irreversible neuronal injury and permanent structural brain damage, emphasizing the need for rapid intervention.
Choice D rationale
Status epilepticus is defined as a state of continuous seizure activity, or recurrent seizures without full recovery of consciousness between episodes. This persistent abnormal neuronal discharge in the brain signifies a medical emergency due to the high risk of neurological damage, systemic complications, and even mortality if untreated.
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