A nurse is assessing a client who has osteoarthritis of the right hand. Which of the following would be the preferred treatment for this client?

Prednisone

Etanercept

Ibuprofen

Hydroxychloroquine

Answer and Explanation

The Correct Answer is C

A.   Prednisone is a corticosteroid used to reduce inflammation and suppress the immune system. While effective for reducing inflammation and pain, corticosteroids are generally not the first-line treatment for osteoarthritis. They are more commonly used for inflammatory arthritis conditions like rheumatoid arthritis.
B.   Etanercept is a biologic agent used to treat autoimmune conditions like rheumatoid arthritis and psoriatic arthritis by targeting tumor necrosis factor-alpha (TNF-alpha) to reduce inflammation. It is not indicated for osteoarthritis, which is a non-inflammatory degenerative joint disease rather than an autoimmune inflammatory disease.
C.   Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that is commonly used to manage pain and inflammation associated with osteoarthritis. NSAIDs like ibuprofen are often the first-line treatment for osteoarthritis because they help reduce pain and inflammation, improve function, and enhance the quality of life for patients. Ibuprofen is a suitable and preferred option for managing symptoms of osteoarthritis.
D.   Hydroxychloroquine is an antimalarial drug that is also used to treat autoimmune diseases such as rheumatoid arthritis and lupus. It works by modulating the immune system and reducing inflammation. However, it is not typically used for osteoarthritis, which is not an autoimmune condition.

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Correct Answer is C

Explanation

A. Gum bleeding can be a sign of thrombocytopenia (low platelet count) and is concerning because it indicates a potential for bleeding complications. However, while it's significant, it might not be the most urgent symptom in the context of HIT compared to symptoms indicating acute thrombosis.

B. A hemoglobin level of 14 g/dL is generally within the normal range for most adults. In the context of HIT, this level does not indicate any immediate abnormality or severe issue related to anemia or bleeding, making it less concerning compared to other symptoms that might indicate acute complications.
C. Tachycardia (increased heart rate) and shortness of breath are concerning symptoms in the context of HIT. These symptoms can be indicative of a thrombotic event such as a pulmonary embolism (PE) or deep vein thrombosis (DVT), which are serious complications of HIT. The presence of these symptoms requires urgent evaluation as they suggest possible life-threatening complications.
D. Petechiae are small, pinpoint red or purple spots that appear due to bleeding under the skin, often associated with low platelet counts. While petechiae are a concerning sign and indicate bleeding issues, the presence of tachycardia and shortness of breath generally represents a more immediate threat to the patient's life due to potential thromboembolic events.

A. The bleeding occurs from peptic ulcers in the stomach. B. This type of bleeding is treated by giving chewable aspirin. C. The bleeding occurs from tears in the lining of the duodenum. D. The bleeding occurs from a tear in the mucosal lining where the esophagus meets the stomach.

Correct Answer is D

Explanation

A. Peptic ulcers are sores that develop on the lining of the stomach, small intestine, or esophagus due to the erosion caused by stomach acid. A Mallory-Weiss tear is not related to peptic ulcers. Instead, it results from a different type of injury related to forceful vomiting or retching.
B. Chewable aspirin is not a treatment for Mallory-Weiss tears. In fact, aspirin can exacerbate bleeding and is typically avoided in situations where gastrointestinal bleeding is present. Mallory-Weiss tears are generally managed by supportive measures and sometimes endoscopic interventions, not with aspirin.
C. A Mallory-Weiss tear specifically affects the mucosal lining at the junction of the esophagus and the stomach, not the duodenum. The duodenum is part of the small intestine, and tears or bleeding here are not characteristic of Mallory-Weiss syndrome.

D. A Mallory-Weiss tear is a tear or laceration in the mucosal lining at the gastroesophageal junction (where the esophagus meets the stomach). It is typically caused by severe vomiting or retching, which can lead to the tear and subsequent upper gastrointestinal bleeding.

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A nurse is assessing a client who has osteoarthritis of the right hand. Which of the following would be the preferred treatment for this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has been diagnosed with heparin-induced thrombocytopenia (HIT). Which of the following clinical manifestations should the nurse recognize as the most concerning for a client with this condition?

Correct Answer is C

Explanation

The patient is admitted with upper GI bleeding following an episode of forceful vomiting due to excessive alcohol intake. The nurse suspects a Mallory-Weiss tear. Which of the following is true of a Mallory-Weiss tear?

Correct Answer is D

Explanation

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