A nurse in a provider’s office is assessing a client who has rheumatoid arthritis (R
Low-grade fever
Weight loss
Anorexia
Knuckle deformity
The Correct Answer is D
Choice A reason: Low-Grade Fever
Low-grade fever is a common early symptom of rheumatoid arthritis (RA). It is often associated with the body’s inflammatory response to the autoimmune activity occurring in the joints. While it can persist throughout the disease, it is not considered a late manifestation.
Choice B reason: Weight Loss
Weight loss can occur in RA due to chronic inflammation and its effects on metabolism and appetite. However, it is more commonly seen in the early to middle stages of the disease rather than as a late manifestation. Persistent inflammation can lead to muscle wasting and weight loss, but these are not specific to the advanced stages of RA.
Choice C reason: Anorexia
Anorexia, or loss of appetite, is another symptom that can be present in RA. It is often related to the chronic inflammation and pain associated with the disease, which can reduce a person’s desire to eat. Like weight loss, anorexia can occur at various stages of RA and is not specifically a late manifestation.
Choice D reason: Knuckle Deformity
Knuckle deformity is a late manifestation of rheumatoid arthritis. As RA progresses, the chronic inflammation can lead to joint damage and deformities, particularly in the hands and fingers. This includes changes such as ulnar deviation, swan neck deformities, and boutonnière deformities. These deformities result from the destruction of joint tissues and the formation of scar tissue, which can significantly impair hand function.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason:
A client who has Guillain-Barré syndrome: Guillain-Barré syndrome (GBS) can cause significant muscle weakness and paralysis, including the muscles involved in swallowing. Clients with GBS are at high risk for aspiration and may require specialized feeding techniques or assistance from a nurse rather than an AP.
Choice B reason:
A client who has systemic sclerosis: Systemic sclerosis, also known as scleroderma, can affect the esophagus and cause difficulty swallowing. These clients may need careful monitoring and assistance with meals to prevent choking and ensure adequate nutrition.
Choice C reason:
A client who has amyotrophic lateral sclerosis (ALS): ALS affects the motor neurons and can lead to progressive muscle weakness, including the muscles involved in swallowing. Clients with ALS often require specialized feeding techniques and close monitoring during meals to prevent aspiration.
Choice D reason:
A client who has a lumbosacral spinal tumor: A lumbosacral spinal tumor primarily affects the lower back and may cause pain or mobility issues, but it does not typically impair swallowing. Therefore, this client is the most appropriate for the AP to assist with meals, as they are less likely to have complications related to eating.
Correct Answer is C
Explanation
Choice A reason:
Bradycardia: Bradycardia, or a slow heart rate, is not typically associated with diabetes insipidus. Diabetes insipidus primarily affects the body’s ability to regulate fluid balance, leading to excessive urination and thirst. Bradycardia is more commonly related to conditions affecting the heart or the autonomic nervous system.
Choice B reason:
Hyperglycemia: Hyperglycemia, or high blood sugar, is a hallmark of diabetes mellitus, not diabetes insipidus. Diabetes insipidus is characterized by the kidneys’ inability to concentrate urine, leading to large volumes of dilute urine and increased thirst3. Hyperglycemia is not a symptom of diabetes insipidus.
Choice C reason:
Dehydration: Dehydration is a common and significant finding in diabetes insipidus. Due to the excessive loss of water through urine, individuals with diabetes insipidus often experience severe thirst and dehydration if they do not consume enough fluids to compensate for the loss. This is a key symptom that helps differentiate diabetes insipidus from other conditions.
Choice D reason:
Polyphagia: Polyphagia, or excessive hunger, is typically associated with diabetes mellitus, particularly when blood sugar levels are high and the body’s cells are not receiving adequate glucose. In diabetes insipidus, the primary symptoms are related to fluid imbalance, such as excessive urination (polyuria) and thirst (polydipsia), rather than hunger.
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